Should Training Posts In The NHS Be Just For UK Graduates?

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Main Category: Medical Students / Training
Article Date: 21 Sep 2007 - 0:00 PDT

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Several young doctors did not manage to get NHS jobs this summer. In the British Medical Journal (BMJ) two experts give opposing views (Head to Head) on whether training posts should be set aside for UK graduates.

Edward Byrne, Dean at the Faculty of Biomedical Sciences, University College London, believes that society has a moral duty to make sure that young individuals who successfully complete a rigorous primary medical course have the chance to finish their training and enter medical practice.

While acknowledging that in a global world the free exchange of know-how is desirable, one cannot disregard the training needs of UK graduates. One solution might be to encourage graduates to do some work abroad towards the end of their specialty or family medicine training, he adds.

UK is among the best in the world as far as medical training is concerned. A country of the UK's wealth and stature should cover its own medical workforce needs without having to bring in doctors from less well advantaged countries in Europe and other parts of the world.

If the UK can send a number of trained doctors to work overseas, this would be a useful contribution to international health. However, not being able to provide training opportunities for most UK graduates and enable them to enter practice is a waste of human potential and a failure to care for young doctors.

Edwin Borman, Consultant Anesthetist at Coventry and Warwickshire NHS Trust and Chairman of the BMA's International Committee, on the other hand, says that it is detrimental for the profession to limit access. Throughout its existence, the NHS has had to rely on medical graduates from abroad to top up the number of UK graduates. Today, over one third of doctors registered to practice in the NHS qualified outside the UK.

It is thanks to the medical profession that during the crisis of MTAS (medical training application service) all eligible applicants have received equal treatments and that posts have been apportioned according to merit.

The Home Office, which introduced changes to immigration rules without notice, has already damaged the good name of the medical profession in the UK. Why should the profession tarnish its reputation by abandoning its principle of solidarity that dates back to the Hippocratic Oath?

Borman suggests that the current MTAS mess is the Department of Health's fault for deciding that medical staff did not need to be planned centrally anymore. He stresses that the number of training places should reflect future requirements for consultants and general practice principals.

In a Personal View, Parashkev Nachev, clinical research fellow at Imperial College London, believes the system has undermined professional standards. Nachev points the finger at the royal colleges for not acting when there was still time to do so.

"Head to Head: Should postgraduate training places be reserved for UK graduates?"
BMJ Volume 335, pp 590-1

"Personal View: MTAS or a tale of evidence heedless medicine"
BMJ Volume 335, p 615

http://www.bmj.com

Written by: Christian Nordqvist
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