Overseas Doctors' Cautious Welcome of English Test Extension

Rachel Pugh

June 26, 2020

Hundreds of doctors qualified overseas now have the chance to complete their training to work in the NHS, thanks to a decision by the UK Foundation Programme Office to extend the deadline for the completion of essential English language proficiency tests.

Doctors who gained their medical degree outside the UK have to pass an English examination run by either the Occupational English Test (OET) or the International English Language Testing System (IELTS), in order to gain access to the UK Foundation Programme (UKFPO). However, many watched in growing alarm as their chances of taking it by the September 2nd deadline were reduced by the cancellation of almost all tests since March because of COVID-19 safety fears.

Now the UKFPO has made the following announcement of an extension of the deadline on its website: "We are now in a position to confirm that the deadline for applicants to provide evidence of English language proficiency has been extended to 12:00 (noon) on Wednesday October 7th, 2020. If you do not have evidence of English language proficiency by the close of the application window on Wednesday 2nd September, you will have until Wednesday 7th October to send this evidence to helpdesk@foundationprogramme.nhs.uk. Unfortunately, we are unable to extend this deadline any further due to the implications for other component parts of the application process."

It went on to say that applicants meeting all other criteria with 'outstanding evidence of English language proficiency' would be considered 'eligible with conditions' until this deadline is reached, at which point their application would be amended to either 'eligible' or 'ineligible', based on the supporting information received by this deadline. 

'Delighted but Cautious'

The news was welcomed by overseas doctors who have been putting pressure on the UKFPO to push the deadline later into the autumn, rather than forcing them to delay their opportunity to complete their preparation for work on the NHS front line by a further 12 months.

Members of a 230-strong WhatsApp group of overseas doctors all wanting to apply for the foundation programme beginning in 2021 have welcomed the extension. Some of them have been financing themselves for years working in supermarkets, cafes and as carers whilst also working to comply with the regulations to join the NHS.

Dr Zita (who does not want to give her full name for fear of damaging her application) is one of the three administrators of the group. She was delighted but cautious, telling Medscape UK: "This is amazing news. I have a feeling that they [the UKFPO and the GMC] have started to listen to our worries, perhaps because many of us have been persistent in asking for more time. But I would be more relaxed if the UKFPO and the General Medical Council (GMC) could come up with an alternative path for international medical graduates, as we don't want things to continue to happen at the last minute."

An EU national, who qualified in a non-EU university, Dr Zita has provisional registration and has already passed the IELTS after several attempts (including one while on holiday in Canada) since coming to the UK in 2014. However the test must be taken within 2 years of application to the UKFP and hers expired as a result of her giving birth. She was booked for the OET in March, but this test and a further one in May were cancelled because of COVID-19 and she is now waiting to take the OET in July.

She works for a medical testing company but told Medscape News UK: "Frustrations in the group are rising. We are doctors and we want to work. This is my sixth year in the UK and still I do not have a job in the NHS. So many obstacles are put in the path of overseas doctors I just hope the Government will take us into account and suggest some alternative solutions. The NHS needs us today, as our tomorrow is under a big question mark. We have to help each other out as we live in the same community, if the system fails us now, they cannot expect anything from us in the future."

Critical Role

The OET runs English tests twice a month in cities across the UK (as well as all over the world). Tomorrow (June 27th) it will pilot an online version of the language test, which it hopes will soon be rolled out to relieve the backlog of applicants as a result of COVID.

An OET spokesman told Medscape News UK: "Overseas doctors play a critical role in supporting the NHS. It is vital that they have the right communication skills to ensure patient safety. OET is the only healthcare-specific test available to applicants for the UK Foundation Programme. If anyone has particular needs to access the test, flag it up to us when you apply and we will look at them."

The closing date for the last possible OET test is now 17th August, for an exam date of 12th September, to make the UKFPO October 7th deadline for 2021 entry.

The IELTS is expecting to resume exams in the UK in July and is more than doubling the number of test sessions globally, increasing the number of computer sessions to allow multiple sessions a day, 7 days a week, as well as putting on additional paper-based tests to help clear the backlog.

Whilst being delighted about the extension to the deadline, many overseas doctors feel unnecessary barriers are being put in their way to accessing work in the NHS, such as the higher language test scores required by applicants to the foundation programme, compared with those applying at more senior grades. 

Some also feel the Herculean efforts made by the GMC and medical schools to accelerate final year medical students onto the COVID-19 front line (including the creation of intermediate foundation roles) could have been done for them. 


WhatsApp group member Dr Mailén Sganga, who graduated in Buenos Aires, Argentina, and worked there as a physician, said: "It feels like they pave the path for UK graduates, scraping off obstacles, exams and allowing them to start early, whereas, for people already qualified who are living in the country, the opportunity to help in times of crisis is non-existent."

She is waiting to take the OET having taken the IELTS five times and passed it (but it expired). She says: "If the UK has taught me anything it is patience. My English level is high and though I understand that language is important to safety, I have been working for 3 years as a health support worker unable to do what I am trained to do."

Dr Madiha Urooj, who qualified in Pakistan, and came to the UK to marry in 2016, has had seven attempts at the language exam and passed it but it expired. She confessed that the number of hoops she needed to pass though, alongside working as a dispensing assistant, had got her down.

She said: "Last year I was so depressed about the number of exams that I have had to take, that I decided to quit medicine. But the pandemic gave me new motivation because I really want to help. I am highly disappointed as I, together with so many others with provisional registration and a license to practice with the GMC, are not being considered by the NHS to come forward as junior doctors and help our senior colleagues in this coronavirus pandemic."

Pleas to Home Secretary

The BMA has this week put its support behind the overseas-qualified doctors whose entry to the Professional and Linguistic Assessments Board (PLAB) 2 exams to license them to enter the NHS has been impeded by COVID-related cancellations.

It is calling on the Home Secretary to automatically extend the visas of around 200 doctors left stranded in the UK and unable to work, after PLAB 2 exams that would allow them to practise here were postponed due to the COVID-19 pandemic. More than 3000 doctors were waiting to take it when the GMC postponed the exams due to concerns around its ability to meet social distancing guidelines.

Of these, the BMA understands that around 200 doctors are already in the UK – meaning they face a visa renewal fee of £993 alongside continued living costs if they wish to stay. Many will be unable to return home due to restrictions on flights or being unable to afford the airfare.

A GMC spokesperson says it is taking steps to make sure that the PLAB 1 goes ahead this month for 500 candidates each in Manchester and London, plus smaller numbers in Cardiff and Belfast. 

It is also working to develop a PLAB 2 exam, that meets all Government requirements, to restart in a modified form, from August. This involves making changes to the format and length of the test, to the physical structure of the assessment centre and to the IT infrastructure.

The GMC is also exploring alternative ways for these doctors to demonstrate that they have the necessary medical knowledge and skills to practise safely in the UK. They have waived the PLAB 2 fee for the 240 doctors who were stranded in the UK when PLAB 2 was cancelled.

Commenting, Dr Chaand Nagpaul, BMA council chair, said:"The NHS is significantly understaffed and we know it relies on our talented international colleagues to provide patients with the high quality care they need."


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