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GMC to make test for overseas doctors more robust

EU legislation on European doctors leaves major gap in regulatory defences

Louise Prime

Thursday, 02 October 2014

The General Medical Council has welcomed the recommendations of an independent review that it should strengthen the test for overseas applicants to the UK medical register. The GMC said the measures would help to ensure that doctors had the right training and attributes to work in this country – but it warned that there remains a ‘major gap in our regulatory defences’ because EU legislation prevents the GMC from checking European doctors’ competency.

The GMC commissioned the review to ensure that the Professional and Linguistic Assessments Board (PLAB) test remains objective, fair and fit for purpose. The review group was led by Health Education England’s chief executive Professor Ian Cumming OBE, who described the PLAB test as “an effective method of testing the skills and knowledge of those doctors with international qualifications”. The report’s several recommendations include that the GMC should:

  • extend the test to examine a wider range of ethical values outlined in the core guidance for doctors, Good Medical Practice
  • explore reducing the variables affecting elements of the objective structural clinical examination (OSCE), such as introducing two examiners to assess candidates’ performance at each mock clinical station
  • limit the number of retakes for the written part of the test to four, as is already the case for the practical stage
  • limit the validity of a pass in either part of the PLAB test to two years, rather than the current three
  • continue to review the disparity in outcomes for PLAB candidates in postgraduate exams and consider amending the purpose and standard of the PLAB test as necessary.

GMC chief executive Niall Dickson (pictured) said: “[The] recommendations, which we fully accept, will help to make our test for overseas trained doctors as robust and effective as possible, ensuring that those who are admitted to the register are of the right standard.

“We have recently increased the English language standard we require from doctors coming here to practise and for the first time doctors from Europe will be covered by this provision … to make sure that the patients in the UK have access to good doctors with the right training, attitudes and skills to practise safely and effectively in this country.”

However, he warned: “Under current EU legislation we cannot check the competency of doctors coming from Europe and that is a major gap in our regulatory defences. It is vital that employers make sure that the doctors they take on have the skills to do the job for which they are appointed – and even for overseas doctors who do pass our exam, that should only provide assurance that they are at a level equivalent to a UK trained doctor who has just joined the register. In other words they may be an inexperienced practitioner who needs close and ongoing support and supervision.”

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