Tougher tests for foreign doctors could cut errors by 50%
- Doctors who qualify outside EU are twice as likely to be suspended or struck off
- Limiting how many times they can sit language tests could slash this number
- Researchers at University of York examined test results of 27,000 doctors
MailOnline Reporter
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Tougher rules on English tests would cut the rate of serious mistakes by foreign doctors by up to 50 per cent, a study found.
Doctors who qualify in a country outside the EU are twice as likely as those who qualified in Britain to receive a sanction for malpractice, such as a warning, suspension or being struck off.
But this figure could be reduced with stricter limits on the number of times international doctors are allowed to resit language and competency tests before practicing, York University researchers have found.
Greater risk: Doctors who qualify outside EU are twice as likely to be suspended or struck off
Lead researcher Dr Paul Tiffin said failing the ‘relatively simple’ language tests multiple times could show a doctor was not up to a high enough standards to work in the UK.
Complaints about doctors who resat the tests several times were often about non-clinical issues that could have sprung from ‘misunderstandings’ or a failure to understand ‘subtle cultural differences’, he added.
All doctors from outside the EU who want to work in Britain must sit an English language and a clinical skills test to show they have the skills needed to work in the NHS.
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Previously, those who failed have been able to resit the Professional and Linguistic Assessment Board (PLAB) tests multiple times.
From September, a limit of four resits is being imposed by the General Medical Council (GMC). The tests were also made tougher last year.
The study examined the test results of more than 27,000 doctors between 2006 and 2012 – before the new tests were introduced.
It found about 60 per cent passed first time but those who did not were much more likely to receive fitness to practice sanctions later.
The study’s authors predicted that if doctors were only allowed to practice in the UK if they passed the tests first time, the number of sanctions for malpractice would have been halved and would be in line with the level for British-trained doctors.
But they noted this would have led to a shortage of specialist doctors in the country.
In-depth study: Researchers at University of York examined test results of 27,000 doctors
Only 0.8 per cent of international doctors received sanctions over the period studied, but this compared to 0.4 per cent of those who qualified in the UK.
The researchers found doctors who failed the language part of the test multiple times were most likely to be complained about.
Of these, those who resat the skills test several times were most likely to go on to receive official sanctions.
THE MEDIC WHO RELIED ON A TRANSLATOR
Italian urologist Dr Alessandro Teppa worked in UK hospitals from 2012, but his English was so poor he could not speak to patients without an interpreter.
Italian urologist Dr Alessandro Teppa worked in UK hospitals from 2012
The Medical Practitioners Tribunal Service last week extended for 12 months his nine-month suspension, warning he posed ‘significant risks to patients’. Dr Teppa, currently in France, plans to improve his English and return to the NHS next year.
Bulgarian surgeon Dr Ludmil Veltchev pointed to instruments in theatre as he did not know the names.
The locum, who worked in UK hospitals for two years, was suspended for 12 months after colleagues complained. One at Southend University Hospital, Essex, said his understanding of basic language was ‘exceptionally poor’. Dr Veltchev has since left Britain.
Polish heart doctor Tomasz Fryzlewicz treated NHS patients for eight years until staff at Princess Alexandra Hospital, Harlow, reported ‘serious concerns’ over his poor English, which they feared could harm patients. He failed three language tests and was ordered to work under supervision. The hospital fired him.
The report, published in the journal BMC Medicine, found banning doctors from resitting the skills test more than three times would have led to the rate of sanctions dropping by 8 per cent.
Dr Tiffin said the GMC’s new limit of four resits would not have ‘substantially reduced the rate of sanctions in this group of doctors’ because very few took the tests more than three times.
He added: ‘Our findings suggest that further limiting the number of resits permitted may help protect patients from malpractice. The numbers are small but just one incompetent doctor can cause a disproportionate amount of problems.’
He suggested that language ability was a good early indicator as to whether or not a doctor was good enough, adding: ‘If you have got doctors sitting tests that are relatively easy and they are taking them three or four times, obviously there’s an issue there and they are more likely to run into problems later.’
Charlie Massey, chief executive of the GMC, said the study was based on the old test and that the new limit of four resits would soon be introduced.
He added: ‘We feel this new rule, in conjunction with the test itself being more robust, strikes the right balance between protecting patients and making sure the UK medical workforce continues to receive a steady supply of appropriately-qualified new doctors.
‘Once in the UK these doctors, like all others, are subject to regular checks to show they remain safe to practise, through annual appraisals with their employers and through revalidation.’
Doctors from inside the EU do not have to take the PLAB tests because EU rules say they contravene freedom of movement laws.
Previous studies have found doctors from EU countries were twice as likely to be struck off, suspended or given a warning compared to those from the UK.
The Royal College of Surgeons has called for the Government to use Brexit to introduce safety and language checks for doctors, dentists and nurses from the EU.
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