GMC tightens PLAB test rules for overseas doctors

The GMC has announced plans to toughen up tests for internationally-trained doctors seeking work in the UK, in a move that officials admit could limit the pool of doctors available for the NHS.

GMC chief executive Niall Dickson
GMC chief executive Niall Dickson

The GMC has said it will overhaul the Professional and Linguistic Assessments Board (PLAB) test to make it ‘more thorough’ and potentially harder to pass from September this year.

With a quarter of doctors in the UK being trained overseas, the GMC acknowledges that changes to tighten up the test could have an impact on the number of doctors eligible to work in the UK.

The regulator said the changes were to ensure the test was more robust and reliable, and it was not trying to create a barrier to entry.

International graduates who qualified outside of Europe must take the current PLAB test to assess whether they have the knowledge and skills necessary to practise in the UK. It consists of a written knowledge test and a practical assessment of clinical skills.

In the last year, the pass-rate for the knowledge test was 69%, while 68% of applicants passed the practical test.

Overseas doctors

The changes will allow the practical test to ‘better reflect’ real life consultations in the UK health system and test hopefuls on a wider breadth of knowledge in the written test, the GMC said.

Tests will take longer and assess candidates’ professionalism and understanding of ethics in addition to their clinical skills.

Applicants will face limits on the number of attempts they are allowed to take the test, and only be allowed to apply for a licence to practise in the UK within two years of passing.

Longer-term plans will see the PLAB replaced by a different test altogether, provisionally called the medical licensing assessment (MLA), which will act as a ‘unified assessment for doctors seeking to practise in the UK’.

This new test, to be implemented ‘at some point in the future’, will give assurance that both UK-trained doctors and those trained overseas have been examined and evaluated to the same high level, the regulator added.

Tougher requirements

Chief executive Niall Dickson said: ‘Doctors working in the UK must have the knowledge and practical skills to practise safely and effectively and they must demonstrate the professionalism patients expect.

'To make sure they are of the highest standard we are introducing changes to modernise the entry test for overseas doctors, making it even more robust.

‘The contribution made by doctors who come here from outside Europe is invaluable to healthcare throughout the UK  and these changes will provide additional assurance to patients that they have passed a stringent assessment and have demonstrated high standards of care and knowledge.’

Professor Vikram Jha, head of undergraduate school of Medicine at the University of Liverpool, chairs the panel for the PLAB practical test. He said: ‘The practical test has been fully revised to make sure it genuinely reflects best practice in medical assessment.

‘The longer, more integrated scenarios are more authentic and require candidates to demonstrate how they apply their knowledge and skills to provide safe patient care. That, along with a new way of setting the pass mark for the practical exam, will enhance the reliability of the test, making sure that only those  doctors with a good level of knowledge and skills are allowed to practise in the UK.’

GPC deputy chairman Dr Richard Vautrey said: ‘I think patients and the public need to be assured that every doctor that works in the UK has got a good grasp of communication and language skills that allows them to deliver safe and effective care.

‘I think the principles of those coming in to work within the NHS need to be able to deliver a service that is acceptable to all patients. As long as the system is fair and proportionate, then patients will be reassured.

‘In terms of doctors coming to the UK, those who are considering doing that shouldn’t have any difficulty demonstrating the necessary skills.’

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