63% of doctors who are either struck off or suspended in the United Kingdom were trained abroad, yet only 36% of all the doctors in the UK medical register are from overseas.

A total of 669 doctors have been either suspended or struck off by the GMC over the last five years. Only 249 (37%) of them were British while 420 (63%) were trained overseas.

The General Medical Council (GMC) has decided to do something about this disproportionate number of foreign-trained doctors being struck of the medical register or suspended. New reforms include better checks, an overhaul of the current testing system for foreign doctors who wish to work in the UK, and an induction program.

Chief Executive of the GMC, Niall Dickson, admitted that they absolutely acknowledge that “when it comes to the serious end of the scale, those from overseas are more likely to appear, and we have set about a series of reforms to address this.”

The GMC has announced that a New Induction Program for all doctors coming in from overseas will be launched as a pilot scheme, during the first quarter of 2013.

The GMC says that doctors who are new to UK practice need to understand the ethical and professional standards they are required to meet when practicing in the United Kingdom.

The GMC’s aim is to address the wide variations in medical practice standards listed in its report “The State of Medical Education and Practice in the UK 2011” (pdf).

The GMC believes that an induction program for all physicians new to its register will help improve medical practice in Great Britain, which in turn will benefit patients.

Doctor shortage – the GMC says that there is a shortage of doctors in the UK. Therefore health authorities in the country have to make sure that:

  • There are enough doctors to treat the country’s population
  • In order to do this, many have to come in from overseas
  • The ones who come in from abroad must be given adequate support

The PLAB (Performance and Linguistic Assessment Board) test for foreign doctors will also be reviewed. PLAB tests doctors’ clinical skills and competence for practicing in the UK.

Revalidation – this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.

The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.

Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.

Chief Medical Officer Dame Sally Davies said “I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors – and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public.”

According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation’s healthcare system.

Language competence – UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union’s 27 nations “must” be free to work elsewhere, with no restriction whatsoever.

According to the British Medical Association’s director of professional activities, Dr Vivienne Nathanson:

“It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.

It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works.”

Written by Christian Nordqvist