Selecting an internationally diverse medical workforce
Doing it with respect is in everyone’s best interests

Two new linked studies tackle difficult educational issues concerning international medical graduates practising medicine in the UK. Tiffin et al1 report that international graduates, mainly from outside the European Union, achieve less satisfactory outcomes than UK graduates at annual appraisals known as Annual Review Competency Panels (ARCP). McManus and Wakeford2 find that they perform less well than UK graduates in postgraduate examinations for trainees in internal medicine (Membership of the Royal Colleges of Physicians (MRCP)) and family medicine (Membership of the Royal Collage of General Practitioners (MRCGP)).

Both these data linkage studies were commissioned by the UK regulator, the General Medical Council (GMC), which is considering revising the two examinations that currently determine an international graduate’s fitness for medical registration in the UK. Importantly, both studies show that the two examinations, set by the Professional and Linguistics Assessment Board (PLAB Part 1 and PLAB Part 2), predict performance in later professional assessments. They also agree that international graduates who do better at compulsory English language tests do better in postgraduate training.

McManus and Wakeford use two different approaches to quantify how much the pass marks for PLAB examinations would have to change to select international graduates who would perform as well as UK graduates. Both methods yielded similar results and confirmed …