Strict new immigration rules are creating problems with recruiting junior doctors from overseas and leaving hospitals short of staff.

Gynaecological services at Erne Hospital in Enniskillen, Northern Ireland, were suspended recently because only one of six new junior doctors recruited from the Asian subcontinent was able to start work on time. The doctors have been told it will take at least 9 to 12 weeks for their work permits to be issued.

“It is bureaucracy gone mad,” said Professor Mahen Varma, a cardiologist at the hospital.

In South Wales, the Abertawe Bro Morgannwg Trust has recruited nine middle grade doctors from India who are waiting the green light from UK immigration. The trust currently has 73 vacant doctor posts at all grades, according to figures collected by South Wales West Welsh Assembly Member Alun Cairns.

Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin (BAPIO), said they had heard of similar problems across the UK with the Working Time Directive making the situation even worse.

He said the problems related to bureaucracy created by the new Medical Training Initiative (MTI), launched in February, which allows international medical graduates (IMGs) to work in the UK for two years and then return home.

The immigration process involves paperwork from five organisations - the royal colleges, deaneries, the GMC, NHS Professionals and the Home Office. 

BAPIO has proposed that all the paperwork should be coordinated by the royal colleges. It has also asked for IMGS to be allowed to stay for longer than two years because it takes them six months to settle in and that they should be given more training under the scheme.

“The immigration process for IMGs is taking too long while hospitals have acute shortages of doctors. These people in their ivory towers should wake up and let these doctors come here and get on with some good work,” said Dr Mehta.

A Department of Health spokesman said: “We are not aware of any delays caused by immigration, however, we will respond to any issues raised with us.”

He said the royal colleges could never take over the role of UK Border Agency (UKBA) or issue the overseas visas. 

But he said the current length of leave for IMGs to stay in the UK and proposals to increase training benefits were currently under discussion.

“The DH continues to work closely with UKBA to ensure the MTI can bring maximum benefit to IMGs and the NHS,” he said.

It’s planned that MTI will provide 750 placements a year for IMGs.

Employers are being warned not to exploit overseas junior doctors taking up new training placements in the NHS through the new Medical Training Initiative (MTI).

The MTI, which provided 250 two-year placements for doctors from developing countries last year, is now being expanded in stages to provide up to 750 opportunities.

Dr Ramesh Mehta, president of the British Association for Physicians of Indian Origin (BAPIO) fears the scheme could be used as a mechanism for filling posts left vacant following the April 2006 immigration ruling that led to the exodus of thousands of international graduates.

“The Department of Health should come clean on the service needs that have made such an initiative necessary. BAPIO’s policy has always been to press for proper workforce estimations and allowing the required number of overseas doctors to enter the UK and then giving them the opportunity to make progress by treating them on merit,” he said.

Dr Mehta said employers must ensure that MTI doctors are given proper induction, mentoring and training and the same pay as UK trainees to ensure they are treated fairly.

“Also it is important that it is made clear to these doctors at the outset the details about their prospective jobs and that this training will not lead to further career opportunities in the UK and that their training may be aborted if they do not demonstrate necessary competencies,” he says.

Juniors are voicing similar concerns. Delegates to the BMA’s recent Junior Doctors Conference, who noted that the scheme has striking similarities to the Permit-free Training Visa, passed a motion calling on the government to ensure that training places are genuine and of high quality.

Health minister Ann Keen said the MTI will enable international medical graduates from countries where medical training was not widely available to secure “vital” training and work experience in this country.

BAPIO’s view on the issue