Newly trained doctors-you need to know this

From the NMC Fitness to Practise report 2024/25 - https://www.nmc.org.uk/globalassets/sitedocuments/annualreportsandaccounts/2025-annual-ftp-report/annual-fitness-to-practise-report-20242025.pdf?tid=rYSMkpZPgM-vDKRimNjqiQ%3D%3D&tuuid=mapoSl2nTyOMnTziT5iTrA&tq=nmc+the+code&ttags=language%3Aen%2Csiteid%3Ad6891695-0234-463b-bf74-1bfb02644b38%2Candquerymatch&thit.id=NMCWebModelsMediaDocumentFile/5b9316b2-4f1f-4e03-97b6-52a3669c29ca&thit.pos=2913

In 2023, we became aware of anomalies in the data of a third-party testing centre, the Yunnik Technologies Test Centre in Nigeria. Investigations determined that the overall pattern of test-taking was statistically significantly quicker than at other test sites. We invalidated all tests taken at the site (affecting 1,995 individuals) and where we had concerns that someone had achieved their test score fraudulently, we took the following action:

So you’re choosing to ignore the “industrial scale Nigerian qualification fraud” currently being investigated which includes the English tests.

Nope no automatic assumption that HCPs from abroad are inferior but recognition that NHS training is world gold standard and we as tax payers are paying for it. As such I’d like to benefit from that and have more NHS trained staff treating vulnerable members of my family.

The mental health sector which is a sector where communication and quality training is key is dire from psychiatrists down and when you have vulnerable autistic people being treated by staff from a culture who believes they are possessed by the devil and should be dead it’s massively worrying for parents.

It’s great you don’t need to worry about that but vulnerable patients and their carers do. It’s a scandal/ tragedy waiting to happen.

I work with many many doctors of all nationalities the vast majority I’ve met speak good English, I accept that 30-40 years ago this might not have been the case especially in the specialities it was hard to recruit in. But in the last 20 years all I’ve met speak good English I rarely if ever see idiomatic differences. I’ve just had a Zimbabwean and a Greek doctor closely shadowing me both had arrived in the UK fairly recently. In both cases I observed caring interested doctors who took time with their patients and were perfectly understandable and in both cases the patients they met were very impressed and gave positive feedback.
I live and work in a region in the UK with a very strong accent (I’m not local) with some idiomatic differences that I’ve got used to now but I have at times completely misunderstood what my white British colleagues mean (much to their amusement) and they probably say the same thing about me and maybe even the patients I care for might say it and because the accent is so strong I frequently have to ask colleagues and staff to repeat something or slow down. But somehow or other we all get by.
Over the years I’ve listened to many of my colleagues “explaining” to patients what’s wrong with them. I’ve listened to highly educated white British colleagues explain to a patient that they have X or Y and I know what’s wrong with then
and don’t understand what they are trying to say. I’ve also been that relative listening to a doctor about a family members illness and I understood what we being implied (very poor prognosis etc) but my DH and his sister didn’t get it at all as it was all cloaked in a mixture of medical language and an inability to spell out the problem clearly. Again a white British doctor who was probably very articulate away from work but didn’t really know how to break very bad news.
On the other hand I watched an amazing Srilankan doctor born and educated there talk to a distressed parent about his child’s very poor prognosis.
We cannot generalise.

Well at least you won't have to worry about doctors from other Englush speaking countries - as I understand it, they are not interested in working all hous for the NHS for rubbish pay and living in a crowded crime-ridden country.

I'm not seeeing racist comments, I'm seeing concerns raised about the numbers of people in our hospitals who have a poor command of the English language which makes communicating with them difficult. I have experienced it more at nurse level but people I think may be nurses may be HCA's wearing a similar uniform. It happens a lot in the big London hospitals, particularly in outpatients.

I have had a couple of particularly difficult exchanges with Nigerian Drs who have, frankly, been very rude. It isn't a recent problem either. Similarly I've dealt with as many home grown doctors who have been equally rude and dismissive. Poor communication is never acceptable but it is easier to make a complaint about a White Brit than an overseas national because there can be no assertion of racism. Poor communication and rudeness are what they are and it should be possible to deal with for what they are.

Equally some of the nicest and most helpful Drs and nurses have been overseas nationals and not white.

I think this is partly true. And I will start by saying that there are some excellent overseas nurses and carers working in our health services - but in my substantial experience, they are the minority. I’ll also say that not all UK trained nurses are great and some leave a lot to be desired.

To practice in the UK, overseas nurses need to provide evidence of meeting NMC English requirements for example having been taught and assessed in English, or pass the English language test. They also need to pass the NMC OSCE - so there are checks there.

So for me, it’s more about the differences in cultural aspects. One of our regional hospitals is now about 70% staffed by Nigerian nurses and porters/domiciliary staff. I’ve experience of the level/type of care from a professional and personal perspective. And they just don’t have the same overall empathy and caring values as locally trained nurses.

For example, one Nigerian patient (an elderly gentleman with prostate cancer who was actually the father of a nurse who’d come here) told me that in Nigeria, most of the hospitals didn’t even have call buzzers so there was no expectation to answer them. Families were expected to come into the hospital to care for their relatives - the nurses/nurse assistants didn’t do “personal care”.

They are also not educated about dignity and person-centred care - patients are just expected to do as they are told, not to have a person centred care plan like our student nurses are required to learn.

There is also the challenge of not being conversant with local dialect/colloquialisms and really thick accents which make communication very challenging - an English language test cannot test this. There was the case where someone died in a care home in England because the nurse making the 999 call could not fully communicate the problem owing to her spoken English.

As a nurse, I feel quite strongly about this and I’ve written about this on many threads- no young 20 something adult Nigerian male is coming to the UK because his dream is to look after elderly British people with dementia, frailty and multiple health conditions - they are coming for the visa and the money and T&C’s the NHS offers.

We really need to make nursing more attractive and be able to fully staff our own places of care.

And agree about the doctors - one medical student (who is about to qualify) I spoke to last week told me he had a 1-in-14 chance of getting any job, anywhere in the UK. Ok they are not bad odds if you’re gambling, but we should be employing all graduating doctors who want to practise medicine or else it’s just been a massive waste of money.

Probably because the NHS don’t do the training anymore, the Universities do it and there’s no joined up thinking, when I trained I was employed by the NHS within the hospital’s school of nursing, they knew what was required, you were trained to a high standard….the unis do not care about competence or patient care, they only want people to pass so they get the funding

But the issue has been caused by international doctors applying for the roles. Otherwise the number of training places would match the numbers graduating from medical school.

Also it isn't just a problem for doctors. Many nurses seem to be in the same position.

The answer to me seems simple. Current Uk residents should get priority for jobs. If the vacancy can't be filled it should then be possible to consider overseas applicants.

This is alarming. I have a teen dd who is very keen to study medicine - obviously I know about the challenges within the NHS but I didn’t know how impossible it is to get work when you are newly qualified.

What’s the solution? Is this likely to change?

And yet there are many many doctors from overseas who have very thick accents and are difficult to understand. I have spent a lot of time taking my mother back and forth to hospital. Her consultant who seems very nice is so hard to understand that we both come away from appointments none the wiser.
surely there should be some test. I know this Dr has all the words and can probably write well but his pronunciation is heavily accented.

It's a massive problem

DD is graduating as a physio next year along with hundreds of others. There just aren't enough jobs available for them all. She is thinking of going to work in NZ.

Nephew due to start F1 next year. He is already thinking of going into pharma work when qualified as so few clinucal jobs available for qualified doctors. And friend's son has recently completed GP training and cannot get a position anywhere in the greater Manchester area (where his wife works and they have a house).

It's depressing.

But your figures do not include 3200 retiring, and 4800 non uk doctors returning overseas!

Can i just add that nurses that come from other countries, have to go through a process and exams to prove that they can nurse to U.K. standards. They can’t just walk into a job. It’s more nuanced than that, but that wouldn’t appease the openly racist this themes on this thread would it.

Also Harold Shipman.

UK. trained old fashioned family doctor. It’s almost like anyone of any colour in any trusted profession can commit terrible crimes.

F2 doctors are fully registered. F1s aren't.

You’re missing the fact that this is about a lack of doctor training spaces. This is not about fully qualified doctor roles, which ARE frequently filled by fully qualified doctors from overseas.

That's what I said. FY2 are not full drs yet.

But the data for Drs from abroad, that is full post specialisation drs.

They are not the same thing.

Surely the government could fix this problem extremely easily by only allowing those currently without the right to reside in the uk to apply for roles as doctors and nurses if the job had first been advertised to those already here and no suitable candidates had been found.

The fact the BMA is a mess doesn't stop the government from doing this.

What am I missing?

I think this debacle is disgusting. Our government(s) seem incapable of investing in our young people at every level or predicting future needs and trends. I am sad for the newly qualified doctors and nurses who are having to leave their country and I am even more sad for our country to be losing them.

Nowt to do with racism - communicating with patients ie fluency in English is a job safety essential.

If you can’t understand your patients or colleagues, the people you’re shitting on most are locals who don’t have English as first language.

Translators work globally with English. Lots of Londoners need them.

Patient safety is non-negotiable. Avoidable deaths rising now in hospitals because no one can identify patient language - we don’t want to enable the doctor to start finishing people off too.

It’s not the government who doesn’t want to pay for doctors - it’s the general public.

We’ve had endless threads on here around the budget, moaning about the amount of tax.

These training places are an investment in the future of our young would be doctors and the NHS, but they need to be paid for somehow. It is politically difficult for Labour to impose tax rises, so how are they meant to be paid for?

I think you can dispense with the second half of your sentence and put a full stop after crap.

But it's been the same for successive governments. Health and health planning should be absolutely removed from party politics. It's FAR too important. All that's being done is tinkering around the edges of a system that's utterly utterly broken, yet no government has the balls to take it on, convinced as they are that the great British public is ideologically wedded to the NHS, when actually it's that significant numbers of the great British public are ideologically wedded to receiving endless free healthcare they don't have to pay anything. And so it gets worse...and worse...and worse

It should be removed from the realm of politics and put into the hands of actual experts, and a more sustainable system put in place. But it won't because after eighty years, it's far too late for that. So going forward, people who want to be treated, alongside the high taxes that are levied to fund it, will have to also pay sky high insurance premiums for private healthcare. Except...there's still the staffing issue. So what do we do? Cross our fingers, look after ourselves and pray for good health I guess.

She's right. It is racism. The automatic assumption that because a HCP comes from overseas that they're inferior. Which is ridiculous because the UK puts the checks in place when we recruit them.

I've read this morning about the requirements within the Nigerian nurse training system. 7 or 8 years of training to become a nurse. Requirement to pass IELTS to work in the UK (English language tests).

I've had a lot of medical treatment/surgery over the last 15 years (cancer). The ONLY poor quality staff I've encountered have been white British staff. The nurse that ignored me post op after a 13 hour surgery, leaving me crying and in pain. The doctor in A&E that dismissed my problem, which was genuine and then turned into a much bigger problem, requiring many other treatments costing a lost more. Both British trained.

Every surgeon I had was non-British. And I'm here 15 years after a very high grade, aggressive cancer, because they saved my life.

There are plenty of job vacancies for doctors (foreign doctors apply for them) but there aren't enough training posts for newly qualified drs. Training posts need to be increased but until we train more UK graduates, someone needs to fill in the current positions for trained drs which can't be filled by the new graduates.

Just to mention, I had a really really bad experience with a male doctor from a different culture years ago. I still think about it sometimes and regret not reporting him somewhere at the time and I wonder if he's still working with patients... He was trained in the UK though but how was he allowed to come near any patients - I genuinely don't know.

No, it is for places on the training schemes to become a cobsultant or GP as well as for jobs after that. Government doesn't want to pay for doctors