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Mentoring refugee doctors

GPs can help migrant doctors qualify to practice in the UK, says Dr Helen Sapper

Running a doctors’ study group was not what I anticipated when I attended a ‘mentoring refugee doctors’ seminar. The proposal I received was vague: help refugee doctors into jobs.

The first session of the group, called the ‘Journal Club’, was held in the Migrant and Refugee Communities Forum’s (MRCF) office in West London with four refugee doctors. This is a migrant and refugee-led community development umbrella organisation. Many using its services are healthcare professionals who, when they have cleared the UK’s immigration hurdles, hope to resume their careers.

The Overseas Trained Health Professionals Project intended to ease this process launched in 2001. Funding came from local health agencies, social services and voluntary bodies. The purse-string attached was to create a facility for the doctors’ special use. The Journal Club seemed the best option.

GMC registration
Many overseas doctors do not realise that their qualifications might not be recognised as suitable for GMC registration.

With few exemptions, registration then depends on passing professional and linguistic board (PLAB) examinations. The GMC runs these exams to determine professional competence and to serve as a guarantee of sufficient knowledge and skills to function at foundation year two level. The pass mark for language skills is set high and failure, which is frequent, delays entry to the two tests of medical knowledge that follow.

PLAB1 entails answering 200 extended matching questions in three hours and PLAB2 is a series of objective structured clinical examination stations testing practical and communication skills.

Refugee doctors also need familiarity with colloquial and medical English, norms of UK clinical practice, NHS functions and a raft of regulations we take for granted.

We cover a lot of ground using case discussion and talking through clinical examination. We work through old PLAB questions systematically and under exam conditions which refreshes knowledge.

The format evolved has enough flexibility to accommodate digressions, inconsistent attendance and variable competence linguistically or medically. We do not have a lecture programme although outside speakers are invited.

Seminars focusing on aspects of acute care are organised where knowledge gaps are evident. There is also CPR training every few months.

Chelsea and Westminster Hospital’s clinical skills laboratory provides a course for those preparing for PLAB2 whenever numbers can justify the cost.

Diverse needs
There are practical difficulties. Attendance is erratic and punctuality is a problem. The group’s size seldom drops below 15, it is usually above 20. Apart from their medical background the group have few common characteristics and their needs are correspondingly diverse.

The three-hour weekly session often extends into a fourth hour. Preparation is essential and some tasks I cannot delegate to the co-ordinator or support workers.

Many of those attending regard themselves as family doctors and want to observe how general practice functions here. However, opportunities are limited and ad hoc arrangements are discouraged by educationalists.

The proprieties do need to be observed but this is an area where help could be of great value to these doctors.

The attraction for me lies in the challenge. The volume of work the Journal Club generates is not compatible with full-time practice. The emphasis has to be on what you can give rather than receive. Mentoring and befriending possibilities are plentiful.

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