To be frank, it is a truth that a foreign doctor will be scrutinized more and will have to undergo a harsher treatment if God forbid anything untoward happens. It is partly to be blamed for by the cultural difference but the truth remains still the same , as the figures say for themselves, foreign doctors need to be 10 times better than a local doctor to achieve the same level.
Local people are no better than foreign doctors and in fact every person is an individual with a different mind and a body.
Habit of generalization to state that foreign trained doctors are not competent is similar to saying local graduate are well trained! We know this is not the case.

Mr.A.Yadav, Manchester, UK

Don't know about you...but immediately I have a conflict of interest,
I am a doctor and am foreign trained so that makes my views immediately suspect.

Firstly the amount of doctors struck off here is 54 out of 100,000.....these are people who daily take inordinate risks with other peoples lives........therefore it is likely that any mistake is likely to have devastating consequences for the recipient.

But what causes complaints? Mistakes and acts of commision..and probably the inabliity to communicate effectively.

But remember communication is a two way process.

It is sad that some Drs' don't accept responsibility for their mistakes.But then so is racism.

It exists in all races and is prejudice.But saying it is not a factor while at the same time saying "all" foreign doctors are badly trained somehow doesn't ring true.

Ravi, London,

Mistakes are committed by both "English" and " Overseas" doctors. EU doctors dont even need an exam or English language competency to practise in the UK!!
UK needs to have a robust qualifying exam FOR ALL, both English and Overseas doctors who want to work in the UK. Doctors from every country except the EU/England pass this exam to work here.
Then if they do commit mistakes the body which tries them should be free and fair.

santos, London,

Dear Mr J.F. White
I feel extremely sorry for your wife. It should not have happened in NHS. You didn't mention what instructions were given wrongly. I am really not convinced to draw any conclusions without any specific details.
Secondly I must tell you that noone wants to take up a junior doctor's post in Cardiothoracic Surgery because there are no consultant's posts coming up in this speacialty in a decade at least. So NHS bosses should have thought about these scenarios in advance.

B Singh, Rhyl,

I genuinely support the points raised by BAPIO's president though I am not a member of the said association.

Since the emergence of un-proven allegations and news of the foreign doctors being involved in Bomb plots, there has been an increasing talk over the issue within almost all sectors of the NHS and most of the foreign doctors can feel that they are now-a-days being targeted for one reason or another with a constant "Critical and Catching Eye" of the authorities whitin the Trust and GMC both.

If the foreign doctors, on the other hand, are deemed ineffective with regards to their clinical practice, why do forget who makes them fit and eligible to Practice in the UK. We all know the answer, Don't we?

Fahad Jamil, London,

The facts:
-More than 30% of NHS doctors are from overseas.
-Without them the NHS would not have survived till now.( not my personal view alone, check out any number of official sources)
- Even now, with all this cry about unemployment , it is an open secret that many hospitals in less glamorous locations depend only on overseas doctors, as no UK trained doctor is willing to work in these places.
- Overseas doctors from non-EU countries have to take stringent language and professional skills tests before working in UK. However EU nationals are exempted
- A large number of studies have shown that race or country of origin does not determine the quality of a doctor. The same studies confirm that overseas doctors face severe discrimination in many areas and are more likley to face disciplinary action.
- If anyone has concerns about the performance of a doctor, there are clear pathways to raise these concerns, rather than raise the bogey about overseas doctors incomepetence.

Anjay Pillai, Great Yarmouth,

Not surprisingly most people who have responded to Dr Mehta's article have had bad experiences but the majority public who have indeed enjoyed being treated by overseas trained doctors' over the years seem to be quiet. We cannot have a balanced and a fair debate unless we also hear the views of the majority who have been treated successfully by overseas trained doctors.

I have worked in the NHS as a doctor for over 20 years and have noticed many a times that when a UK trained doctor makes a significant mistake, he/she immediately gets support and the issue is hushed up. But when an overseas doctor makes an error, he/she is less likely to be supported and more likely to be reported.

This kind of general attitude within the health service does put overseas trained doctors' at a clear disadvantage and shows UK graduates in a much better light.

It is therefore important to have a rational debate otherwise it is pointless.

A. Beckaya, Banstead,

There are foreign doctors with exellent professional records in the system and I believe that is the main reason for less or boaderline competent local doctors are not finding succes in the job market. After all the current world's high profile ideology is GLOBALISATION and those with competence will find success. The main reason for foreign doctors coming to UK is because there are opportunities and the system welcomed competent professionals. I cannot understand what would be the reasons for a Highly Skilled Professional to live and work in a primitive and less productive set up if there are opportunities else where in the world to employ his skills and earn more returns. This is how I see the foreign professional coming to UK and locals lossing the competition.

After all no body can say because of one Dr Shipman all white and British doctors are bad and all foreign doctors are incompetent because of the incompetence of some. There must be adequate systems to ensure safe practise

Dr A K John, SMALLFIELD, SURREY, UK

To excel in any field you need an opportunity , talent, good luck,hardwork,dedication and perseveration, if you have these qualities you will be among the best.
There should be a difference between stuffs imported from china and doctors from overseas.If a doctor is not performing well there is a system to identify the skill gap and bridge it. Most of the time the system fails to recognise the skill gap or fails to supervise.It is not failure of doctor I think it is failure of the system.
I totally agree with Dr. mehta's view.It is unfortunate but true that overseas doctors are discriminated. There are excellent people who would recognise your talents and achievements but there are few who are overtly racist. Probably some of the junior doctor needs positive reinforcement (some are fortunate enough to get that and some of them don't).
Constructive criticism doesn't mean playing racist card.This is the right time to reflect and change.........

Rahul, Darlington,

There are foreign doctors with exellent professional records in the system that is why some of the locally qualified doctors are lossing out in competition. We have to understand the ideology of contemporary world is GLOBALISATION and anyone with right qualification and expertise will succeed irrespective of colour or nationality. As long as the UK want to make advantages from globalisation, it will keep its doors open to rest of the world and that is the main reason professionals are coming to the UK. Blaming foreign doctors is not the best solution for the failures, but try to become more competitive.

Dr Ajo K John, SMALLFIELD, SURREY, UK

I am a foreign doctor working in NHS. My personal experience is that a incompetent overseas doctor will come to attention easily. Incompetent UK doctor will go unnoticed until they commits a major blunder. When a small mis chap is caused by a local doctor people will rally behind him or her. But a ethnic minority doctor has to be extremely good for this to happen. I have no doubt in my mind that some of the complaints to GMC have race as a contributing factor. I won't be surprised if more complaints are made by the patients against foreign doctors. There are cultural differences to bridge and misunderstandings can arise. It is worrying that the institutions are making proportionately more complaints. I am appalled by generalizations made in some of the comments expressed above. There are incompetent doctors on both sides.

K Ananth, Southampton,

Why is it that in the current climate no matter how fair or supported by facts is the criticism it seems to be necessary to play the 'racist' card in an immediate act of defence, this does not give me any confidence although I have always felt that the medical professions were very much a field in which the inhabitants of the Indian sub continent excelled . The defence springs to the aid of the minority who need to be sorted out whatever their skin colour or culture simply beacuse they are not white. This is a culture of racism.

B.Watkins, andover, hants;

It is sad that playing the racism card has to involve traducing your white colleagues. You say that the worst crimes such as murder are committed by white doctors such as Harold Shipman and ...who else, exactly? Dr Crippen? Dr Jekyll?

Bob Grant, Leicester,

After reading Dr Mehta's article and responses so far posted, the main issues here are foreign doctors' professional competence and communication skills, and local doctors lossing jobs due to foreigners. It is a fact that GMC has a system (PLAB Test) to test the professional and language competence of Non-European doctors and at present it requires a Certificate of Good Standing from their home country. European doctors are exempted from this assessment under EU Law. After they have qualified the PLAB Test there are "robust" appointment procedures and systems to monitor their practice. It is a truth that some may be less competent to perform their professional duties to the level the system and society expect. If they continue in the system, then the problem mainly lies with the system rather than the individuals. It is NOT wise to blame all the foreign doctors for above reasons. There are foreign doctors with exellent professional records in the system that is why (continued)

Dr Ajo K John, SMALLFIELD, SURREY, UK

The lack of common sense and grasp of the English language of a doctor I was treated by some years ago appalled me - she couldn't tell the difference between my forename and my surname, and seemed to not understand that patients' name sare always written on their case files with the surname first.
Foreign doctors only work in the UK because their incompetence won't be tolerated in their native countries.

SP Burns, birmingham, england

There are now so many English doctors that cannot get a position or placement anywhere, whilst this corrupt govt has allowed a flood of foreign doctors to take preference over our ` own `...........

Henry , London, UK

Ethnicity and colour are irrelevant here, country of training is what matters. Leave race and ethnicity out of this. There is a huge shortage of doctors in most developed countries so finding English speaking doctors is just getting harder and harder. Canada has a good solution, it imposes a test for all foreign trained doctors. The UK could work out a system for which countries do doctors require to sit for a test and which do not, just like driving licences.

Sami, London,

to understand this, we have to understand our socsity and its attitudes in general. what stereotypes do we have about Black youth? about Asians? about Liverpudlians? about the Irish and the Scotts, and about Jews, and now about Muslims?
do we not sensationalise and stereotype? when we do, do sufferers not suffer? is racism not a form of stereotyping? lord Mcpherson saw it in Stephen lawrence case. others have proven it in the NHS, Prison and Fire Services. should it not be about understanding how we perceive matters. What is foreign doctor? how foreign one has to be to be foreign? do locally tained doctors not make mistakes? are foreign doctors not subjected to racism ad institutional discrimination?
this, at the same time does not mean that those guilty of wrong-doing should not go unpunished. that should be robust, fair and equal for all. not a mass execution of a whole group. vulnerable communities have suffered for centuries because we were all busy stereotyping.

m akmal, ipswich, uk

When I was a lad,Doctors sat at the right hand of God,they were above reproach.Finding Doctors convicted of crime and malpractice,is very disturbing,but it happens,and in the West Midlands 95% of these are immigrants.Before someone screams "racist",check it out,newspaper archives tell the story.

Ray Barrett, Daventry, england

Sorry, there is certainly not 'a climate of discrimination' against foreign doctors at all, rather a climate of political correctness and discrimination against 'white English' applicants for any government post.
Labour has also attacked academic standards and prefers schools and universities to be engines of equality. The exodus of hundreds of excellent junior doctors after the EMTAS pogrom will no doubt accelerate the decline in standards.

Hildebrand, Abingdon, UK

You have had it THREE TIMES - why have you lost it ? ?

Mike, Whitley Bay, UK

I feel that the constant hounding and villification of foreign doctors, who are essential to the 'seamless' functioning of the NHS, is very saddening and disappointing. There seems to have been a recent surge in the reservations expressed about foreign doctors, most utterly misplaced and prejudicial. This can only be wholly detrimental to the trust and confidence that foreign doctors ought to inspire in their patients and will deter doctors from coming to the UK. Lest one forgets, we as a nation are depriving foreign countries, mainly in the Third world, of their best doctors to our benefit, however relative, and to the cost of the Third world countries. We should accord them such respect.

Finally, it is most undesirable to use certain instances of malpractice on the part of foreign doctors and make the subsequent claim that it is widespread and prevalent among foreign doctors. Although I have sympathy for the above writers, it is most unwelcome and unnecessary to be so dismissive.

Shahib Ali, London, England

I was unfortunate to encounter a male foreign doctor whilst pregnant with my third child. Being an older mother I requested an amniocentesis. He initially refused to give me one "just because I couldn't cope with a down syndrome baby". I refused to back down; he abruptly stood up, shouted at me, insulted me, threw my records on the desk and stormed out. Do any health managers take into consideration the feelings and safety of women who are treated by doctors who originate from a culture where women are treated as second class citizens? Men should try having an internal examination by someone who hates your gender!

Jayne, Wales, UK

It is quite wrong that British nationals, trained at British expense, cannot get jobs in British hospitals, and that they are discriminated against in this way. The standards of English amongst many overseas doctors are appalling. Overseas, non-EU doctors should not be allowed to practice here unless they have skills that are not otherwise available in the UK.

Jim Kurtz, London,

I regularly visit the GMC website where lists of Fitness to Practice decisions are noted. Before reading this news report and comment I was appalled at the number of foreign doctors who appeared to be facing disciplinary hearings. This is NOTHING to do with racism. It is EVERYTHING to do with competence.

This is not to say that UK trained doctors don't make mistakes. Of course they do. They are human. But at least one would hope that they can speak and read English fluently.
Frankly, whenever possible I go privately where I can choose my doctors. Lucky? Yes. Sensible? Absolutely.

Jay, London,

If you want to know the true value of foreign doctors in the NHS you should seek the views of the nurses who work with them. Many are not just incompetent but arrogant beyond belief. Most come from a culture far removed from ours with a totally different perspective towards women, the elderly, the mentally ill and, dare I say it, even the value of life itself. Communication in the NHS is also a major problem these days. We need to start employing far more doctors, and nurses, with whom English is the native language and culture before healthcare in this Country falls apart totally.

Paul, Rochester, UK

I'm a junior doctor working in the NHS.
I have worked with colleagues trained both in the UK and overseas who are excellent doctors. I have also worked with people who are not good.
The problem is nothing to do with race, but with communication and expectations. Some poeple just don't seem to be able to communicate with patients or colleagues and seem to have lower expectations of patient care. I have met both UK and overseas doctors who demonstrate these characteristics, but fortunatly they are few and far between.
We only hear about the bad events in the press, no one seems to focus on the fact most doctors are reliable, honest and caring professionals who readily help, teach and support their less able colleagues.
There are sytems in place for the reporting of sub-optimal docotrs and I know most of my colleagues would never put patient safety at risk by failing to utilise these.
If a doctors is under-performing they will be assessed regardless of where they are from.

Rob, Bristol,

I am a Malaysian, and as such, I am used to living in a multicultural environment. Half of the population is Malay, 25% are ethnically Chinese, 10% are ethnically Indian and the rest are from the indigenous tribes.

Having lived in the UK for 4 years now, I must get it off my chest that it seems to me that based on my conversations and interactions with Indians and British Indians, I feel that they are not accustomed to living with other races.

I have, on numerous occasions, rebuked an Indian acquaintance or friend for automatically playing the race card when faced with a situation that does not favour them. Several University coursemates accused a lecturer (behind his back) of racism when they did not get the scores they thought they would (personally, I felt they were just plain incompetent).

.. and why is there a need for a "British Association of Physicians of Indian Origin"? What would DR Mehta say to a "Association of White Doctors"? .. He would call them racist.

Pete, Cov,

Although the experiences described by Sophia and Mr White (below) are undoubtedly horrific, they are isolated incidents. You cant say that "all" foreign doctors are therefore incompetent or ignorant. I find it sad that Sophia's experience has lead her to believe that "the sole reason why Asian doctors in particular chose to practise in this country is to make lots of money." Unfortunately many white people do have a distrust of foreigners and in particular people from ethnic minorities. This distrust becomes more acute when the foreigner in question is responsible for their health. We must remember that the overwhelming majority of doctors are hard working and selfless people, regardless of the colour of their skin.

Rob King, Norwich , UK

It is very common for someone to be unhappy with the fact that you are competent, capable and non white and a better health care provider. These people will say every "chocolate pot wants to move upward and let us stop this here and now". They gang up with other like minded colleagues to create problems and trouble where none existed. This is generally the start of most fitness to practice cases. The GMC and the public only see these long time after they have snowballed into something totally different from where it all started.
I believe minority doctors are targeted for their competence. How come it not a problem in the US?

Nirmala, Syracuse, USA

What makes these people think that one example proves the rule? You cant condemn all asian doctors to tighter scrutiny on the basis of your experience with just one.

Annabel Smith, Croydon, Surrey

Mistakes happen in medicine. To target them on International doctors is incorrect, and I am sure this study will prove this beyond doubt.
The rules need to be the same for all doctors, not 'tighter for ethnic minority doctors' as suggested above, and that is what Dr Mehta is suggesting.
Nowhere is it suggested that they should not be investigated for conduct issues, only that they must be treated fairly and at par with their local colleagues.
Don't forget that it is these International doctors who have contributed so much to British Medicine: Prof Yacoub, Prof Agnelli, Prof Kumar, and the 30% who prop up the NHS. These are hard working honest professionals who dedicate their lives to patients.

Dr J Grover, Wroughton, Wiltshire

I am sorry but I disagree with you. The GMC are presently investigating a complaint that I had to submit against a "foreign doctor" who abused his position, an experience which has left me traumatised.
The doctor involved is a senior medical practitioner and playing this race card I find somewhat appalling given that I am myself an ethnic minority. I have come to believe as a result of my experience that the sole reason why Asian doctors in particular chose to practise in this country is to make lots of money. Patient care is a secondary consideration.

Only today another ethic minority doctor was charged with child abuse. Are you suggesting that this doctor has been unfairly targeted?
The problemis that most doctors are regarded as demi-gods and thenthey themselves beging to beleive that they are beyond reproach and can get away with anything.
There do need to be tighter rules for ethnic minoroty doctors.. whether they like it or not...

Sophia, Yorkshire, England

Last year my wife was due to have heart surgery and was given a pre-op briefing by a foreign doctor who misread or didn't undersrtand the consultants instructions, the result was that when she was admitted to the hospital she wasn't given the correct drugs and subsequently suffered a stroke, this doctor didn't even apologise when she admitted the mistake. My wife was disabled before this, to a degree, but is now a wreck, and the hospitals involved are still treating us like lepers. Where are the checks and guarantees that we should have when being "treated" by the NHS ?

Mr J.F.White., Hucknall, Nottingham.England.