April 20, 2014
Half of all foreign doctors in Britain do not have the necessary skills to work here but can practise because the competency exam is too easy, a major study finds.
The majority of the 88,000 foreign doctors in the health service would fail exams if they were held to the same standard as their British colleagues, according to the research.
The disclosure will add to concerns over the reliance of the NHS on foreign doctors. The language ability of some has been questioned in recent years. The research potentially shows more wide-ranging inadequacies. Around 1,300 foreign physicians are licensed each year by the General Medical Council after passing an exam which assesses clinical and language skills.
But the study, commissioned by the GMC and carried out by University College London, found that around half would fail to reach the standards expected of British doctors. Its authors have called for the pass rate of the competency exam to be raised from 63 to 76 per cent to “ensure patient safety”.
Chris McManus, professor of psychology and medical education at UCL, said: “There is no real mechanism for checking that doctors coming from outside Britain have been trained to the same level as British doctors. We wanted to find out what level overseas doctors would have to reach if they were to be as competent as British graduates. I think it’s inevitable that the bar will need to be set higher.
“The fact that you already have overseas doctors being over-represented at GMC hearings is indicative of the problem. Many are simply not trained to the same standards.”
More than 88,000 foreign-trained doctors are registered to work in Britain, including 22,758 from Europe. They make up almost a third of all NHS doctors but account for approximately two thirds of those struck off each year. The Professional and Linguistics Assessments Board, the exam they must pass to practise in Britain, is designed to ensure the same skill level as a British graduate a year after completing medical school.
But UCL discovered there was “no formal mechanism” to ensure the exam was as tough as assessments taken by British doctors. When researchers compared results they found that foreign doctors were consistently performing less well.
Around half of doctors trained abroad would not pass the most comparable British test, the report authors said.
“It may be that some overseas doctors have had poor training and when they come to Britain they will catch up quickly and thrive in a better environment,” said Prof McManus.
“But alternatively some may feel completely overwhelmed, particularly with new technology that they have not yet come across. And that is of concern.”
Figures from 2012 showed that of 669 doctors who were struck off or suspended in the previous five years, 420 had trained abroad.