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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.