Can your overseas medical degree help you climb the UK career ladder?

by Leo    11 Comments    Posted under: Career, International

Can I make it in my chosen specialty in the UK with an overseas degree? Doesn’t the NHS just look after its own?

This is a common question i’m getting asked lately. It seems to originate from two groups of people.

There are those that are are already at, or about to start at an overseas medical school and are worried that moving to the UK might not afford them the same career opportunities as it does for local UK graduates.

A second group of individuals are worried that they may not make the cut for medicine this year and are thinking about taking up an expensive place at an overseas medical school. Commonly this might be in the Czech Republic, Romania, the West Indies but also elsewhere.

Let me start by saying something a little controversial.

The NHS has historically discriminated against foreign medical graduates whenever it has found itself in a comfortable enough position to do so.

This situation does not commonly arise and certainly woud be unlikely to apply to all areas.

So to a large extent it depends on what you want to do and the current job situation within the NHS.

To explain this, let me give you a bit of useful background that you should already be aware of.

In the 1960s plenty of consultant and GP posts were taken up by foreign graduates who had been encouraged to the UK and had also done most of their postgraduate training overseas. The UK was desperate for doctors due to a major shortage and there were plenty of them arriving from Indian and Pakistan. These were deemed to be of exemplary quality by none other than Enoch Powell who lead the call for overseas recruitment.

Why?

Well you see, the UK repeatedly gets its medical workforce planning terribly wrong due to perennial political interference. The shortage of the 1960’s happened because of a planned cut in medical school places by the Willink Committee of 1957 along with vast numbers of British doctors emigrating to find better conditions in the US and elsewhere.

By the 1990s however, graduates from India and Pakistan as well as other less well off countries suddenly found it much more difficult to climb the career ladder and find suitable specialist posts.

There were accusations of discrimination from well qualified foreign specialists who found themselves stuck in staff grade posts with no clear route to consultant jobs which often seemed suspiciously reserved for British graduates.

Clearly there were more local graduates in the pool now and the NHS could now afford to pick and flick accordingly.

By 2005 disillusioned foreign doctors in some specialities were already leaving after realising that the path ahead was pretty well blocked for them in the UK. Even UK graduates found that competition in some specialities, particularly surgery had stiffened with tens of applicants per post. Many left for Australia and many abandoned their hopes of ever getting ahead in their first choice specialities.

Of course those who set their goals elsewhere may not have noticed the change and in the world of pathology and psychiatry there was an ongoing recruitment drive that also helped mop up the fall out from more competitive areas.

That’s a long winded way of saying that you can’t trust the system to always help you out paticularly if you’re aiming for something competitive or lucrative in the long run.

For example, who knows whether dermatology will be as competitive as it is today in five or ten years time when you are finally applying for specialist posts. If it is, you may find that a foreign degree is indeed a disadvantage and you will need to show a more bejewelled CV to muscle past the local favorites.

However most applicants to medical school are just happy to get a place and to have a shot at becoming a doctor at the end of the process. If the speciality and the region in which you end up are not critical you probably* should not be worried.

How to ignore the above and rise above the competition
My final advice to anyone with an overseas medical school education and a firm desire to work in a competitive area in the UK would be to start sorting your CV out early.

If you have two original papers in the BMJ and a review article published in the lead speciality journal for your intended area of interest, you stand an excellent chance of getting through. Those are difficult things to get done and will take months and years to accomplish. Consequently they carry great weight and will eat up the competition. The majority of UK graduates at present leave medical school with a CV that may as well be blank when it comes to postgraduate competitiveness.

So, decide what you want to do early, and make contacts in the relevant fields. They will give you research ideas and guidance.

On the other hand if you’re sure you’d be happy as a salaried GP in a small town far away from London, relax, enjoy the sun (yes, SGU Carribean) and work on your golf swing.

And don’t fail finals.

*Unless a policy maker somewhere really screws it up. This is common.