This section describes the story of IMGs from outside the EEA and NHS training posts so far.

For years, IMGs have been working in the NHS and getting trained in NHS posts under an arrangement called Permit Free Training.  Lately, the IMGs from countries including  India have been allowed entry to the UK on Highly Skilled Migrant Programme (HSMP) visa status to compete for training posts in the NHS in the same manner as UK trained British doctors.

To reduce the reliance on overseas doctors, many UK medical schools increased their undergraduate student numbers since 1997.  In addition, 4 new medical schools have come up over the past few years thereby increasing the number of British trained MBBS/MbChB doctors who need to obtain training posts in the NHS in order to progress to a hospital consultant or General Practitioner career.

In order to assist UK trained doctors obtain postgraduate training posts in the NHS, in March 2006 the Department of Health introduced a ruling that IMGs already in the UK on HSMP status will not be allowed to apply for postgraduate training posts in the NHS on the basis of their HSMP status unless no suitable UK or EEA qualified doctor were available for such training posts.  In such a case, these IMGs may still be appointed to training posts but only on a work permit.

In July 2006, permit free training for IMGs from outside the EEA was abolished.

In response to this decision of the government, the British Association of Physicians of Indian Origin (BAPIO) launched a legal challenge against the government but lost it in the High Court in February 2007.

BAPIO subsequently appealed against the High Court decision and in November 2007, the Court of Appeal ruled that the government's decision was unlawful, hence giving one verdict in favor of BAPIO.

The government then appealed to the House of Lords to conduct a hearing into this affair.  This hearing went ahead on 29 February 2008 and the decision was published on 30 April 2008, again ruling that the government's action was unlawful. This, however, pertains only to IMGs from outside the EEA on HSMP status who are already in the UK.

Meanwhile, the number of doctors applying for a limited number of training posts in the NHS continues to grow.  Much of this is thought to be due to a large number of IMGs from outside the EEA holding HSMP status applying for such posts.  This year, for example, it is thought that the ratio of the number of all applicants to the number of training posts available is 3:1.

As a result, it is very likely that thousands of British trained doctors will not be able to secure a training post in the NHS despite it costing the UK taxpayer £250,000 to train local doctors through the medical school to obtain MBBS/MbChB.

Against  this background, in February 2008, the government introduced new rules effectively barring IMGs from outside the UK from obtaining training posts in the NHS based on HSMP status on a prospective basis.  This ruling applies only on a prospective basis and does not apply to IMGs already in the UK on HSMP status.  The new rules do not mean that IMGs from outside the UK and EEA will no longer be awarded the HSMP visa; they just mean that even if awarded, the HSMP visa will not entitle them to apply for training posts.

Therefore, this ruling applies only to IMGs from outside the EEA who wish to obtain training posts in the NHS.  The Department of Health has said that these IMGs are still welcome to apply for non-training service posts in the NHS (such as Staff Grade and Specialist Doctor posts) either on the basis of HSMP status or on work permit.  The Specialist Doctor posts are intended to replace Staff Grade posts.

And like before, even on a prospective basis, IMGs from outside the EEA can apply for training posts in the NHS (on work permits only) in shortage specialties where there are not enough UK or EEA applicants.  However, for popular specialties, this ruling effectively means that IMGs from outside the EEA will find it almost impossible to obtain training posts in the NHS.

In summary, on a prospective basis, IMGs from outside the UK and EEA can still work in the UK either on HSMP visa or on work permit. 

HSMP status- entitles them to apply for non-training posts and be appointed whether or not there are other UK or EEA trained applicants.

Work Permit- allows them to be appointed to non-training posts and to training posts based on the labour test, i.e., if there are no other suitable UK or EEA doctors applying for such posts. 

The other important development is that the Ministry of Health and Family Welfare, Government of India, has decided that acceptable postgraduate degrees obtained by indian doctors from the UK will be fully recognised by the Medical Council of India for practising as a postgraduate doctor in India.  This information was published in Indiain the Official Gazette on 10 March 2008 and can be reviewed at the Ministry of Health and Family Welfare, Government of India, at http://mohfw.nic.in/AAAmed.htm. This information is also available at http://www.academics-india.com/mci.htm and at the UPSC website www.upsc.gov.in.