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Plans afoot for single route onto medical register

GMC may test skills of European doctors too

Jo Carlowe

Thursday, 02 February 2017

The General Medical Council is seeking views on creating a single route to the medical register.

Consultations opened this week on plans for a Medical Licensing Assessment (MLA) that will provide a single route to the medical register for all doctors who wish to practise in the UK.

The proposals aim to address the current variation in arrangements for medical students across the country and those wishing to join the register from outside the UK.

At present, every one of the UK’s 32 medical schools has its own system and although they share some written questions there is no UK-wide process to set a common standard to pass.

International medical graduates (IMGs) also have a number of means of entry, the most common of which is the GMC’s Professional and Linguistic Assessments Board (PLAB) test. Meanwhile, doctors from the EU can secure a UK licence to practise without any test of their competence.

A recent poll of patients for the GMC found that two-thirds would have greater confidence in the checks carried out on doctors if there was a single assessment taken to enter the profession.

Professor Terence Stephenson, Chair of the GMC, said: “Medical training in the UK is among the best in the world – our graduates do well here and when they work overseas. However, current arrangements do not allow us to assess whether UK graduates and overseas graduates have attained the same threshold of competence when they are seeking the same licence to practise in the UK.

“We also know that there is evidence of disparity between medical schools in how prepared UK graduates are for practice. With a planned increase in medical students in the pipeline and new schools appearing, particularly in England, this is surely the moment to look at how we can improve assurance for patients that the standards at entry are consistent.”

Commenting, Professor Neil Johnson, Chair of the Medical Schools Assessment Alliance, said: “One of [the] functions of the Medical Schools Council (MSC) is to provide leadership for the education and training of future generation of doctors and, through that, to protect the public. I am therefore really pleased to see MSC and its members demonstrating that leadership by working with the GMC to develop the UK medical licensing assessment.  

“This assessment will enable the GMC to demonstrate that all future doctors have met a common threshold for competence and safety and will therefore make an important contribution to protecting the public.”

The proposals out for consultation have been shaped by GMC visits to every UK medical school in 2016. The Chair of the Medical Schools Council Assessment Alliance, Professor Neil Johnson, has agreed to head an expert reference group that will advise the GMC how it should develop the assessment in a way which does not subject medical students to over-examination.

The GMC hopes to incorporate the new assessment into existing testing by medical schools.

The UK’s decision to leave the European Union, following the referendum in June 2016, may make it possible for the GMC to test the knowledge and skills of EEA doctors.

Depending on the UK’s future relationship with the EU, it is possible that the MLA could be taken by doctors from the European Economic Area (EEA) alongside UK candidates and doctors from the rest of the world. 

The GMC has long argued that it should have the ability to check that doctors coming to practise in the UK from Europe meet the same standards as those who qualify in the UK and outside Europe.

The GMC’s consultation is open from 31 January to 30 April 2017.

Danny Mortimer, chief executive of NHS Employers, welcomed the launch of the consultation. He said: “A single Medical Licensing Assessment would help provide employers, and patients, with clearer assurance that all doctors practicing in the UK are working to the same standards of knowledge, skills and preparedness. It would also give common recognition to the important contribution of overseas trained doctors through the assurance systems of the professional regulator.”

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