Insightful journalism or inciting racism; you decide

The Daily Mail doesn’t want to scare you about foreign doctors, but…


This week the Mail Online published an exclusive medical story from the Mail On Sunday with a headline that must have made its editorial team think that all their Christmases had not only come at once, but been accompanied by several birthdays too.

“72% of struck off doctors are from overseas” it declared, “nearly three quarters” they helpfully clarify, adding ominously that the “news comes as health bosses want to lure 400 trainee GP’s here from India”.

“Medics trained overseas have been involved in series of shocking blunders” the sub headline explains.

These ‘shocking’ (used twice in the first five lines just to be clear) facts were ‘uncovered in a Mail on Sunday investigation’ which essentially meant a freedom of information request to the General Medical Council (GMC) who regulate doctors in the UK.

The figures cover six years from January 2010 to December 2015 when a total of 460 doctors were ‘struck off’ (the official term is ‘erased’) from the GMC list of Registered Medical Practitioners of which 330 were “trained abroad” and 130 were trained “in the UK”.

The rest of the story details the, frankly shocking, individual cases of six doctors who had been ‘struck off’ for gross misconduct (some actually criminal). The chosen examples were GP’s from India, Ghana, Malaysia, Sudan, Italy and Britain, respectively.

The ‘largest contingent’, however, of those foreign doctors who had been erased from the list was from India, followed by Pakistan and then Nigeria.

These “foreign-trained doctors now make up a third of NHS doctors” the authors warn.

Now I wouldn’t claim that any of these statistics or facts is untrue or mistaken, except perhaps to point out that the proportion of GMC registered doctors whose primary medical qualifications were obtained outside the UK is actually well over a third (actually 36.7%), but I am uncomfortable with the implied danger of foreign doctors.

What the article fails to make clear is that there are 273,761 doctors practising medicine in the UK of which 100,486 qualified abroad, some 30,000 from the EU and well over 70,000 from the rest of the world.

That means that the total proportion of doctors who were ‘erased’ from the list for misconduct is less than 0.2% (that’s less than a fifth of one percent or one in every 500) and the proportion of the total number of foreign trained doctors erased is around a tenth of a per cent higher at 0.33% percent or one in every 300.

To use the statistics another way, even if you are consulting a ‘foreign trained’ doctor you can be 99.67% confident in their clinical abilities. Of course in a perfect world we’d all wish that was 100% but as long as human beings are involved in any process perfection can only ever remain an aspiration.

The apparent disparity between the proportion of International Medical Graduates (IMG’s), as they are officially designated, who are erased from the list compared to UK trained doctors is by no means a revelation..

The Guardian highlighted this issue over a year ago in January 2015 when it examined the facts behind a claim made by Nigel Farage that foreign doctors’ language skills were “a political scandal”.

It found that of the 669 doctors who had been struck off or suspended in the previous five years 63% had been trained overseas but none of these had been criticised for their ability to speak or write English.

At the time the GMC commented that it was a recognised phenomenon that patients were more likely to make official complaints about foreign doctors because they were culturally and inherently suspicious of their competence, essentially assuming that British training is inherently superior to any other.

They also suggested that patients and doctors sharing the same cultural and ethnic backgrounds were much more likely to “talk through” adn resolve any issues before they could be escalated.

There was no suggestion of racism on the part of the majority of patients, but certainly a cultural bias could be implied even though a 2015 survey among British patients revealed their favourite profile for a GP was young, female and Asian.

So if it is a cultural phenomenon that makes British patients suspicious of their “foreign” doctors, articles like the one in the Mail On Sunday can surely only fan the flames.

Whether that is intentional or incidental may perhaps be judged by comparing it with the article published 25 minutes later on the Mail Online India website with the ‘shocking’ headline;

“Racism alarm: Top Indian origin doctors warn of ‘disparity and discrimination against non-white staff in the NHS”.

Sounds like someone is having their Christmas and birthday cakes and eating them…



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