Overseas doctors: future training and employment.

The Royal Commission on the National Health Service assumed that "the expansion of entry to United Kingdom Medical Schools will eventually result in a reduction of overseas doctors employed in the NHS."' This would happen, it thought, because of the formidable difficulties overseas doctors would have finding jobs, but it did not propose policies for controlling the immigration and training of overseas doctors. Surprisingly, perhaps, an increasing number are still trying to come to Britain, and it seems short-sighted and cruel to leave overseas doctors to discover for themselves the harshness of postgraduate medical life in Britain. Something more effective and humane needs to be done. In many ways the problems of overseas doctors are those of British doctors writ large. Finding good training posts and career jobs once trained remains a testing obstacle course for home graduates. David Smith in the rather idealistic conclusions to his very practical study of overseas doctors in Britain thought that if the ratio of consultants to junior doctors was greatly increased and if all training jobs were gathered together into organised schemes then the problems of both overseas and British doctors would be much reduced.2 The Central Manpower Committee has been looking at these problems for many years, but has made only painfully slow progress. Meanwhile, the Department of Health and Social Security is studying the feasibility of providing a computer-based information service on training jobs available in the NHS. Such changes are not achieved overnight, however, and there is a need to improve the relationship between overseas doctors and the NHS right now.