Overseas Exchange Programme - Assisting NHS with Recruitment
The Medical Training Initiative (MTI), designed to allow overseas doctors to undertake up to two years of training in the UK, is already assisting NHS employers with recruitment and fostering exchange programmes with overseas health services and organisations.
The MTI, which went live in November 2008, has the backing of Royal Colleges and the English Postgraduate Medical Deaneries and operates under Tier 5 of the UK Borders Agency points based immigration system which embraces education and training initiatives sponsored by government departments.
Although individual NHS employers are responsible for the employment of the MTI postgraduate doctors - agreeing terms and conditions - all posts also have the approval of a Royal College and one of the Deaneries.
The key stakeholders believe that the NHS benefits from increased medical workforce capacity to support patient care and to assist EWTD implementation. The Initiative will also enhance the international reputation of the NHS for high quality medical training for overseas doctors.
Among the colleges supporting the MTI are The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Paediatrics and Child Health (RCPCH).
Dr Tony Falconer, RCOG senior vice president - international office, says:
‘We have a long and fruitful experience of utilising similar schemes. Philosophically RCOG believes that we have a duty of care to provide education for trainees from overseas.
‘We have embraced all the components of MTI and in the summer of 2009 we recruited new appointees.’
Richard Warren, honorary secretary of RCOG, says the College, which has 50% UK and 50% global membership, has a long history of international involvement and is keen to improve womenís health internationally. ‘We have a role to support education, training and standards globally,’ he says.
He acknowledges that the EWTD has increased the need for more doctors. ‘While we strongly support the consultant expansion as a long term solution, we know that will be a gradual evolution.
‘But in the meantime, the MTI can help to provide the extra well qualified middle grade doctors needed to support EWTD compliant rotas during that evolution.’
Mr Warren believes that the two year MTI should be extended by six months to allow ‘a period of acclimatisation’ in which doctors could gain experience of the UK health system and its technologies.
‘Although the doctors may be well qualified, they may not have practised some of the technologies which we take for granted or have the organisational skills necessary to play a full role in the service and gain the most from the current two year period,’ he says.
All RCOG sponsored programmes include an induction period of between three and six months, in which doctors work at a lower level and with greater supervision than in their own countries.
Dr Mary McGraw, vice president for training and assessment at RCPCH, reports that in August this year (2009) 30 MTI doctors approved by the college were already in post and a further 27 with job offers were being processed.
She says the college has particularly strong links with Sri Lanka, where trainee doctors are required to spend one year overseas. The College is also the external assessor for some examinations. ‘This means that doctors from there fit easily into our system,’ she says. ‘Most come for clinical rather than research experience.’
Dr McGraw believes that the MTI benefits both the trainees and the NHS. ‘The trainees gain access to experience they cannot get in their own country which will enhance their individual learning and, in the long term, the health of the children in their own countries.
‘It also strengthens our long standing international relationship with countries which we greatly value.’
Dr McGraw says the NHS is enhanced by the ideas doctors bring from other countries, allowing the UK to consider different perspectives.
She believes the two year period should be more flexible. ‘For example, if a doctor with a lot of general paediatric experience comes to the UK to learn about clinical management, they may be able to acquire a lot of knowledge in a relatively short time,’ she says.
‘But if they want to develop in a specialist area - learn about dialysis or transplantation - to establish that service in their own country, they are likely to need much longer.’
She believes that ‘there is more work to be done here and abroad’ in promoting the MTI and wants to establish links with overseas organisations who can act as local sponsors for the Initiative.
The Initiative has also been used to attract a group of Egyptian military surgeons to the UK who plan to divide their time between clinical practice and research. In September (2009), the first 15 of up to 40 surgeons arrived to take up posts with different trusts.
Under the arrangement, the university fees for the surgeons, sponsored by the Royal College of Surgeons of Edinburgh, as well as Imperial College and individual trusts, will be paid by their Egyptian employers and their salaries by the trusts.
The recruitment was led by Nigel Standfield, head of the School of Surgical Specialties at Imperial College, London who has long standing links with the Egyptian military medical teams.
With two UK colleagues and two doctors from Egypt, he interviewed over 70 surgeons in Cairo whose expertise ranged across many specialties.
Working Time Directive 2009 
