Thursday, 14 May 2009

GMC in denial

The story of the German GP who negligently killed an English patient whilst working as an out of hours GP locum has been in the news a lot recently, and quite rightly so. It appears that this was not an isolated incident either, this GP was clearly way out of his depth and other patients died that day.

I do not wish to dwell on this case because it is the theme that is important, the theme being the fact that non-UK trained doctors from the EU can easily register with the GMC after only the most minimal of checks, they are then free to compete with our own doctors for jobs, despite the fact that their education and training may not be nearly comprehensive enough to prepare them for the work they will be doing in the NHS. We now know that these EU trained doctors can then kill patients negligently, return home, receive the lightest of punishments and then return to practice as if nothing has happened. This is a disgrace.

If there is going to be a free market of labour in the EU in terms of health care work, then there must be a rigorous system of regulation in place that holds people to account if they make negligent errors whilst working away from their homeland. The blame lies squarely at the door of the government who have signed us up for this free market of labour without thinking of the serious consequences of a dangerously patchy system of regulation. Any doctor working in the NHS will tell you how they have encountered several non-UK trained doctors from the EU who have shockingly bad language skills and who lack even the most basic of medical knowledge, yet strangely they had no trouble getting their full registration from the GMC. This is not good enough.

There are many medical schools in certain EU countries that do not train doctors to the level of competence that our own UK graduates achieve, however the GMC cares not for the standard of your medical degree, any EU degree is good enough for them, while their language test is so easy that even a martian could secure top marks. Bizarrely excellent Australian and New Zealand graduates are now faced with a mountain of stupid paperwork before they can practice in the UK, while some of their dangerous counterparts from the backwaters of the EU can get in without any trouble at all. Well done the government and well done the GMC. Although the free labour market helps you push people around, it is killing patients at the same time, well done.


Anonymous said...

There are many medical schools in certain EU countries that do not train doctors to the level of competence that our own UK graduates achieve...


How true, but few more years of dumbing down the NHS will soon level the playing field


Dr Aust said...

Do you think a national qualifying exam, taken in English, and which ALL doctors would have to do before being allowed to practising in the UK, would offer any kind of solution, Ferret?

Garth Marenghi said...

Not a bad idea.

The US have the USMLE and won't accept anything less, why don't we do the same.

The problem is we do need to import a lot of doctors for a lot of posts, so it would be unworkable to do this for everyone.

However maybe some degrees should not be accepted as they are not up to standard.

Dr Aust said...

Hmm... but how would you tell which ones?

Speaking as a University type - though my expertise in "international comparisons" is in bioscience degrees - it is incredibly difficult to know which degrees maintain what standards when it comes to o/seas Univs. Basically, when we get applicants for PhD places from students in the former Eastern Bloc countries, we have to contact our academic mates in the relevant country and ask "Is this Univ a serious one? Where are they in the national pecking order? How do their students compare?" But doing it officially would be politically very fraught.

The attraction of insisting on a standard pre-practice exam in English would be that it gets around all this.

For Western European countries you can probably assume a broadly common standard within a country, though different countries must surely vary. I expect medicine is a bigger problem here than life science degrees, as the way medical courses are structured varies widely. I remember I used to work with a couple of Spanish medics-turned-academic-researchers 25 yrs back, and I recall them telling they had graduated from medical school in early 80s Spain without ever seeing a single patient.

There is, I hear, a move afoot in the EU to insist that all medical schools "harmonize", with the object of allowing students to potentially transfer from, say, end yr 2 in Med School A in Italy to start yr 3 at Grumblefield Univ in the UK. I can't see it, myself, unless absolutely everyone reverts to an old-style "2 yrs preclinical, 3 yrs clinical" set up. But the word has definitely gone round our Med School that this is "in the wind".

Anonymous said...

I don't think the standard of medical graduates from UK medical schools is at all the same. Some schools produce much better doctors than others.

There is no common standard. Just as there is no real common standard for PhDs or MDs.

A lot of people know this but you only hear it whispered in corridors. It is a very sensitive issue to suggest that some UK medical schools are not up to the standard of others.

the a&e charge nurse said...

Ferret - did Dr Ubani train in Germany or elsewhere (I understand he practices in Germany)?

Either way, which system of medical training is so dire that doctors (after qualifying) still do not understand the properties of opiates, or if in doubt, where to find information about this drug group?

It's the sort of schoolboy error I would not expect a nurse prescriber to make.

Garth Marenghi said...

interesting points raised.

i agree there's a hell of a lot of variation between medical schools, even in the UK.

maybe if a country has even one medical school that is not up to scratch then everyone from that country should have to pass the standardised UK exam.

however if a country is regarded to have a good system then we could accept people without any exam, for example NZ and australia.

if a country has a good standard but isn't english speaking then an english medical exam should still be obligatory.

the harmonization idea sounds like utter EU tripe, in practice it will be a huge disaster.

one example i have heard of recently is an african doc who cam over for fy1 training having done a degree at some awful uni in poland, he doesn't know a bloody thing, not even how to treat a chest infection, a pe, or what aspirin is! amazing