Are We Too Lax In The Way We Allow Foreign Doctors To Practice In This Country?

[anotheoldgit]

http://www.telegraph.co.uk/health/healthnews/9771022/Revealed-3-in-4-of-Britains-danger-doctors-are-trained-abroad.html

/// Under the current system, British hospitals and medical agencies which hire doctors are not allowed to test the language skills of those from EU countries to seek if staff will be able to communicate safely. ///

[Sqad]

AOG......the problem with poor communicating skills is not at Consultant level (on which that report focuses) but at Junior and GP level.

Although it is an authoritative report....I disagree with it's conclusions, in that we need a Consultant based NHS rather than GP orchestrated system and that means paying consultants more and Gp's less.

This will never happen as the BMA (the Medical Union) bats for the GPs mainly and has little concern for the Consultants.........particularly those in private practice.

\\\\\ He said: "The NHS of the future needs the right workforce in place to make sure patients get the best care. The Government is taking action now so that patient's needs will continue to be met in 2025, and money is not wasted training more doctors than the NHS requires, who could end up having to go abroad to find
work. ///

That song has been sung over and over again during the past five decades..................and will continue to be sung over the next five decades.

[anotheoldgit]

We are being side-tracked by assuming that the language difficulties are the main cause for concern when actually it is the lack of clinical skills etc. that are the problem.

/// In 2008, the pensioner David Gray was killed by a German-trained doctor, Daniel Ubani, who gave him ten times the recommended dose of pain relief while working as a locum. ///

/// Dr Ubani, who was born in Nigeria, was working his first shift in this country and later said he had never heard of the medication diamorphine, which is not commonly used by GPs in Germany, before he administered it. ///

/// A series of other cases at the GMC have included Vladan Visnjevac, struck off after a baby girl he was delivering died of a fractured skull and brain injuries when he used forceps wrongly, and Navin Shankar, who failed to diagnose a young woman’s cancer over six years before her death. ///

[boxtops]

There are two separate issues here then - one is the examination of clinical skills (learning and experience) and the other is language skills. A doctor or nurse (or indeed any of us) can be expert in their field in their own language, but would be lost if they can't communicate in the language of the country where they are working.

[emmie]

boxy, totally agree, what we need are doctors, nurses who are proficient in their field of medicine as well as in the English language.

[Sqad]

AOG

Many ...many,,,foreign doctors are well trained and have excellent clinical and communicating skills, but some are poor.

Many many..UK doctors are well trained and have excellent clinical and communicating skills........but some are poor...very poor.

Foreign doctors, particularly GP's who have poor clinical and communicating skills come to the UK as locums.........the land of plenty......plenty of opportunities and plenty of money and there is little that we can do about it, because the NHS needs them and it is allowed (encouraged) by the EU.

[whiskeryron]

Surely is possible in NHS Hospitals that ALL diagnostic treatment should be written down by the treating doctor or his/her aid & then checked by a senior nurse before treatment is carried out by nursing staff.

WR.

[boxtops]

WR - the doctors wouldn't like that .....

[whiskeryron]

boxtops, Hard Luck !!!

WR.

[Sqad]

WR.......why not bypass the doctor (which seems now to be the object in the NHS) and make the "senior nurse" write down the "diagnostic treatment....whatever that is.....

[anotheoldgit]

Squad

/// because the NHS needs them and it is allowed (encouraged) by the EU. ///

Thankfully not all of them, since 420 (63 per cent) of those struck off in the last five years, were trained abroad

[boxtops]

Nurse practitioners can do just that, sqad.

[emmie]

what about the rest, those who are kept on, despite the damage they have done. Shuffled into another job, hospital..

[McMouse]

My wife had a couple of days in an NHS hospital two weeks ago and one of the british born registrars was almost impossible to understand because his spoken english was so accented. One of the nurses actually discussed matters with him in a common asian language. To be fair, Mrs McM received excellent treatment despite communication difficulties.

[lcg]

yes....i have met some shockingly bad dr's in my time. i would say that psychiatry has quite a large foreign dr base. some of them need their hands holding and their attitude.....well.....x

[boxtops]

lcg, when I worked in a postgrad centre (and since) I noted that most of the psychogeriatric physicians were from abroad - it's not a popular branch of medicine, it seems.

[slaney]

There is ( and has been for some time) a compulsory language skills test which includes a structured clinical examination, but for doctors outside the EU only.

http://en.wikipedia.org/wiki/Professional_and_Linguistic_Assessments_Board
http://www.gmc-uk.org/doctors/plab/Blueprint.asp

I presume the government is trying to extend this to EU doctors as well, which would help. Perhaps a more rigorous clinical assessment should be added to the PLAB test.

More than a third of GMC registered doctors in 2010 trained outside the UK, so we certainly need them. I can't see this changing in the near future. The majority, as sqad has said, are excellent.

So where are the UK graduates going? Abroad presumably..
http://www.ft.com/cms/s/0/5063a2a0-b651-11e1-8ad0-00144feabdc0.html#axzz2GXNQfZVQ

Maybe they should be contracted to stay and work for the NHS for a minimum of 5 years, say, to recoup the cost of their education and training.

[237SJ]

Slaney, that`s exactly what I have always said. In the private sector, if an airline (for example) spends tens of thousands of pounds training a pilot, they`re bonded and if they leave within (say) 5 years, they pay the money back. I don`t see why the NHS can`t do the same with their doctors.

[Sqad]

237SJ....I cannot be sure of my statement, but in my experience, the majority, the vast majority have done 5 years in the NHS before they decide to emigrate.

I am sure there will be a website somewhere that supports my statement or rejects it.

[slaney]

You could well be right sqad; the The UK Medical Careers Research Group do this kind of work. I'll have a look.
But if you look at this graph (Figure 1) you will see that a significant number moved to NZ within 5 years of graduation.
http://jrsm.rsmjournals.com/content/105/1/25/F1.expansion.html

[joko]

if a person has the intelligence and tenacity to manage to become a doctor in the first place then i am sure they can manage to do some language courses that teach them to understand more and be understood - in fact i would imagine many would welcome it.

if that means delaying the start date for their job then so be it... but i doubt it would take that long for them to get up to speed with some intensive language sessions...even if they were done with audio software, itd be better than doing nothing at all.

i too have been frustrated at trying to have a conversation with a locum ... i have gone there wanting to discuss a problem but feel what i trying to 'get across' is just being met with baffled looks, because i am not sure how to describe the symptoms, and i am sure a native english person would have grapsed it.