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GMC makes it harder for international recruits to enter general practice

The GMC has been warned about putting up ‘barriers’ to international GP recruits as it appeared to be making it more difficult to enter UK general practice.

The GMC has announced that international medical graduates wanting to work in the UK will face a ‘strengthened’ test from September, which will include ethics as well as clinical skills, new limits on number of times an applicant can sit the test and a new time limit to apply to practice after passing.

Although the GMC said the strengthened test would make sure recruits from overseas ‘are of the highest standard’, the chair of the Family Doctor Association (FDA) warned they may be placing barriers to recruitment at a time when the GP workforce is already ‘reduced’.

The GMC approved plans to develop a single, unified exam to replace the the Professional and Linguistic Assessments Board (PLAB) exam last year. The new exam – which has a ‘working title’ of the UK Medical Licensing Assessment (UKMLA) – has to be taken by all doctors wishing to practice in the UK.

The GMC said the changes to the test will include:

  • The PLAB practical assessment will include an increased number of longer scenarios that more accurately reflect real life consultations. Candidates must reach a level expected of doctors entering the second year of their foundation training. The scenarios will assess candidates’ professionalism and understanding of ethics, as well as their clinical skills.
  • Applicants will also undergo a broader general knowledge test and will face a limit on the number of times they can sit the test.
  • Meanwhile, a two-year limit to apply for a license to practice in the UK after passing will be imposed.

GMC chief executive Niall Dickson said: ‘Doctors working in the UK must have the knowledge and practical skills to practice safely and effectively. To make sure they are of the highest standard we are introducing changes to modernize the entry test for overseas doctors, making it even more robust.’

Dickson added that employers remained responsible for making sure all doctors, including those from within Europe, have the relevant qualifications, skills and experience required for the role.

An independent review of the assessment commissioned by the GMC and published in 2014 found that PLAB graduates had poorer clinical knowledge and skills than UK graduates on average, according to their performance in the MRCGP exam.

Following the publication of the research, the GMC announced plans to tighten up entry examinations for international doctors wishing to work in the UK.

But Family Doctor Association chair Dr Peter Swinyard, a GP in Swindon, said: ‘If this means that barriers are being put up then we have a problem, specifically for an already reduced population of doctors.

’On the surface it looks acceptable - high standards are good as long as they are realistic - but if we are putting up barriers to people who have already worked in [a] health service then that would be counterproductive.’

It comes as the GMC had already raised the barrier for passing the PLAB in 2014, by reducing the number of times a non-EU doctor could take the test.

What is being done to boost recruitment from overseas?

The news comes as there are calls from the profession for the Migration Advisory Committee (MAC) to add general practice as a shortage profession to aid international recruitment by removing stringent Home Office visa requirements. So far, these calls have been rejected.

The Government is also trying to boost numbers of GPs trained in the UK who want to return to the NHS. But although the new scheme to tempt GPs back to practice attracted 60 new GPs in its first few months, it only attracted a single GP to each of the two areas in England with the highest vacancy rates for GP trainees.

Pulse also revealed that only one in 100 returners was able to immediately begin practising upon returning via the ‘simplified’ scheme.

Readers' comments (17)

  • No suprise here. the GMC makes it hard enough to work as a doctor in the UK even if you're born , raised and trained here.

    For IMGs.....dont bother coming to the UK, look to working in other jurisdictions where your skills and talent will be valued!!

    In the UK many of its own homegrown talent are looking at careers outside anyway, i suggest you all follow their example.

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  • the public demands quality overseas doctors.

    the UK has a lot to offer - free University Education, world class state managed schools, cheap cost of living, cheap housing, free health service, progressive government, booming economy, and generous pension plans.

    once oversea doctors compare the UK with elsewhere they will start queuing up.

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  • I wonder if anyone can answer this question...

    what happens to UK doctors (trained and educated) who have worked abroad (lets say oz. new zealand , usa , canada etc) for some years and wish to return?

    whats the process regarding this currently??

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  • @6:40 absolutely spot on.

    In fact since I left the UK i've noticed that my pay has plummeted, morale has sunk to rock bottom, the schooling for my children is absymal and i cant afford to educate them privately. I absolutely hate my skiing and beach holidays and i cannot stand any longer the lack of bureaucracy and freedom to practice without interference.

    Im a millenial living a bloody nightmare of home ownership, financial independence.


    I want to come home, i miss my hoo

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  • GMC hate doctors. I think they have a massive chip on their collective shoulders and are doing all they can to torture and control them.
    I wish we could go back to the days when the GMC were actual doctors, not ex-parking ticket inspectors.
    I think international doctors are being done a favour by being deterred by the GMC toxic effluent.

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  • IMGs taking the PLAB exam are at a huge disadvantage. Huge cultural and system differences are to blame. For example, some cultures encourage shyness and modesty while brits are taught how to be confident and extraverted. Translate that into being watched in an artificial exam/consultation setting. Not to mention the subconcious bias this provokes. The GMC does not get it at all.

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  • Best news heard for a while, hard working IMG;s can go to countries where they will be respected and have a fair chance of making a good life for themselves. Rather than being staff grades or career SHO in a broken system that does not respect their skills or hard work, where they are broken by acting exams or referred to any number of institutions that makes thier life a living hell. Best and most fair thing GMC have ever done for any doctor.

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  • Anyone not connected to a responsible body no matter what there level will have to pay for and pass this exam to get a license to practice. A complete nightmare.

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  • I qualified in the UK but am well aware that the GMC is a haven for poorly qualified work shy failures who have no ability to do any positive work themselves.They are merely viewing the medical profession as a easy political target whether from overseas or the UK. They are a uniquely idiotic group of individuals with a lack of common sense which should actually encourage some research into why the GMC appears to attract such clowns to oversee professionals whom they do not have the ability or intelligence to judge!

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  • IMGs are much better in their clinical and communication skills than their EU counter parts. It's loss of GMC rather than IMGs. My suggestion to IMGs is to work in country where they are appreciated and respected.

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