Hospital Dr News

Tougher stance on international recruitment

Patient care will be compromised by new measures preventing hard-pressed trusts from recruiting experienced doctors from overseas, the Royal College of Physicians has warned.

Following the immigration cap for skilled workers entering the UK, trusts had to use the Medical Training Initiative to employ overseas doctors. The MTI allows non-EU doctors to practise in the UK for a maximum of 24 months before returning home.

But now the MTI is under threat. Later this year the Home Office intends to cut net migration and reduce the maximum length of stay for doctors on the MTI to 12 months. Such a short stay would remove any training incentives for non-EU doctors and make it even more difficult for NHS trusts to recruit experienced overseas medical graduates.

The RCP said that, while it supports a fully home-grown healthcare system, there is currently a need for trusts to recruit from overseas and it is vital for patient care that hospitals can employ experienced non-EU doctors.

President of the RCP, Sir Richard Thompson, said: “Through the MTI, NHS trusts not only contribute to the training of doctors in developing countries, but also experienced medical graduates on the scheme help to ensure hospitals in England are adequately staffed.”

The MTI scheme has been criticised in the past for not enabling enough doctors to enter the country and for being bureaucratic.

Matthew Foster, head of international affairs at the RCP said: “Reducing the time limit of the tier 5 MTI will result in an inflexible system and international doctors and health leaders overseas will lose interest. They will go elsewhere and it will be the UK’s loss.

“The current arrangements ensure that the UK continues to maintain clinical links around the world, and support the World Health Organisation’s code of practice on international recruitment of health personnel.”

Professor Rezvi Sheriff, director of the Postgraduate Institute of Medicine, Colombo, Sri Lanka, said: “Training time in the UK is of great importance to Sri Lankan doctors and the continuing development of our health system. After so many changes to UK immigration regulations in recent years, restricting the Tier 5 medical training initiative to 12 months will force our doctors to shift their focus away from the UK.”

Tier 1 and Tier 2 visas were capped; the former allows highly skilled migrants to apply for permission to work or train in the UK without a job offer; the latter allows UK employers to recruit workers from outside the UK and European Economic Area to fill vacancies which have undergone the resident labour market test.

The MTI scheme falls under Tier 5, which allows overseas nationals to participate in government authorised exchanges. The scheme provided 250 two-year placements for doctors from developing countries in 2008 and was expanded by several hundred more by the previous government.

Read the WHO’s code of practice on international recruitment of health personnel.

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9 Responses to “Tougher stance on international recruitment”

  1. joshek says:

    it is ethically unacceptable to recruit doctors from countries that have less doctors per head of population than the uk. end of.

  2. mb says:


    These international doctors that come on the MTI come for a maximum two years for training. They are not recruited for longterm contracts. The purpose of the MTI is to train these doctors to enable them to take new knowledge and skills back to their home country to further build upon their own health system.

    The MTI does not contribute to brain drain.

  3. joshek says:

    Hi MB – thanks for replying. Unfortunately, i find your argument not very convincing – especially when it comes to the knowledge and skills the e. g. Sri-Lankan doctors take back to their country. Apart from the doctors who do not return and are lost to their contry of origin, the medical needs of the e.g. Sri-Lankan population are different from the most commonly encountered pathologies in the UK – which is what these doctors will get trained at in the UK. For example, i am not aware of an obesity epidemic in Sri-Lanka and/or a tropical diseases problem in the UK. How does coming to the UK provide Sri-Lankan doctors with the best training to serve the Sri-Lankan patients?

  4. sk says:

    To joshek

    exchange of ideas, personnel and expertise is part and parcel of today’s life across almost all fields. It only leads to betterment of services and individuals.
    The UK is not the only country allowing for this……It may well stop here but other countries will provide for this growth. I feel the loss will be to the UK which still can’t staff itself as required with local and EU talent. Short staffed hospitals aren’t good for the patients or the doctors in the UK … doesnt affect the populations and doctors of the non European nations as much at all

  5. joshek says:

    Fair point SK — however: Like all of us, I have met a few colleagues from Sri-Lanka. They worked very hard – but none of them had any plans to return to Sri-Lanka – the ones who did not apply for UK training posts and a UK career worked on moving on to the US … totally understandable from the colleagues’ point of view. Now I do not say that my first hand experience gives the overall picture – but … you see what I am trying to say?

  6. wmcc says:

    there are surely enough doctors produced in th EU to fill all the posts needed. It is not acceptable for Trusts to harvest doctors from the developing world like some neo-slave trader. Make jobs attractive enough and they will be filled

  7. Laura says:

    I am not a doctor, my bf is, but I do know a lot about HR. Of course there are enough doctors in the EU to fill all posts – all the hospitals have to do is to make the posts attractive and compete properly in the “Market for Talents”. It is rather obvious that the employers do not want to do this … for the employers to be more powerful than the workers, there needs to be a surplus of workers whom the employers can play against each other and choose from. In order to achieve this situation, the employers try to make the pool of jobseekers as big as possible. It is the done thing in every line of work, every industry. This is why the employers want international recruitment to be made easy for them. The comment suggesting that it was done in order to support international co-operation was clearly a joke.

  8. Nuradh says:

    I am a Sri Lankan doctor, training in Oncology.

    After training for 4-5 years in local hospitals, our postgraduate training programme requires a mandatory period of overseas training of around 24 months. This is meant to give us an exposure and experience in working in a different health care system.

    Many trainees of my country completed this period under the MTI and have returned to my country. As an overall figure almost 80-90% of our trainees return to the country.

    Reducing the tier 5 visa duration would mean that we may have to look to other countries such as Australia to complete this component.

    And Joshek – we do have an obesity epidemic in Sri Lanka !!

  9. Joshek says:

    hi nuradh – thank you for your post! I must have met the exceptions to the rule then as far as my Sri-Lankan colleagues are concerned …

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