Policy criticised over medics' jobs

Retired postgraduate Dean Professor Graham Winyard said immigration was such a sensitive subject that it was little discussed and remained the "elephant in the room".

Writing in the British Medical Journal (BMJ), he said the "direct connection" between immigration policy and the likelihood of unemployment for UK medical graduates was "inescapable".

Blame could therefore not be put solely at the door of the Government's failed Medical Training Application Service (MTAS), which was shelved earlier this year following an outcry.

In the late 1990s, UK medical schools had around 5,000 graduates a year - far fewer than was needed by the NHS, he wrote. This led to the recruitment of a large number of overseas doctors.

In 1997, the Medical Workforce Standing Advisory Committee advocated a long-term policy aim of being able to rely largely on UK doctors, and called for an expansion of medical school places.

This expansion means the number of graduate doctors is set to rise to 7,000 in 2010, an increase of 40%.

Despite the Committee's aim, Prof Winyard said, it is illegal to discriminate against doctors on the basis of the country in which they graduated.

High numbers of doctors from across Europe also meet the criteria for seeking a job in the UK through the highly skilled migrant programme, he said. This allows them to enter the UK and seek work without a specific job offer.

Prof Winyard argued that the UK "urgently needs policy coherence" on immigration and medical training.