The NHS has scrapped a longstanding scheme that let overseas doctors boost their skills in UK hospitals and was seen as an example of British “soft power”.
Senior doctors have criticised NHS England’s decision to axe the Medical Training Initiative, under which 400 to 500 foreign-trained doctors were given placements in Britain every year.
The MTI is known in the NHS as “earn, learn and return”. It enabled medical graduates from low- and middle-income countries such as Pakistan, Sri Lanka and Nepal to spend up to two years in the health service enhancing their skills, making them better doctors when they went home.
The UK’s medical royal colleges are aghast at the unexpected and “abrupt” axing of a programme they say helped not just the medics but the NHS and their home countries. It had cost NHS England just £176,000 to fund each year and has given thousands of overseas doctors a chance to work in the UK since it was set up in 2011.
Some fear it will exacerbate the already acute shortage of doctors across an NHS that relies very heavily on international graduates, who comprise two-fifths of all its medics.
A spokesperson for the Academy of Medical Royal Colleges, which represents all 23 of the institutions, said: “While we respect NHS England’s decisions we are obviously very disappointed.
“We believe the MTI has been a successful example of international medical collaboration, supporting both the NHS workforce and healthcare development overseas.
“The programme has without doubt strengthened professional relationships between the UK and partner countries, supported the development of the global medicine workforce and demonstrated the UK’s longstanding commitment to sharing clinical expertise and education internationally.
“We think it’s also made a vital contribution to the UK’s international reputation on the world stage and represents a prime example of British soft power.”
The academy administers the scheme, sponsors the doctors who come to the UK for up to two years, and helps arrange their temporary visas.
Doctors already in the UK through the MTI will be able to finish their placements and those who applied for the next round by March will still get theirs. But the scheme will be wound up after that. The decision was taken in March.
An unpublished internal review by NHS England concluded the MTI “wasn’t meeting its intended purpose” because some foreign doctors were staying in the UK and not helping their home countries.
The review also found evidence of “wage exploitation” – foreign doctors being paid less than their UK peers, despite doing the same type of work.
Senior doctors believe NHS England has axed the MTI to help the government resolve a dispute with resident – formerly junior – doctors in England. They privately suspect it was an attempt to appease the British Medical Association, which at the time was arguing for UK medical graduates to be given priority in the allocation of scarce places on training schemes for surgery, A&E care and other types of medicine.
But an NHS England spokesperson said: “This taxpayer-funded initiative was closed after an independent review found it was not meeting its purpose to improve the quality of healthcare overseas.
“While action is also being taken to prioritise the needs of UK-trained medical graduates, the closure of this scheme was unrelated. The NHS is now considering other models to enable its world-leading training to help improve healthcare in low- and middle-income countries.”
Dr Clare McNaught, the president of the Royal College of Surgeons of Edinburgh, said the end of the MTI along with UK graduates being prioritised in medical training was concerning because the NHS relied so heavily on international medical graduates.
McNaught said a way should be found to give UK graduates priority “without alienating the international doctors who are vital for the ongoing provision of safe and high-quality care”.
Prof Mark Strachan, the president of the Royal College of Physicians of Edinburgh, said he was “disappointed” at the axing of the MTI, which his college was proud to have been part of. “It offered real benefits to the international medical graduates taking part – who would then take their learning and new skills back to their home countries – and to health services in the UK.”
