Rather than blaming unemployment among UK medical graduates on MTAS, a failed computerized recruitment system, an article in the British Medical Journal (BMJ) explains that the problem has been caused by the government’s policy on medical immigration.

Graham Winyard, a retired Postgraduate Dean, writes that towards the latter half of the 1990s UK medical schools did not turn out enough graduates each year to match the needs of the NHS (National Health Service) – almost 5,000 people graduated from UK medical schools each year during that period. However, as more medical school places began in 1997, the annual production of UK trained graduates was geared up to reach 7,000 by the year 2010 – a rise of 40%.

The idea was that the increase would ultimately satisfy domestic demand – the annual increase would gradually replace those coming in from abroad. However, Government immigration policies made it such that thousands of foreign doctors vied for postgraduate training posts. It is illegal for trusts and deaneries to discriminate according to country of qualification when taking people on.

Winyard writes that enlarging medical schools makes no sense if the additional graduates cannot pursue a career in medicine. Doctors trained in the UK started to express their unease about likely unemployment a couple of years ago. These concerns have become a reality this summer, when MITAS was introduced to select doctors for training posts.

There were just about enough vacancies to take on the UK applicants, together with those from the European Union. However, including thousands of overseas doctors has altered the prospects for all candidates and has made it inevitable that huge numbers fail to secure a proper training post, argues Winyard.

Winyard writes that the United Kingdom needs, as a matter of urgency, policy coherence on immigration and medical training. It is not possible to separate policy on medical immigration from the chances of unemployment for UK medical graduates.

The Highly Skilled Migrant Programme should be suspended, he writes. The Programme allows highly skilled people to migrate to the UK and seek employment without having had a specific offer of a job. As doctors are highly skilled the Programme applies to them. There should be a two-stage recruitment process, as is found in other countries – a process which gives domestic graduates priority.

While Winyard believes the rights of overseas doctors already in the system should be protected, he warns that the situation will worsen next year if decisive action is not taken.

He concludes that honest discussion and clear leadership is needed, as this mess is in nobody’s best interest.

“Medical immigration: the elephant in the room”
BMJ Volume 335, pp 593-5

Written by: Christian Nordqvist