Does the UK really need more Doctors?

There is a widely held view overseas that the NHS faces a shortage of doctors. In the last few years, the GMC has opened several new PLAB test centres in India and elsewhere, sending a clear signal of need at the entry level. Yet, overseas doctors are facing difficulties in finding jobs here.

What do you think?

• Is there a shortage of doctors in the NHS? At what level?
• Has Britain done a good job of informing overseas applicants about the market?

Applications system under strain

The job applications system has evolved at a time when there was less pressure. Today, staff face hundreds of applications for a single post. Each trust has its own quirky requirements, forms must be filled in manually (often several times). It is not uncommon for a hospital trust to ask for five paper copies of a single application by post. Most NHS trusts do not even inform applicants if they have been rejected.

What's your experience?

• Are you getting lots of applications for each job?
• Can the system cope?
• What do you feel should be done?

A long struggle for doctors already here

Many overseas doctors are now already here in the UK, and are applying for jobs. They have completed MBBS degrees in their own country and have passed further exams to show that they are on a par with UK graduates. They have made significant career choices and have invested time and large amounts money to have reached where they are.

Anecdotally, overseas applicants are spending gruelling hours filling out tens of applications per week, and even then not getting shortlisted.

What next?

• Should they go back to their countries of origin and start again?
• Should they wait it out in the hope of job success?
• How long does it take you to complete an application?
• How many applications have you submitted to get shortlsted?

Equal Opportunities for Overseas Doctors?

Foundation courses make training more organised for UK graduates, but also reduce posts available to international doctors. Overseas doctors are restricted from applying for certain posts as they can only get limited registration from the GMC. Visa rules mean they cannot apply for short term locum positions either, making it hard to earn money.

Abroad, the UK has the image of being a fair and equitable society. Each application form clearly states that the NHS is an 'equal opportunities employer'. Yet, anecdotally, it appears that many hospitals first select from UK applications before going on to international CVs.

What do you think?

• Does your hospital consider UK graduates first?
• Do overseas doctors deserve 'equal opportunities'?
• Should the system favour UK graduates?

Equal opportunities applies to those who have the right to live and work in the UK ie those with citizenship and permanent residency. It does not extend to those who are do not have these rights. Most overseas doctors are on visitor's visas hence have the status of tourists. A tourist has no rights let alone equal rights.
All countries put the interests of their own nationals first and rightly so. They have spent large amounts of tax payers' money training them. They cannot subsequently put those graduates on the dole and replace them with foreigners who are largely unknown commodities. The Government knows the standard of UK graduates. The PLAB does not guarantee the standard of foreign graduates.
With the expansion of the EU, EU graduates have the right to live and work here and so the opportunities for non EU candidates are diminishing.
It seems that large numbers of overseas graduates have unrealistic expectations and a misplaced sense of grievance and entitlement. When one arrives as a visitor in a foreign land, one does not have rights or guarantees. There is no guarantee of passing PLAB and no gaurantee of getting a job. Those who embark on this journey must be aware that it a risk. It may pay off or it may not but it is ultimately a substantial risk.
If it fails, there is no point in blaming the Government, GMC or other agency.

Posted by: K Wilson

Yes exactly right what is written "All countries put the interests of their own nationals first"
But only thing the job status and difficlty to be updated regularly.
Like people came 3 yr ago no such problem not waiting for 6 to 9 month.
After enough information if any body accept that tife of difficulty then he should not blame any body else.
yes but information regarding job situation to be updated regularly and some reliable database site.
There is lot of difficulty for that type of information, but it depend on the person who is coming here for how long and how far he is ready to struggal and face the difficulty.

Posted by: Vikas

The GMC cannot ban the PLAB exam as there are jobs for a number of overseas doctors. The GMC also must allow all applicants who are eligible to take the exam to do so. The GMC cannot ration places as that would mean discriminating against candidates and having the exam places taken on a first come first served basis which would not necessarily attract the best candidates.
The fault of the GMC is perhaps that the exam is too easy. Making the PLAB 1 more difficult would reduce the number of elegible applicants for PLAB 2. That would be a fairer way of doing it.
As it stands the exam is almost definitely too easy and too many people are passing.
However the GMC and the Government do not have responsibility for overseas doctors as they are not British citizens. People do not have to come here. It is their own choice. Likewise there is nothing stopping them from leaving if they cannot secure a job. That also is their own choice.

Posted by: k wilson

Dear Karen
It is important to realize that the NHS is extremely dependent on foreign doctors and it is only fair that the GMC should be more specific about the current post-PLAB job situation rather than just a vague warning that the PLAB does not guarantee a job.
It is wrong to say that tourists do not have ANY rights - they DO have the right to correct information. I firmly believe that it is the duty of GMC and DoH-NHS to collaborate and provide clear statistics and information to ANYONE contemplating the PLAB. While moves towards providing such information are on, and the demand for PLAB has decreased, the information has come too late for many.
Wasted doctor hours of post-PLAB doctors from developing countries have reached a terrifying level -
the UK must not be so selfish as to not even obtain and share correct information - not in the least because overseas doctors have kept its NHS from being defunct.

Posted by: Dharmesh Shukla

The GMC conducts PLAB I &II just to earn money. If there are no jobs for these candidates then the whole purpose of exams is nullified. That way you have no benefit and nor do the candidates. Its a transparent picture that you project.Ban the PLAB exams and stop the overseas people from snatching your jobs.And what happens to people who have passed PLAB and are looking for the job for over an year? If UK is so fair and just as it potrays then do something about these people.Its double standards of the Brits to suit them.
Posted by: Parveen | 23 November 2005 at 12:39 PM
To begrudge the UK of looking after their own graduates first is to be unreasonable. The truth we should all understand is that this is an island and cannot really sustain the amount of people comming in, me included. that said and done the system should be designed in such a way that it provides a level playing ground for everyone.The application method should be stopped and all positions should be filled on basis of CVs and interviews only.This will sort out those who have doctored thier cvs.

Posted by: Tony Hemeson

Yes actually UK needs more docs, but not at the SHO level, its at the Consultant level and GP level. It wont help the tiniest if they keep advertising about shortages of docs here where on one hand they are introducing EWTD and cutting down doctor posts and on the second hand have introduced the Foundation programs which have totally sucked up whatever posts were remaining as stand alones leaving everyone, who is not in a rotation, feel suicidal! Two options remain: 1. Go back to our own countries before the system kills us, and make a fresh start, no matter how many difficulties we need to face, after all its our OWN country!
2. Go for USMLE/Aussie/CAnadian/etc exams and carve your niche there.
After 1and 1/2 years of jobs (not without extreme struggle) even I am finding it very difficult to get anything, I am not eligible to apply for foundations and nor getting any rotations...so I am about to reach a dead end soon. and I am starting to make my moves in the said directions above.
Hope for the best and we need an Andolan to stop the PLAB and sort our lives out in the first place!

Posted by: Akshay

HI
All I can tell about the current situation of INDIAN DOCTORS in UK is that there is a need of lot of introspection to be done.
FIRST ABOUT PLAB. PLAB was a very tough exam before 2000 after which it was eased out to allow the influx of doctors from abroad to fill up the vacancies in UK. In 2000 there was a move to increase the number of medical seats. As a result since 2000 many doctors applied for jobs after clearing their PLAB. EAST HAM BHIDE (silly advert) and not mention the of land lords in EASTHAM were all benefited and since our country has abundance of doctors many people came here. The result was such that GMC from being a small office building now has an amazing building in one of the POSH LONDON locations. It is all from the money that coming from INDIA.
As the years trickled GMC discovered that UK qualified doctor is valued in INDIA hence they banked upon this fact and they increased the number of PLAB examination both in the number of student taking and in the number of centers where it is conducted. No one wants to stop a flourishing business.
It also meant good business for people like BHIDE. But then things got saturated and now every one is cribbing about it.
THE PLUSSES I SEE IN PLAB ARE THAT Who ever had a MBBS qualification from INDIA did a very nice thing by coming to UK in 2000. I am sure every one is settled by now. It worked out well for all of them.
It was rather a smart move. It was even better for those who moved in 2000 after doing their postgraduation and had some experience in INDIA because they had nothing to loose even if they would not get a job in UK.
Even those who came to UK around 2003 June still have succeeded in UK if they had a postgraduate degree.
It is still a worth while prospect to come to UK if some one has got a postgraduate degree from india along with some experience and if some one has saved some money. Well worst case scenario they might not get a job but they dont have anything to loose other than money which they can always earn back in INDIA though it might take them a year or two.
THE WORST thing about PLAB. What PLAB did was it was a diversion to those who were fresh and were wondering about the direction they needed to take in life. The most important thing after MBBS is to try and get a post graduate training. We all know how difficult it is to get a post
graduate seat in INDIA so many people tried to come to UK hearing stories that the pay is definitely a lot more than in INDIA and after all money is what matters. However the year after graduation is the most precious year. One can take indian entrances or try GRE/ TOEFL route to US or take up USMLE and then try luck for US VISA or take up UK PLAB.
Well who ever is going through this website must understand and keep track of things. Please go through the internet find out as much as you can and as much as you want before you decide to come to UK.
Personally it is not an ideal place for fresh MBBS graduates. It might be worth it for post graduate students because they have nothing to loose.
Many might be insisted up on parents, peers, teachers to go to UK. But then in the long run we are searching for training in a particular feild be it general medicine, general surgery and all others.
It would be wise on our part to think and strategize our career. We are all learned people. We have a very good degree in our hands called MBBS. Yeas just MBBS may not be suffice but then it is up to us to explore the possibilities that are available. The problem is that 6500 people are in UK struggling for jobs in reality are we doing justice to our qualifications that we have had. Instead of blaming GMC, BHIDE, UK, or anything let us look into ourselves first. GUYS we are doctors. We have to be proud that what we know is special. We must think before we do some thing. Internet is for all of us. There are so many options like health care system administration, biomedical informatics, bioinformatics, molecular biology cell biology, medical underwriting and hundreds of them which are the feilds which are coming up.
My comments would be to those people like me who have got MBBS only. We were too young when we decided our careers now we are mature enough. It is never a bad idea to stratergize now again. It was good 6 years ago when we decided up on our careers but then with time situation have changed.
It would be worth if people chalked out plans well before coming to UK.
I dont say doctors should not try UK but then we are intelligent enough to keep some alternatives. It would be fantastic if we would speak to career counsellers before we decided to come to UK/ to go US/ to take up PG courses in INDIA.
It is very unfortunate that we being the best brains in the society are looking at a system like PLAB with out understanding its dynamics as to how and why things have developed. We are blaming the system instead of being smart. I guess instead of blaming any body any system in india US or UK. It is high time we started to look around, did some kind of soul searching instead of having a very dogmatic approach to our careers.
We are the best brains in the society and we must be proud of our accomplishments we must have the mind set to take up the pressures of the society, difficulties of the system and
"decide our future rather than to predict our future"
I have put this comment not to discourage people coming to UK. Even I wrote plab 1 & 2. I went through the streets of eastham, I ate at the gurudwara and also had food at the temple. I am thankful to god that he gave me food and shelter. I however came back after a breif stinct in UK and am working on my alternatives. I guess these alternatives could be something one must like to do and to be forced upon our selves.
We must speak to people from all possible feilds, related to medicine, our professors, counsellors, go through websites, speak to our parents, freinds, seniours and to people whom ever we can before we decide up on our career moves.
MY COMMENTS WOULD BE MORE TOWARDS THOSE WHO HAVE FINISHED THEIR MBBS ONLY AND ARE SEARCHING FOR CAREER OPTIONS.

WISHING YOU ALL THE BEST.
thank you
Cool dude

Posted by: Vasudev