Non-European doctors and change in UK policy

Editor—O'Dowd quotes 1000 international medical graduates as the number likely to be affected by the Department of Health's ruling to end permit-free training.¹ Ten thousand may be nearer the mark, as most of the 12 707 international medical graduates who passed part 2 of the Professional and Linguistic Assessments Board (PLAB) examination between 2004 and 2005 will be affected by the ruling (personal communication, Registration and Education Directorate, General Medical Council, 2006).

Whether one, or 10 000, the principle is the same. When applying for junior posts, nationality is now to be promoted over merit. The humanitarian and racial implications are the first consideration, but service provision will also be affected as will training and research relationships with countries outside the European Economic Area (EEA).

Unless modified, the ruling will lead to hundreds, perhaps thousands, of highly skilled doctors leaving the United Kingdom in July. The short term gains for UK graduates will be bought at the expense of ill feeling, vacant posts, and a breakdown of carefully nurtured training relationships, which have brought such benefit to medicine in the UK over the past 50 years.

We urge that at the very least the ruling be downgraded to apply only to new graduates taking PLAB and not applied retrospectively to those already in training.

It is also critical that those taking PLAB are warned from today in the strongest possible terms of the ruling. The number of PLAB places needs to be cut drastically if we are to rescue anything from the current debacle, which reflects so badly on the NHS's reputation as an equal opportunities employer and is causing such distress to international medical graduates and all who work with them.