‘Why I resigned from the BMA over its international doctors policy’

Dr L-J Evans on resigning from the BMA following its vote to prioritise UK graduates over international medical graduates

You and I entered medical school having been told that, once qualified, we would have a ‘job for life’. As doctors, we hope to be respected and well-paid. Or at least earn enough to counteract the often-crippling debt resulting from a long, demanding university course.

But shockingly, guaranteed employment for doctors no longer seems to be the case. Medical school places have increased significantly, yet post-qualification training places have not, leading to unemployment and huge emotional and financial stress for those affected. So, whose fault is this?

Brexit preyed on the fear of ‘immigrants coming and taking all our jobs’. Nine years on from the vote and five years on from implementation, we have massive deficiencies in vital sectors, including health and social care. We are under-doctored in the UK, compared to other countries with better health outcomes, so surely the answer is for the Government to increase training places and ensure access to these based on merit, not country of qualification?

Over the history of the NHS, immigrants to the UK have been vital for the service to function. This is why the backing of a proposal to prioritise UK medical school graduates over international medical graduates (IMGs) for training posts at the BMA’s annual meeting last month has left a poor taste in my mouth. To prohibit them from taking training posts and expecting them to work in jobs with poorer terms, pay, conditions and no hope of career progression is unfair. It also means we are unable to fill gaps in areas and specialities that British graduates don’t want to live/work in, including general practice.

GPs have already expressed concerns over the exclusionary policies being promoted by certain factions within the BMA. At our recent LMC conference, the ‘protectionist’ policy of the Resident Doctors Committee was condemned. We work alongside GP registrars daily in our surgeries, a large proportion of whom graduated abroad. We welcome them as respected and valued members of our workforce and hope they will remain to live and work in the UK, as many of those with British citizenship leave to work in North America, Australia, New Zealand etc.

The BMA prides itself on its values of ‘finding strength in unity and valuing diversity’. It seems to have forgotten that is partially-funded by all the IMGs currently living and working in the UK, who are relying on it to promote their interests alongside those of UK graduates. Do we think that one member is ‘more equal’ than another? A doctor is a doctor and access to specialty training should be based on merit alone, with exceptions made and support given to those with protected characteristics, not whether or not they graduated in the UK.

As the employment/recruitment crisis in general practice continues and we struggle with overwhelming demand, let’s welcome all those who are willing and able to join us and ensure the Government adequately resources both training places and jobs for qualified GPs. As our term on the BMA’s Sessional GP Committee came to an end last month, our final agenda item was to pass a motion calling for:

(i) governments to provide full funding for one whole-time equivalent GP per 1,000 registered patients in every practice in the UK and;

(ii) any further increase in patient list size to be matched by further full funding to employ or engage another whole-time equivalent GP to maintain the ratio of one whole-time equivalent GP per 1,000 registered patients.

Lets hope this comes to pass. I have been a member of the BMA since my first days at (UK) medical school and an active member for well over a decade. Over the years I have worked alongside many IMGs in senior leadership positions within the organisation, including previous chairs of the GPC.

But, following the decision of the representative body to prioritise the wants and needs of UK medical graduates over IMGs, I am no longer able to support the BMA as an organisation. I have resigned my membership, writing to them to explain why. I truly hope they will change their mind in future and choose to represent and negotiate on behalf of all doctors and medical students in the UK, as the LMCs have promised to do.