GP leaders have criticised BMA resident doctors for supporting a ‘protectionist policy’ around speciality places, which they argued disadvantages international medical graduates (IMGs).
At their national conference in Glasgow last week, LMC representatives from around the UK voted in favour of a motion asking GP committees to ‘distance themselves from the protectionist policy passed by the BMA resident doctors committee’.
The policy, passed in March by the BMA Resident Doctors Committee (formerly the Junior Doctors Committee) during a meeting, demanded that the UK governments ‘implement a specialty training recruitment process that lawfully prioritises medical graduates from UK medical schools’, to tackle high competition ratios.
Since the policy passed, the BMA said it is now set to lobby the UK governments to adopt ‘a plan of action’ to address the ratios.
At the LMC conference, many GPs spoke in favour of distancing themselves from the policy, recognising ‘the enormous contribution’ of IMGs to general practice.
Chair of North Staffordshire LMC Dr Chandra Kanneganti, who is also president of the British International Doctors Association (BIDA), said he was ‘deeply concerned’ about the resident doctors policy.
‘This is not just a policy misstep, it’s a betrayal, it’s a betrayal of our values,’ he told LMC leaders.
Dr Kanneganti said IMGs are ‘not just contributors’ but ‘the backbone’ of the health service, arguing that the resident doctors policy ‘sends a damaging message that IMG doctors are somehow less welcome, less value, despite meeting the same standards’.
He added: ‘Let us not allow protectionism to masquerade as progress. We must call for this policy to be reversed.’
Dr Oge Ilozue from Barnet LMC said GP unemployment is a ‘travesty’, but called for clarity about ‘where the real issues lie’.
She said: ‘It’s not the immigrants taking our jobs, it’s that the system has consistently failed to plan, train and refuses to adequately fund a sustainable healthcare workforce that our patients need and deserve.
‘In one breath we’re praising the invaluable contribution. In the next we implement a policy that literally throws them on a scrap heap.’
But some GPs spoke against the motion, with Dr Mark Protheroe from Lincolnshire saying it is an ‘acute waste of resource’ if the UK’s ‘own medical graduates who the NHS has paid for’ cannot get into specialty training.
He told the conference: ‘I want to emphasize my appreciation for international medical graduates. I’ve worked with many, but I think there’s an issue of our home grown graduates not getting employment, and the cost to the country of that, particularly if they’re likely to go towards Canada, New Zealand and Australia.’
Dr Chris Morris from the BMA GP registrars committee also spoke against the motion, emphasising that ‘comparative countries have some form of prioritisation for medical graduates that they have trained’ which makes the UK an ‘outlier’ with ‘zero prioritisation’.
A BMA spokesperson told Pulse that the union’s policy is ultimately determined by the Annual Representative Meeting, with the next meeting happening next month.
The spokesperson said: ‘The BMA recognises how indispensable international medical graduates are to general practice and as such, we want to ensure that they are adequately supported, and protected from any discrimination, throughout their training and career.
‘We will continue to provide the best possible support for IMGs, which includes lobbying extensively on visa issues, supporting them when they experience workplace difficulties, and providing legal support to our members through our immigration advice service.
‘Whilst the Local Medical Conference sets policy for local medical committees and informs the work of the BMA’s GP committees, it does not set policy for the BMA.
‘Further, it is not binding on the Resident Doctors Committee, which has recently set out its position to improve access to speciality training – something we know is broken and needs fixing, in a manner that helps IMGs in the UK as well and considers the unique circumstances for doctors on the Island of Ireland.
‘The competition ratios are unsustainable and RDC is calling for urgent action on this, including more training places, but recognising that prioritisation is necessary when successive Governments have failed to do proper workforce planning.
‘Ultimately, BMA policy is determined by the BMA’s Annual Representative Meeting, with the next meeting happening in June of this year.’
In 2023, the GMC said the NHS must address why general practice is less attractive to UK graduates, while revealing that the number of IMGs joining the GP workforce has almost tripled since 2018.
Motions in full
UK LMC conference motion (9th May)
AGENDA COMMITTEE TO BE PROPOSED BY NORTHERN IRELAND EASTERN: That conference recognises the enormous contribution of international medical graduates (IMGs) to general practice in the country and calls on GPCs and the wider BMA to:
(i) not have any policy that disadvantages IMGs in applying for jobs and training posts in the NHS – PASSED
(ii) lobby the RCGP and relevant health education bodies for increased educational and practical support for those IMGs who request it during their GP training – PASSED
(iii) work towards making available optional longer training programmes for IMGs with the aim of reducing extensions of training for these valued individuals – PASSED AS REFERENCE
(iv) publicly acknowledge the significant benefit that IMGs bring to the NHS, and distance themselves from the protectionist policy passed by the BMA Resident Doctors Committee – PASSED
Resident doctors committee motion (passed 4 March 2025)
This committee condemns the persistent failure of UK and devolved nation governments to significantly expand medical specialty training posts and resolves to
i) demand that UK and devolved nation governments, NHS/HSC bodies, and statutory education bodies implement a specialty training recruitment process that lawfully prioritises medical graduates from UK medical schools.
ii) ensure equal access to specialty training for those international medical graduates (IMGs) who are already GMC registered and practising in the UK on or before the 5th of March 2025 who have completed or go on to complete two years of NHS/HSC experience or NHS/HSC funded care working as a medical doctor (grandfathered IMGs). Any IMG doctor starting medical practice in the UK on or after 6th March 2025 will be deprioritised for the purposes of specialty training applications compared to UK medical graduates and IMGs meeting the grandfathering criteria previously mentioned. Work will be undertaken to consider how this policy could be delivered across the 4 nations recognising the different circumstances presented by cross-border working in Northern Ireland and the Republic of Ireland.
iii) demand that UK and devolved nation governments, NHS/HSC bodies, and statutory education bodies provide increased funding for the expansion of postgraduate training posts and subsequent consultant/GP posts to meet the growing demand for specialty training, significantly reduce competition ratios, prevent unemployment amongst doctors, and help provide the medical workforce the UK population needs.
iv) work robustly towards reform of trust/board recruitment practices so resident doctors in locally employed posts are free from exploitation, career uncertainty, risk of excessive financial burdens, and are able to seamlessly evidence the experience they gain in these posts against equivalent experience in training.
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READERS' COMMENTS [3]
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Maybe the seniors should stay out of it. It doesnt affect them. Classic ladder pullers. Have some empathy for juniors who have to compete against the whole world
choosing Geography vs Talent… what can go wrong?
The actual RDC motions and explanatory page on the BMA website actually have a much more positive and egalitarian slant : that priority for training posts in UK be given (with safeguarding arrangements for IMGs already here ‘in the system’ and originally based here OR in Eire) to doctors currently in Britain, over those currently overseas who have never been here. I am sure it would be possible to continue also the special status given to certain countries in previous arrangements who do not have their own specialty training programmes (certain overseas dependencies and carribbean islands come to mind!) There is a problem if you entice graduates and IMG doctors already here, to commence a training programme here, and then tell them there are not enough such posts for them to complete the training! There are also a number of other considerations : Britain needs to train enough graduates in the speciaties we need in Britain, who are most likely to stay here and work afterwards, because we are currently desperate for increase in certain specialties. It is probably a debate we should have, regarding how we prioritise the needs of the patients in Britain, over those overseas, who may benefit from IMGs training here, but the full statistics would be needed to illustrate this properly and debate it meaningfully. Whilst the initial impression is very negative, and the language used to propose it or convey it initially unhelpful, I think we should at the end of the day, probably thank the JDC for bringing us to acknowledgement that informed debate is needed concerning the inability of local graduates and IMGs already in Britain (counted differently in different stats maybe?) to gain access to specialty training or even their next NHS job !