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International graduates to face ‘more robust’ test for working in UK

The GMC has raised the bar for international medical graduates (IMGs) wanting to work in the UK by ensuring the assessment that allows them to practise medicine in this country is ‘more robust’.

The number of times a non-EU doctor can retake the Professional and Linguistics Assessment (PLAB) test will be limited to four and a pass will be only valid for two years, rather than three, the GMC has announced following an independent review of the assessment.

The GMC-commissioned review, part of an ongoing evaluation of the test, also recommended the possibility of using two assessors at each stage of the PLAB’s practical objective structural clinical examination and called on the GMC to continue to analyse the disparity in postgraduate exams between PLAB candidates and UK medical graduates.

It also warned that the current two part – written and practical – test limits its ability to assess the ‘values and principles’ contained in the GMC’s Good Medical Practice. It recommended the introduction of another way of testing these values, possibly through a situational judgement test, saying the PLAB should be renamed to reflect its aims.

The PLAB test is designed to ensure that non-EU trained doctors demonstrate the same level of medical knowledge and clinical skills as UK graduates who have completed their first foundation training year (F1) and is required for IMGs to work in the UK.

The RCGP recommended last year that the GMC review the PLAB ‘as a matter of urgency’ saying it was ‘in the interests of patient safety’ after researchers found that graduates of the PLAB had poorer clinical knowledge and skills than UK graduates on average, according to their performance in the MRCGP exam.

The GMC said it ‘welcomed and accepted’ the recommendations of the review, chaired by Professor Ian Cumming, chief executive of Health Education England.

GMC chief executive, Niall Dickson said: ‘This has been a thorough review and its recommendations, which we fully accept, will help to make our test for overseas trained doctors as robust and effective as possible, ensuring that those who are admitted to the register are of the right standard.’

However he warned there was a vital role for employers to play.

He added: ‘Under current EU legislation we cannot check the competency of doctors coming from Europe and that is a major gap in our regulatory defences.’

‘It is vital that employers make sure that the doctors they take on have the skills to do the job for which they are appointed.’

The review also recommended that the GMC should recruit more female examiners for the practical part of the test. At present, it uses 135 examiners, of whom only 20 are women.