Top doctors 'not ready for posts'

By Chris Bowlby BBC Radio 4's Analysis programme

The Postgraduate Medical Education and Training Board was set up in 2005

Doctors in England are being allowed to apply for jobs as hospital consultants before they are ready for such posts, the Royal College of Surgeons has said.

College president Bernard Ribeiro told the BBC it was a matter of "public safety" and concern to patients.

He said the Postgraduate Medical Education and Training Board had been overruling his college's rejection of some candidates.

However, the board insists its procedures are sound.

The college makes its own assessment of candidates, and recommends that some are not qualified.

"We would expect the overseeing body to accept that recommendation", Mr Ribeiro told Radio 4's Analysis programme, "and that has not been happening".

The dispute centres on candidates who may not have a conventional UK-based training but who claim to have equivalent qualifications and experience.

What we are discussing here is a legal process, and it's a process that depends in the end of the day on evidence, not on opinions Professor Peter Rubin, of the Postgraduate Medical Education and Training Board

In a recent parliamentary answer Health Minister Lord Darzi confirmed that since PMETB's creation in 2005 over 50 candidates had been approved for either the consultants' or GPs' register despite "adverse recommendations" from assessors linked to the royal colleges or medical faculties.

Mr Ribeiro claimed that in some instances the references given by candidates approved for the specialists register were from doctors "who had not been in active practice for many, many years".

He added that PMETB's procedures did not always provide for a specialist from the candidate's own speciality to asses an application.

PMETB chairman Professor Peter Rubin told the BBC that "the safety of the public is our paramount concern".

He said in a "tiny number" of applications the colleges, when recommending rejection, "had been unable to support their opinions with evidence".

Evidence needed

In such cases, he added, the board would go back to the colleges to ask for more evidence.

If that was not forthcoming the clinical or medical director of the candidate's hospital would be consulted, and all the evidence would be reviewed at a specially convened panel.

"We always ensure that specialist advice and specialist input happens", he said.

Asked why such a difference of opinion was possible between the colleges and the board, Professor Rubin said: "What we are discussing here is a legal process, and it's a process that depends in the end of the day on evidence, not on opinions".

The dispute comes against a background of tension between the royal colleges and PMETB, which was set up in 2005 by the government, to which it reports.

PMETB has taken on responsibilities for medical training and selection formerly held by the medical profession's own organisations.

As the official regulator it has the final say, but royal colleges are still involved in setting professional standards.

Analysis is broadcast at 20.30 on Radio 4 on Thursday 24 April. The programme is available for one week after transmission on Listen Again or as a podcast.

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