Published: 10/02/2005, Volume II5, No. 5942 Page 37

Many well-qualified doctors from overseas find it difficult to have their skills recognised in the UK. Education Action International offers help and support to new arrivals, reports Donald Hiscock

For doctors who have been forced to leave their home country and seek work in the UK, the prospect of relaunching their medical careers can seem daunting.

'It is a catch-22 situation, ' says Kona Katembwe, employment project officer at charity Education Action International.

'Once they have satisfied the language and professional assessment tests they are eligible to apply for limited registration with the General Medical Council, provided they have a job offer.

However, they need a registration number to apply for a job.' But guiding clients through the red tape and supporting their ambition to find employment is all part of the job for Kona, who runs a project especially for health professionals in EAI's refugee education and training advisory service, a division of the charity.

RETAS supports the social and economic development of refugees and asylum seekers in the UK and at a European level by offering advice and guidance on education, training and employment.

'Having reached the required level in the English language exams the people I work with have to pass parts one and two of the GMC's professional and linguistic assessment board tests, ' says Kona. 'But the major hurdle after this is gaining a clinical attachment.' Arranging clinical attachments for doctors from abroad has still to be fully resolved, according to Kona. 'There is a concern in some trusts over who has responsibility if something goes wrong.

This is why many doctors only receive an observership.' Most doctors who are new to the UK need to learn how the NHS is structured.

Having the clinical competence is one thing, but knowledge of the culture of delivering healthcare is something that takes time to acquire.

Dr Adel Abdulmohsun is about to start work at Kingston Hospital in Surrey. He is seeking asylum, having left Baghdad in 2001 where he worked as an anaesthetist.

'RETAS put me in touch with a mentor who then helped me to find a clinical attachment. It was from this that I learned how to deal with patients and how the NHS works, ' he explains.

Having little money to start with, Adel worked as hotel receptionist, then as a phlebotomist while studying for his exams.

'RETAS did a lot for me, particularly with financial aid. They still keep calling and sending me letters, ' he adds.

Although many of the people Kona advises have built up a professional record with many years' experience in their own country, they can only start in the UK on a senior house officer grade.

'This is where having a mentor helps, ' says Kona.

'They can give realistic advice about which jobs to apply for. The mentor can also act as a referee, an essential part of any job application.' A young doctor who had only just graduated but was forced to flee her home country is full of praise for the help she has received from senior medical staff in the NHS.

'I had to leave while I was starting my internship, ' she says. 'I had to start from scratch both emotionally and professionally, but I got great help from some consultants, who were very positive. I think It is difficult for some overseas doctors here who have a perception that they will not be helped, but the help is there if you go and find it.' She has a personal interest in human rights and it was through this that she was introduced to Education Action International.

'They gave me the connections and I made the most of them.' While working as an agency nursing assistant she received financial assistance from RETAS to help her with the GMC exams. She admits that whenever she needed something she would simply turn up at their offices.

'They offered me whatever they had, ' she says. 'I think that all I've achieved here has been mainly to do with Kona.' The doctor is currently working as a locum, but she was offered a job while on attachment at a hospital in east London, which she hopes to take up the post soon.

'One of the hardest things for doctors in my situation is having to start again and work your way back up, ' she says. 'It can be very disconcerting and off-putting.

But if I can make it anyone can.'