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Indian Journal of Surgery, Vol. 68, No. 6, November-December, 2006, pp. 336-337 Letter To Editor Training for overseas doctors in the UK Srinivasaiah N, Yalamuri RR Academic Surgical Unit, University of Hull, Castle Hill Hospital, Cottingham, East Yorkshire, HU16 5JQ Code Number: is06100 Related Article: is04069 Sir, We read with interest the article by Raghu et al[1] and have been following the correspondence till date. The system of education and training in the UK is going through a metamorphosis, though not much of an emphasis is being given to the overseas doctors to be a part of it. In the midst of this, the sudden change in the immigration policies for the overseas doctors is a shock. The articles in Minerva section of the British Medical Journal (2006)[2] and Press Release from the Department of Health UK[3] are sensational shocking news for the thousands of overseas doctors among whom Indians form a major chunk. Currently, there are well over 115,000[3] doctors practicing in the NHS. Of these, 45% are overseas-qualified doctors. This compares with 40% who have qualified in the UK and 15% within the European economic area.[4],[5] There are pros and cons associated with the sudden, unexpected, uncautioned change in the immigration policies. Loss of health professionals from underdeveloped and the developing countries would decrease,[6] which would benefit their healthcare system. The unemployment rate of the homegrown graduates in the UK would decrease.[7] On par the extent of impact, it would have on the finance, education/training, and psychology on a section of the doctors who are already in the UK is well beyond one's imagination. Training in the UK is popular amongst overseas trainees, because it is perceived to be good and well-thought of abroad.[8] The financial stability it brings makes overseas doctors to dream about UK. Many doctors who have passed PLAB test wait for several months and in some instances ranging from six months to a year before they can find a job.[9],[10],[11],[12],[13] There are doctors at various stages of their career; beginning from somebody who is looking for an observer post to gain some local experience to the ones who are on honorary contract. Some are on locum appointment, hunting for a substantiate post and some, half way through their training awaiting eligibility for their exams. There are good few who have passed their exams and are applying for research posts and higher specialist training. The competition to get onto a structured higher specialist training programme is fierce. In the surgical specialty alone on an average, there are about 200-250 basic surgical trainees competing for 1-2 slots on a higher surgical training programme.[14],[15],[16] There are a couple of bottlenecks in the career pathway where the trainees do struggle and the new immigration policy is an add-on. The British Medical Association (BMA) in its response to immigration proposals, UK said - Treat Unemployed Overseas Doctors Fairly.[17] They acknowledge the fact that the sudden change in the immigration policy has hit overseas doctors the hardest. The BMA has expressed its concern for the thousands of overseas-unemployed doctors who are already in the UK, having made enormous personal and financial sacrifices to work in the NHS. The new system came into force from July 2006.[3] The logistics of the transitional process will be a hardship given the significant number of doctors waiting to get a job after their PLAB exam.[17] These changes should not be implemented in such a way that their welfare is harmed. They are now faced with a hurdle of suddenly having to get a work permit. The highly skilled migrant programme[18] services can be of help in this situation at least for those who are already working in the NHS. Considering the changes in training and immigration rules, the impact on overseas doctors is significant. If we could hope for an extended time period for a gradual transition, it would be a breather for thousands of overseas doctors. It will be very difficult for the fresh overseas graduates to train in the UK. The abolition of permit free training, the need for a work permit, the fact that government policies prefer UK and European graduates - all these would not make the career pathway rosy for the overseas graduates. References
Copyright 2006 - Indian Journal of Surgery |
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