‘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.
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READERS' COMMENTS [5]
Please note, only GPs are permitted to add comments to articles
Good article, and respect to you. I don’t think we live in an era where we should follow the heavily indebted but oligarchic USA, and succumb to anti-meritocratic protectionist forces or to mercantile policies in the NHS or care sector (or others). [even Adam Smith disciples should agree with me]. In fact we should welcome into the UK the scientists, researchers, doctors who are being “ethnically” cleansed by the current administration.
Alas, the parochial BMA’s Resident Doctors Committee has surrendered to nativism and fallen foul of the lump of labour fallacy.
I agree with you that the real issue is that the NHS has been under-doctored and underfunded for years.
Anything else is distraction (the recurring ploy of the 1%) and the usual “blaming of the immigrants”.
Next, the Govt will be blaming immigrants for the potholes in our roads!!
At the start of your article you admit that there IS a real problem of unemployment in new qualifying doctors as they are unable to get on the training schemes. The fact that in some cases it is promoted that 50% of training places are given International medical graduates is not a coincidence.
I agree that we are under doctored but until the government DOES agree to increase training places we have to prioritise our young people (who we have put into thousands of thousands of pounds worth of debt) to get places. It is also unfair on other countries whose doctors we are stealing and also very jarring for the graduates who have no experience of the NHS whatsoever to come and work in this system ;their lack of knowledge of the NHS often shows when they start working here.
I completely agree with The BMA stance.
I was a member of the representative body this year and was present throughout the debate on this. I’m a UK medical graduate and a GP. The debate was a lot more nuanced than this article suggests.
Whilst this policy makes me deeply uncomfortable, the voices in support of it were not arguing that UK graduates are better than IMGs. They argued that it’s wrong to be recruiting IMGs from abroad on the promise of a job for life when there aren’t enough jobs. They also argued that it’s wrong to be training UK graduates then having them leave the country because there’s no training jobs here.
The argument that we should be pressuring the government to provide sufficient training places (and consultant and GP posts) was well made and indeed is already BMA policy. This policy was voted for in response to the fact that this hasn’t happened and certainly wasn’t voted for on the basis that UK graduates are “better” than IMGs.
Doctors who are already permanently resident in the UK should be prioritised. This is usual recruitment practice in most places around the world in most sectors of employment. There is a vast number of doctors in the world can speak English and would have a better standard of living in the UK, so it is unsurprising that they wish to complete with UK doctors for jobs, who can blame them? There should be priority for UK doctors who mostly can’t speak other languages to a good enough standard to work outside the Anglosphere.
It is standard policy on all countries and most job markets to prioritise their own graduates or citiziens. Why has this come as a shock to anyone ? You can argue the pros and the cons but of you qalify here and have worked here, you should be first in the que not last .