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International medical graduates : a fairer future

Discussion paper on a single application process to international foundation posts in the UK
Junior Doctors Committee (JDC) of the BMA and the British International Doctors Association (BIDA)
August 2005

Background
There is an increasing number of international medical graduates (IMGs) coming to the UK with an unrealistic expectation of finding work and being trained in training grade posts (please see Appendix I for background information). IMGs in the UK face prolonged financial and emotional hardship, unemployment, exploitation and discrimination, with little hope of eventual employment or training benefits.

Competition for junior doctor posts is ever increasing. On average 400 applications are made for each house officer advertisement and 210 for each junior doctor advertisement, with recent ads attracting over 1,000 applications. The reasons for this are diverse and include the facts that:

• since 1999 the number of medical school places has expanded to address the general shortage of doctors in the NHS but the number of junior doctor posts has not been increased to accommodate the increased number of graduates
• there is a deficit in deanery funding which means that deaneries cannot afford to give educational approval to many of the new trust grade posts that trusts have created to meet local demand and to meet targets for EWTD-compliance
• a number of SHO jobs have been subsumed into foundation year 2 posts
• overseas recruitment campaigns and an increase in the capacity for the GMC’s PLAB examination have increased the number of international junior doctors looking for training posts in the UK.

This situation is likely to worsen during the transition phase between the current training system and the implementation of MMC. SHO jobs are being phased out, trust grade posts are increasing to fill the consequent service gap and by August 2007 the legacy cohort will need to compete with emerging F2 trainees for training numbers in the new specialty training grade.

Increased competition for posts increases the chances of discrimination in the shortlisting process of applications.