Government Medical College Chandigarh Old Students Association






Rohit Rambani ('92)

Knee Fellow, Orthopedics, Kings College Hospital, London, UK

(Posted 01/06)

An ever increasing craze for Indian doctors to work and study abroad coupled with the increasing competition for getting a post-graduation in India, made giving PLAB and moving to the UK an alluring option in the past. The thing to realize is that unlike the US, most other countries want doctors for service and don’t want career doctors. This should be kept in mind whenever any doctor tries to make a decision to go abroad for study or work with an intention of settling there. My aim of writing this article is not to discourage people from coming to the UK, but to present an insiders view of the currently existing ground level realities. Individual decisions should be made with careful deliberation and thorough research given the time, finances and overall stakes involved.

Moving to the UK was as obvious option for me as it is extremely difficult to get into a residency/fellowship training program in orthopaedics in the US as a foreign medical graduate. Furthermore, one of my key motivations to go abroad was to get more opportunities to do research, which I did not get in India.

Leaving aside how I have progressed in this country, I would like to tell my colleagues that things have changed drastically in the last few years. After 9/11, getting a US visa became very difficult and there was an exodus of physicians to the UK with the belief that getting into and advancement in this country was easier. However, the situation has become very difficult in the recent past. I have been personally involved in coaching students preparing for the PLAB exam for the past year and have noticed a steep fall in Indian doctors coming to UK. The primary reason for that, I believe, is a great paucity of and the struggle involved in getting a job.

To give you a good perspective, here are some numbers issued in December 2005 on behalf of the Academy of Medical Royal Colleges, the Department of Health, the General Medical Council and the Conference of Postgraduate Medical Deans (

  1. Competition for junior posts in the UK has been very high for the past 2 years but has increased further in the past 6 months.

  2. There are on average 493 applicants per junior doctor advertisement. This compares to 398 per advertisement 6 months ago. One third of these advertisements are for non-training posts.

  3. In the past 6 months at least 13 adverts have attracted more than 1000 applicants.

  4. The number of International Medical Graduates unemployed 6 months after passing part 2 of the PLAB test has increased from 20% of those passing part 2 in January 2003 to 47% of those passing part 2 in January 2004.

  5. Competition for junior posts is expected to increase further in 2006 when the number of UK graduates will rise by 20%.

There are currently more than 4000 overseas doctors sitting idle after clearing PLAB part-2 and most of them are not getting any clinical attachments, leave aside getting a job. And everybody should realize that UK needs overseas doctors as service doctors and not career doctors, meaning they just want us to do the scut-work with very limited possibilities of advancing to consultant positions.

There are a few who have achieved success and reached their desired position, but good luck and good connections usually play a major role. Since there are at least 500 plus applications for each advertised job, none of the consultants has time to go through all of them. Hence, besides being at the right place at the right time, a good recommendation or a phone call from a consultant is typically needed to land you in that coveted spot. The situation gets worse as you advance in your career.

Furthermore, the UK training system is transitioning under the ‘Modernising Medical Careers (MMC) programme’, which began in August 2005. Under this programme, medical graduates from UK medical schools must complete a 2-year ‘foundation’ programme before embarking upon specialist or general practice training. The first Foundation year (F1) is similar to the internship we go through after graduating from medical school, and these posts are matched to the output of the UK medical schools. Overseas doctors will therefore not be able to obtain these posts. During the second year of the Foundation training (F2), there may be 10-15% extra posts than the F1 posts, and a few overseas doctors may be able to secure these extra posts. However, these posts will be far fewer than those available currently, and will be extremely competitive. More information on the MMC programme is available at

In the end, I would like to say that the situation very similar in other countries like Singapore and Australia, where again, they want service doctors. I would suggest all doctors planning to come abroad to consider all options and discuss the pros and cons carefully with their friends and seniors in that country before moving.

With the increasing numbers of corporate hospitals opening up in India, most doctors of Indian origin would like to come back and earn well in the private sector and have the luxuries of staying in India, which you only realize when you move abroad.




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