Failure to support international doctors undermining workforce, warns GMC chair

The NHS is losing a significant number of international doctors due to poor support, a lack of training opportunities and a bureaucratic registration process that is not fit for purpose, the chair of the GMC warned.

GMC chair Dame Clare Marx (Photo: Pete Hill)

Speaking at the RCGP annual conference in Liverpool today Dame Clare Marx said that 'a simple change' to the legislation governing how overseas GPs apply to join the UK register could 'make a significant difference' to the GP workforce.

'Large volumes of international doctors under the age of 50 are leaving the UK,' she said. 'Some of that will be because they have come to the UK for specialist training, but in other cases they are still reporting bullying or lack of training opportunities as being why, having come in expectation, they either return home or move to other countries.

'If we could only hold onto those doctors for a little bit longer and persuade them into general practice that might make a huge benefit to patient care.'

International GPs

Dame Clare, who is the first woman to chair the GMC in its 160-year history, said that the NHS needed to 'remove the barriers' that meant international doctors' skills were not recognised and make it easier for them to work in the UK. In particular, she said that the current process via which GPs who trained overseas apply to join the UK register – the Certificate of Eligibility for GP Registration (CEGPR) – was outdated and in need of reform.

'It’s unwieldy and time consuming. Very often you have to wade through a complete rainforest of papers if you are one of the assessors. We ask our [international] colleagues to provide 1,000 pages of documentation, it costs about £1,500, it takes more than nine months to complete and at the end of it maybe you’ve only got a 50/50 chance of getting onto the register,' the GMC chair said.

'We really do need a different approach to this sort of assessment and sadly legislation in the Medical Act will be the only way we can change it. At the minute most of our aspects are covered by the 1983 Medical Act and that is clearly not fit for purpose.

'If only it was a little more straightforward to register doctors with expertise we could make a significant difference to the numbers that want to come into general practice and a simple law change could help with that.'

Doctor wellbeing

Dame Clare's speech also focused on the importance of improving wellbeing among doctors, which she said was key to building a sustainable workforce.

'There must be a renewed focus on improving your wellbeing and workplaces, driven by a stepchange in culture and enhanced leadership,' she said. 'Lack of supportive cultures and burnout are key risks to the retention and sustainability of the medical workforce.'

The GMC will be publishing a Mental Health and Wellbeing review next month, which will provide practical recommendations on how to tackle the workplace factors behind poor wellbeing.

'At present there is no consistency across the UK and this review aims to change that,' Dame Clare said.

'All the evidence indicates that organisations that prioritise staff welfare and show leadership at a high level will improve levels of patient satisfaction.

'Failure to change risks more good doctors leaving and missing the golden opportunity to develop a sustainable workforce. We know medicine has always been hard. We know it always will be but we must stop making it harder than it needs to be by getting the basics right.'

The GMC chair also reiterated the organisation's support for GPs to be recognised as specialists. Dame Clare said the GMC was actively encouraging the DHSC to bring all medics together on a single advanced practice register.

She said: 'There still is wihthin the medical community some very old0fashioned snobbery about GP training. [Recognising GPs as specialists] would simplify the structure and make crystal clear the parity of expertise held in this room and across UK general practice.'

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