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The way forward

• Trusts should ensure that members of interview panels and selection committees receive equal opportunities awareness training.
• Deaneries and Trusts should provide guidance on filling in application forms and information about interview procedures.
  This could include examples of likely questions or points for discussion so that interviewees can be adequately prepared.
• Equal opportunities monitoring should be carried out by Trusts in relation to applications for job vacancies.
  In the first instance, Trusts should monitor gender, ethnicity and disability. Consideration should be given to developing ways to monitor sensitive data such as religion, sexual orientation and age. Any bias or perceived discrimination should be investigated and appropriate actions taken.
• Trusts should consider the use of anonymised application forms for job vacancies.
  This is one option by which some of the bias that might arise on the basis of non-English names might be removed. This approach would also help to focus the assessment of the candidate on their medical skills and relevant experience.

• The BMA will encourage the GMC and the NCAA in their quantitative analysis of data on disciplinary cases.
  In addition, a report should be prepared which includes qualitatively focused examination of the underlying reasons why minority ethnic and overseas doctors are more likely to be disciplined or suspended. This information would help highlight any issues within the disciplinary system and to target future initiatives and support to the specific problem areas experienced by this group of doctors.
• The BMA should repeat (on a regular basis) the 2004 survey of cases referred to regional services which investigated the underlying causes of doctors’ disciplinary problems.
  This would help to determine how the patterns of disciplinary problems are changing and to identify emerging themes that need to be addressed.

• The BMA should continue to work with the Department of Health to support the implementation and further development of the recommendations contained in “Choice & opportunity: modernising medical careers for non-consultant career grades” (NCCGs, also known as staff and associate specialist grades – SAS).
  These recommendations include:
  • enabling all SAS doctors to have opportunities for career progression
  • developing a fair system of competency based assessment to enable SAS doctors to enter career grade posts
  • developing a system of competencies through which SAS doctors with formally recognised skills can work independently at the appropriate level.
  • providing the resources and infrastructures for continuing professional development of SAS doctors.

• Trusts should ensure that there is openness and transparency within the clinical excellence awards system.
• Trusts should monitor clinical excellence awards in terms of ethnicity, gender, disability and sexual orientation.
  The results of this monitoring should be collated, analysed and published by the Advisory Committee on Clinical Excellence Awards.

• Primary care organisations should collect ethnicity monitoring data for general practitioners.
  This data should be collated and analysed centrally by the health departments in order to provide a clearer picture of the composition of the GP workforce.

• The BMA welcomes the review of the PLAB examination being carried out by the GMC.
  This should consider the relevance and suitability of the test as a means of assessing a doctor’s ability. In addition, the costs should not be prohibitive.
• The GMC, with support from the BMA, should examine the arrangement whereby doctors qualifying outside the UK or EU are currently required to take the International English Language Testing System (IELTS) examination regardless of nationality.
  Action needs to be taken to avoid any unnecessary examination burden for those individuals who, for example, have English as their first language, or received their main education in English.

• A single official web site for internationally trained doctors should provide clear and updated information about their employment prospects in the UK.
  There is much confusion about the registration procedures, and employment processes and opportunities in the UK for doctors with international qualifications. It would be beneficial if one site provided information and up to date links to relevant organisations. For example, the National Advice Centre for Postgraduate Medical Education (NACPME), maintained by the British Council (www.thebritishcouncil.org) is currently updating its website. This website should be the central information point with relevant and accurate information for doctors coming to work in the UK. The BMA will continue to monitor the provision of information on the web, and make appropriate recommendations.
• The GMC should consider developing a central database of overseas doctors who are registered and seeking employment, particular overseas doctors who have passed the PLAB test.
  This could allow monitoring of the types of appointments obtained by this group, the number of applications made and the length of time spent on the register. The data could also be valuable to target initiatives aimed at helping this group of doctors into employment.

• The BMA should work with the Department of Health to encourage and facilitate networking amongst minority ethnic doctors so that they can meet one another to give mutual support, share experience and advice.
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  © British Medical Association 2008