GMC forced to register medical students trained overseas

A loophole in NHS legislation allows medical students trained overseas to practise under supervision in the UK, the GMC has warned.

GMC: concerns over registration of overseas-trained medical students

The GMC has asked the DH to amend the Medical Act 1983, so that students who study medicine at a UK institution abroad are not automatically entitled to UK provisional registration.

The regulator raised concerns after UK medical schools established overseas initiatives offering medical degrees to students abroad. Because the courses were offered by UK institutions, the GMC said it was required to regulate them and offer any students who graduated from them a provisional GMC registration.

A report in GMC board papers for its September council meeting said: ‘As things stand the GMC’s statutory framework would result in an entitlement - subject to fitness to practise not being impaired - to provisional GMC registration for students who have trained entirely abroad and may have had limited interaction with patients in English.

‘If such students are granted a UK primary medical qualification, they are eligible for UK provisional registration. In turn, that gives a platform for clinical exposure to UK patients, albeit under supervision.'

The GMC also warned that it had little control in regulating standards at overseas campuses, because ‘the only formal power we have is to withdraw recognition of a UK university completely'.

'It seems disproportionate to do this if our concerns are limited to the overseas campus,' the GMC warned. 'Such an "all or nothing" power is a very blunt instrument.'

The GMC report said it would like to develop a new framework under which it could treat graduates from GMC-approved overseas programmes as holding an acceptable overseas qualification rather than a primary UK qualification.

This would require the DH to amend the Medical Act 1983. But these changes are unlikely to occur for at least three to five years, becuase the Council for Healthcare Regulatory Excellence has told the DH they are not a priority. By this time students in Malaysia and Cyprus will have graduated, the GMC warned.

As an interim measure, the GMC said it would consider requiring students to undertake experience equivalent to a foundation year one doctor. 

To provide ‘belt and braces’ assurance, the GMC said it may also include a requirement to pass an assessment equivalent to the professional and linguistic assessments board (PLAB) test – a test for International Medical Graduates to demonstrate that they have the necessary skills and knowledge to practise medicine in the UK.

Existing UK/Overseas Initiatives

  • The most advanced initiative is Newcastle/Malaysia, which offers degrees in medicine in Malaysia which ‘are identical to those of Newcastle’s UK-based provision, and lead to the award of the same degrees’.
  • Newcastle/Malaysia, received its first students in September 2011. Those students spent their first two years in Newcastle and will graduate in 2014. Subsequent cohorts will undertake their entire study in Malaysia.
  • St George’s, London, has established a similar initiative with the University of Nicosia, the largest private university in Cyprus, to offer the St George's graduate-entry 4-year MBBS (Bachelor in Medicine and Bachelor in Surgery) programme in Cyprus, the GMC said. St George’s University of Nicosia admitted its first students in 2011, who will graduate in 2015.

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