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The General Medical Council has commissioned new research to establish why UK doctors who trained overseas seem to be disproportionately represented at its fitness to practise hearings.
Figures released by the GMC last month show that of the 3086 complaints lodged against doctors in 2006 where the doctor's country of training was known, nearly 40% referred to overseas trained doctors—roughly in proportion to their numbers in the NHS workforce—but the percentage of overseas trained doctors who were then referred to hearings was twice that among UK graduates (34% versus 16%). However, in a further 1279 complaints made about doctors the doctor's place of training was not given.
Of those 3806 inquiries, 2334 related to UK trained doctors, 1143 were “international,” 309 from the European Union, and 20 were “other European.” Overseas trained doctors also appeared more likely to be struck off: of the 54 doctors removed from the medical register last year, 35 of them had trained abroad.
The figures only refer to whether a doctor graduated abroad (either within the European Union or in other countries) or in the UK so do not give details of nationality, language, or ethnicity. A British doctor who trained in Australia would appear as an overseas graduate, while an Iraqi who trained in the UK would appear in the British statistics.
Paul Philips, the GMC's director of standards and fitness to practise, said, “The number of fitness to practise cases we deal with is going up year on year. Doctors with a primary medical qualification from overseas or within the EU are disproportionately represented, and more are being referred to us than we should be seeing, without a good explanation.”
The GMC began to investigate the issue last November after similar findings from the 2005 statistics, and the Economic and Science Research Council, the UK's leading research funding and training agency, has initiated a number of research projects into the implications of these findings as part of a larger programme examining the links between career transitions and medical performance.
The GMC says that the studies are “designed to help understand the experiences of doctors from different backgrounds and the contexts within which concerns about doctors are referred to us.”
One area of investigation is “the experiences of UK, EU, and non-EU medical graduates making transition to the UK workplace.” This is being undertaken, says the GMC, because “recent international research points to performance problems occurring as a result of the transition process, from . . . one country to another, from one stage of training to another, and so on.”
The study will specifically include groups of international medical graduates and will seek to recruit doctors from ethnic minorities. The results, says the GMC, “will help to explore and explain the issues faced by doctors entering the workplace and identify if there are any issues, specific to particular groups, which might lead to performance problems later in their careers.”
The GMC says that in addition to the ongoing research it is seeking to commission a fellowship “to explore equality and diversity issues relating to our fitness to practise procedures.”