ACCESS TO POST-GRAD MEDICAL TRAINING RESTRICTED
(6 February 2008)

New immigration rules that will restrict international medical graduates' (IMGs) access to UK post-graduate medical training were today welcomed by the Health Secretary Alan Johnson. The rules impose a condition on general migrants and Highly Skilled Migrants prohibiting them from taking a post as a doctor in training. The new rules take effect from 29th February. The new immigration rules are expected to reduce the potential pool of new migrant applicants by between 3,000 to 5,000 in 2009.

They will not impact on recruitment until 2009 and will prohibit the following people from accessing post-graduate medical training posts:

From February 29th

• Migrants from overseas who are applying to the Highly Skilled Migrant Programme (HSMP)
• Migrants already in the UK who are applying to switch to Tier 1 (General)

From April 1st

• Migrants in India who are applying for entry clearance as a Tier 1 (General) Migrant.

The following people will be exempt from the regulations:

• Those who currently have leave to remain in the UK as a Highly Skilled Migrant
• Postgraduate doctors or dentists who are seeking leave to remain as a Tier 1 (General) Migrant

These are temporary changes to the immigration rules. The Department of Health is considering longer-term solutions that will ensure the policy of self-sufficiency is achieved.

In the 2007 specialty recruitment, there were nearly 28,000 applicants for around 15,500 training places in England, a ratio of 2:1. Around 45% of applicants had trained outside the EEA. It is estimated that at the end of the recruitment in 2007, over 1,300 applicants from UK medical schools had not secured a training place in 2007 because of competition from applicants who trained outside the EEA. We expect a similar number to be affected this year. This does not mean that they cannot work as doctors as there are other employment opportunities for UK medical graduates in the NHS. It does, however, mean that they were not able to progress their careers in a training place.

Because of the high numbers of potential IMG applicants that will be exempt from the Home Office regulations - currently estimated at around 10,000 - without further action on top of the new immigration rules the Department estimates around 700 to 1,100 UK doctors will be displaced and unable to secure a training place in 2009, 2010 and beyond.

Therefore, the Department is today beginning a consultation setting out proposals for managing applications to the foundation and specialty training programmes from Highly Skilled Migrant doctors with leave to remain in the UK. Our preferred option is to implement guidance stating that IMGs should be considered for post-graduate and specialty training posts in the NHS only if there are no suitable UK or European Economic Area (EEA) applicants.

The Department consulted on issuing this guidance for specialty recruitment in both 2007 and 2008. The Court of Appeal ruled that this guidance was unlawful. However, the House of Lords is hearing the Department's appeal on February 28th and we expect a decision in May. If the Department's appeal is successful, the guidance could be implemented in time for the next round of recruitment on June 1st.

Most international medical graduates who come to work or train in the NHS do not stay very long - over half leave within four years of joining the NHS. Ultimately, the NHS loses the trained GPs and consultants it needs when IMGs leave.

Alan Johnson said: "Doctors from overseas have played an invaluable role in the NHS for many years and will continue to do so. They have helped us fill key shortage areas such as psychiatry, obstetrics and gynaecology, and paediatrics. But as the number of UK medical school graduates expands, there should be less need to rely on overseas doctors for these specialties.

"It can cost up to £250,000 to train a UK medical student and, with the increase in UK medical schools, we are moving to a policy of self-sufficiency. If UK medical graduates cannot access specialist training because of a large number of applicants from outside Europe, then it is only right that we should consider what needs to be done.

"I cannot stress enough that we are not closing the door to international doctors working in the NHS. These new rules only apply to training places in the UK. International doctors will still be able to come and work in the NHS in thousands of other non-training posts and will still be able to fill training places in shortage specialties."