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Fast tracking for overseas doctors in UK
Fast tracking for doctors in UK
The problems that overseas doctors face in obtaining full registration to practise in the UK might be considerably eased if they were trained in the non-clinical skills expected on a British ward, said Dr Akram Sayeed, chairman of the Overseas Doctors Association, in response last week to the General Medical Council’s new guidelines, which are aimed at speeding up the process for full registration. : By law, overseas-qualified doctors must . gain limited registration before they can . practise in supervised clinical positions in the UK. During limited registration, valid for a maximum of five years, the doctor must obtain the experience and qualifications necessary to satisfy the General Medical Council’s standards for full registration. With full registration, a doctor can apply for non-supervised positions. The
Improvements
to US
having
defined as that which makes inroads on addiction-related social problems-eg, crime, AIDS, and drug-addicted infantsrather than simply on treatment outcome for individual abusers. They drew attention to gaps in the system that fail to link programmes
with
those for AIDS patients; about half the persons with drug-abuse histories who come in contact with AIDS outreach programmes and the criminal justice system have never been in a drug-abuse treatment
:
programme.
Despite
research
showing that
persons
who stay on treatment for several months reduce drug usage, improve their personal health and function, and are responsible for reductions in public health and safety concerns, there remains a shortage of programmes capable of providing the required comprehensive care. In 1990, 42% of all treatment facilities reported
1230
this function would not be in the council’s remit as the registering body. Dr Douglas Buchanan, lead health consultant at the British Council, thinks that it is the Department of Health that should take the initiative. But if, as is likely, such an initiative on the part of the department would require prospective employers-NHS trusts in the main-to finance such an induction period, overseas doctors would become less attractive
potential employees. The new guidelines, to be presented to the full General Medical Council on May 23 and 24, are available from the GMC, 44 Hallam Street, London WIN 6AE, UK, for comments
Sarah
applicants than they could Although successful treatment
Despite huge
services such as medical and mental health care, behavioural counselling, and social services, most services are not
comprehensive enough
to
provide
them. Research reveals that only 29-8% of those with drug-abuse disorders receive any of these services. Eight states do not allow methadone as a treatment for drug addiction, although there is emerging consensus among scientists that proper use of the drug produces successful outcomes. Research shows that in states where methadone treatment is allowed, doses often are too low or treatment course too short to yield optimum results.
: : : :
!
Likelihood of transplant law in Germany at last that, after nearly 20 years of discussion, Germany will have a transplant law by the end of 1995 are high.
The chances
Ramsay
sums spent annually on for adolescents, no treatment has demonstrated superiority over other treatment or even over no service at all. This, they said, is because of the failure to conduct scientific studies that compare treatment outcomes. Major reform and research initiatives have advocated service systems for adolescents that are familycentred, community-based, child focused, individualised, comprehensive, less and accountable for client outrestrictive,
treatment
requires
Leading researchers, selected by the US National Institute on Drug Abuse, have informed state and federal health policymakers that current drug-abuse treatment leaves a large gap between knowledge and practise. There is thus an urgent need to re-examine drug-abuse treatment programmes and to lay out a broad new goal that emphasises public health policy solutions, they pointed out at a meeting sponsored jointly with the New York-based Milbank Memorial Fund, which will publish the policy recommendations. : The public, the researchers said, should be educated to consider drug abuse as a chronic, relapsing disease such as diabetes or hypertension, which has multiple outcomes and must be managed over time. Successful treatment, they said, should be
treatment
guidelines. Sayeed feels that the GMC should help overseas doctors orient to UK professional and doctor-patients relations. A GMC spokesperson pointed out, however, that
more
handle.
addiction treatments?
drug-abuse
last year, asking whether they want to consider reapplying in the light of the new
process was publicly criticised earlier this year by a High Court judge who quashed the GMC’s refusal to grant Dr Balbir Singh Virik full registration (see Lancet Feb 25, p 509). The GMC is seeking leave to appeal against this decision. : The GMC insists that its new guidelines have not been produced in response to Virik’s case but are part of a process of continuing attempts to improve its service, since they allow greater opportunity for doctors’ applications to be "fasttracked" through the system. Since the overseas committee meets only a few times a year, with slow track the time taken from application to acceptance, or refusal, can be months. The GMC denies that the introduction of additional guidelines is an indication that the standard set for the limited-tofull transition has been lowered. Nevertheless, the council has written to 28 doctors turned down by the committee
rigidity of this
overseas
Yet, a disproportionate percentage of resources go to institutional placement rather than to community-based programmes, the researchers said. comes.
Harry Nelson the relatives can tell the doctor that after an agreed time their silence can be taken as approval to organ donation. If no donor card or relatives can be found, organs cannot be removed. The new transplant law also deals with organ trade. Before a vote is taken on the bill later in the year, a hearing organised by the parliamentary health committee will be held in June on brain death and relatives’ decision. A group of German Protestant theologians and a few doctors have made public their view that brain-dead patients are not dead, but dying. The view is that organs should not be taken from such patients unless the patient himself or herself had indicated a desire to donate organs. However, earlier this year the German societies of anaesthesists, physiologists, neurologists, and neurosurgeons published a declaration independent of transplant medicine; it emphasised the concept of brain death as the death of the
Federal Health Minister Horst Seehofer health and the Social Democrats’ Rudolf Dressler, have . spokesman, announced that the Christian Democrat/ Liberal coalition and the Opposition will jointly propose a transplant law, which will be supported by the federal states (Lander). Their joint statement said that a transplant law should not be a party political issue. Further discussions will involve the Green Party as well. Members of Parliament will vote freely on the issue rather than along party lines. : The law will be based on an "opting in" system-ie, organs can be removed if the deceased had given consent, or, if the . desire to donate organs had not been person. recorded, they can be removed when relatives can give permission. Furthermore,Annette Tuffs
The problems that overseas doctors face in obtaining full registration to practise in the UK might be considerably eased if they were trained in the non-clinical skills expected on a British ward, said Dr Akram Sayeed, chairman of the Overseas Doctors Association, in response last week to the General Medical Council’s new guidelines, which are aimed at speeding up the process for full registration. : By law, overseas-qualified doctors must . gain limited registration before they can . practise in supervised clinical positions in the UK. During limited registration, valid for a maximum of five years, the doctor must obtain the experience and qualifications necessary to satisfy the General Medical Council’s standards for full registration. With full registration, a doctor can apply for non-supervised positions. The
Improvements
to US
having
defined as that which makes inroads on addiction-related social problems-eg, crime, AIDS, and drug-addicted infantsrather than simply on treatment outcome for individual abusers. They drew attention to gaps in the system that fail to link programmes
with
those for AIDS patients; about half the persons with drug-abuse histories who come in contact with AIDS outreach programmes and the criminal justice system have never been in a drug-abuse treatment
:
programme.
Despite
research
showing that
persons
who stay on treatment for several months reduce drug usage, improve their personal health and function, and are responsible for reductions in public health and safety concerns, there remains a shortage of programmes capable of providing the required comprehensive care. In 1990, 42% of all treatment facilities reported
1230
this function would not be in the council’s remit as the registering body. Dr Douglas Buchanan, lead health consultant at the British Council, thinks that it is the Department of Health that should take the initiative. But if, as is likely, such an initiative on the part of the department would require prospective employers-NHS trusts in the main-to finance such an induction period, overseas doctors would become less attractive
potential employees. The new guidelines, to be presented to the full General Medical Council on May 23 and 24, are available from the GMC, 44 Hallam Street, London WIN 6AE, UK, for comments
Sarah
applicants than they could Although successful treatment
Despite huge
services such as medical and mental health care, behavioural counselling, and social services, most services are not
comprehensive enough
to
provide
them. Research reveals that only 29-8% of those with drug-abuse disorders receive any of these services. Eight states do not allow methadone as a treatment for drug addiction, although there is emerging consensus among scientists that proper use of the drug produces successful outcomes. Research shows that in states where methadone treatment is allowed, doses often are too low or treatment course too short to yield optimum results.
: : : :
!
Likelihood of transplant law in Germany at last that, after nearly 20 years of discussion, Germany will have a transplant law by the end of 1995 are high.
The chances
Ramsay
sums spent annually on for adolescents, no treatment has demonstrated superiority over other treatment or even over no service at all. This, they said, is because of the failure to conduct scientific studies that compare treatment outcomes. Major reform and research initiatives have advocated service systems for adolescents that are familycentred, community-based, child focused, individualised, comprehensive, less and accountable for client outrestrictive,
treatment
requires
Leading researchers, selected by the US National Institute on Drug Abuse, have informed state and federal health policymakers that current drug-abuse treatment leaves a large gap between knowledge and practise. There is thus an urgent need to re-examine drug-abuse treatment programmes and to lay out a broad new goal that emphasises public health policy solutions, they pointed out at a meeting sponsored jointly with the New York-based Milbank Memorial Fund, which will publish the policy recommendations. : The public, the researchers said, should be educated to consider drug abuse as a chronic, relapsing disease such as diabetes or hypertension, which has multiple outcomes and must be managed over time. Successful treatment, they said, should be
treatment
guidelines. Sayeed feels that the GMC should help overseas doctors orient to UK professional and doctor-patients relations. A GMC spokesperson pointed out, however, that
more
handle.
addiction treatments?
drug-abuse
last year, asking whether they want to consider reapplying in the light of the new
process was publicly criticised earlier this year by a High Court judge who quashed the GMC’s refusal to grant Dr Balbir Singh Virik full registration (see Lancet Feb 25, p 509). The GMC is seeking leave to appeal against this decision. : The GMC insists that its new guidelines have not been produced in response to Virik’s case but are part of a process of continuing attempts to improve its service, since they allow greater opportunity for doctors’ applications to be "fasttracked" through the system. Since the overseas committee meets only a few times a year, with slow track the time taken from application to acceptance, or refusal, can be months. The GMC denies that the introduction of additional guidelines is an indication that the standard set for the limited-tofull transition has been lowered. Nevertheless, the council has written to 28 doctors turned down by the committee
rigidity of this
overseas
Yet, a disproportionate percentage of resources go to institutional placement rather than to community-based programmes, the researchers said. comes.
Harry Nelson the relatives can tell the doctor that after an agreed time their silence can be taken as approval to organ donation. If no donor card or relatives can be found, organs cannot be removed. The new transplant law also deals with organ trade. Before a vote is taken on the bill later in the year, a hearing organised by the parliamentary health committee will be held in June on brain death and relatives’ decision. A group of German Protestant theologians and a few doctors have made public their view that brain-dead patients are not dead, but dying. The view is that organs should not be taken from such patients unless the patient himself or herself had indicated a desire to donate organs. However, earlier this year the German societies of anaesthesists, physiologists, neurologists, and neurosurgeons published a declaration independent of transplant medicine; it emphasised the concept of brain death as the death of the
Federal Health Minister Horst Seehofer health and the Social Democrats’ Rudolf Dressler, have . spokesman, announced that the Christian Democrat/ Liberal coalition and the Opposition will jointly propose a transplant law, which will be supported by the federal states (Lander). Their joint statement said that a transplant law should not be a party political issue. Further discussions will involve the Green Party as well. Members of Parliament will vote freely on the issue rather than along party lines. : The law will be based on an "opting in" system-ie, organs can be removed if the deceased had given consent, or, if the . desire to donate organs had not been person. recorded, they can be removed when relatives can give permission. Furthermore,Annette Tuffs