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Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification

Mehdizadeh, L; Potts, HWW; Sturrock, A; Dacre, J; (2017) Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification. BMC Medical Education , 17 , Article 67. 10.1186/s12909-017-0903-6. Green open access

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Abstract

BACKGROUND: The demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment by the General Medical Council (GMC) because of performance concerns. METHODS: This was a retrospective cohort analysis of data routinely collected by the GMC. We compared doctors who had a GMC performance assessment between 1996 and 2013 with the medical register in the same period. The outcome measures were numbers experiencing performance assessments by country or region of medical qualification. RESULTS: The rate of performance assessment varied significantly by place of medical qualification and by year; χ (2)(17) = 188, p < 0.0001, pseudo-R(2) = 15%. Doctors who trained outside of the UK, including those trained in the European Economic Area (EEA), were more likely to have a performance assessment than UK trained doctors, with the exception of South African trained doctors. CONCLUSIONS: The rate of performance assessment varies significantly by place of medical qualification. This is the first study to explore the risk of performance assessment by individual places of medical qualification. While concern has largely focused on the competence of non-EEA, International Medical Graduates, we discuss implications for how to ensure European trained doctors are fit to practise before their medical licence in the UK is granted. Further research is needed to investigate whether these country effects hold true when controlling for factors like doctors' sex, age, length of time working in the UK, and English language skills. This will allow evidence-based decisions to be made around the regulatory environment the UK should adopt once it leaves the EU. Patients should be reassured that the vast majority of all doctors working in the UK are competent.

Type: Article
Title: Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12909-017-0903-6
Publisher version: http://doi.org/10.1186/s12909-017-0903-6
Language: English
Additional information: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Brexit, Cohort study, General Medical Council, Performance assessment, Primary medical qualification
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics > CHIME
URI: http://discovery.ucl.ac.uk/id/eprint/1547740
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