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BMJ. 2007 October 27; 335(7625): 849.
PMCID: PMC2043465

Doctors criticise proposals to cut specialist training for non-EU graduates

Medical and educational bodies have attacked proposals by the government to cut access of trainee doctors from outside the European Union to specialty training posts in the United Kingdom.

The BMA has refused to answer the public consultation in the Department of Health's chosen format, arguing that it forced respondents “to agree or disagree with questions relating to a narrow Department of Health agenda.” And it has criticised the short duration of the consultation period of only a fortnight, saying this was “insufficient” and “extremely restrictive.”

In its response to the consultation the BMA acknowledges that poor workforce planning, funding restrictions, and a failure to expand, as promised, the consultant grade have forced the health department to reduce competition for specialty training posts. But it rejects the department's proposal that doctors from outside the EU and already in the UK be allowed to apply for specialty training posts only under work permit rules.

The BMA's response includes the views of its international doctors' action group, which represents 18 foreign national doctors' organisations.

The BMA's medical students committee has also objected to plans to reduce access to specialty training for non-EU graduates of UK medical schools. Its chairman, Ian Noble, said: “These people came here in good faith, expecting that they would be allowed to compete for jobs here on a level playing field.”

He added: “They also pay considerably higher fees than British students, averaging £13 000 [€19 000; $27 000] a year in the pre-clinical phase and £23 000 in the clinical phase. That's vital revenue for the medical schools, which could dry up if foreign applicants are driven away.”

Katie Petty-Saphon, executive director of the Medical Schools Council, said her organisations' members “believe very strongly that all their graduates, no matter what their domicile, should have the opportunity to apply for all stages of postgraduate training and have made this point very strongly in their response to the [health department's] consultation.”

Remedy UK, the junior doctors' campaign group, has also rejected the proposals after an internal poll of members and supporters showed that 73% opposed the restrictions.

Matt Jameson-Evans, one of Remedy UK's co-founders, said, “I think everyone agrees it's a terrible idea to recruit more doctors abroad right now.” But those who were already here had “uprooted their whole lives and their families to come here,” he added. “It's incredibly cynical to think we can just turn off the tap like that.”

The health department, which will conduct an equalities impact assessment to determine whether its proposals breach its legal duties not to discriminate, acknowledged in its consultation document that the planned restrictions could cause “potential differential effects on equality.” But options were limited by the glut of applications for training places, the department argues. Nearly two applicants applied for every post in 2007, and the ratio will be closer to three per post in 2008.

The BMA has also voiced concerns about the department's recent compressed consultation periods in evidence submitted to the parliamentary select committee looking into the reforms of Modernising Medical Careers.

These “suggest that [it] has not learnt from the experiences of the past two years,” the BMA told the Commons Health Committee.

The BMA has reiterated its support for the goals of Modernising Medical Careers but said that its rushed implementation had “severely hampered any opportunity to introduce any of the principles behind the reform.”


Articles from The BMJ are provided here courtesy of BMJ Publishing Group