Temporary registration in primary care for dentists moving to the UK from outside the EU: an evaluation of a national pilot scheme

Nearly two years without the Overseas Registration Exam: what's next for internationally qualified dentists in the UK?

Due to the effects of the COVID-19 pandemic, internationally qualified dentists have been negatively impacted. This is due to the suspension of the Overseas Registration Exam (ORE) with no confirmation of any future dates. Similarly, UK dentistry was also affected by a significant increase in waiting lists all over the UK, with long waiting lists being present even before the pandemic. Due to these factors, many have highlighted and argued the need for internationally qualified dentists and urged the need to facilitate their registrations. Additionally, after Brexit, the government has introduced new immigration routes to attract overseas, highly educated human resources, so that they can contribute to different sectors in the UK. Considering these circumstances, there are a few alternatives to the ORE that could be introduced to facilitate the registration of internationally qualified dentists and to support NHS dental services. This paper suggests short- and long-term solutions to support the registration of internationally qualified dentists, considering that after two years, European-qualified dentists might need to undertake registration exams as well.

To raise awareness around the impact of COVID-19 on the overseas dentist registration process and dental NHS waiting lists.

To shed light on the valuable healthcare workforce that can be utilised post-Brexit, especially after the government showed an interest in attracting overseas graduates.

The options to utilise overseas-qualified dentists, including those qualifying from the European Union, are suggested to ease the pressures on NHS dentistry.

Accreditation and professional integration experiences of internationally qualified dentists working in the United Kingdom

INTRODUCTION

Regulatory processes for Oral health care professionals are considered essential for patient safety and to ensure health workforce quality. The global variation in their registration and regulation is under-reported in the literature. Regulatory systems could become a barrier to their national and international movement, leading to loss of skilled human resources. The General Dental Council is the regulatory authority in the UK, one of the nine regulators of health care overseen by the Professional Standards Authority.

AIM

The aim of this paper is to present the professional integration experiences of internationally qualified dentists (IQDs) working in the UK, against the background of regulation and accreditation nationally.

METHODS

Registration data were obtained from the General Dental Council to inform the sampling and recruitment of research participants. Semi-structured interviews of 38 internationally qualified dentists working in the United Kingdom were conducted between August 2014 and October 2017. The topic guide which explored professional integration experiences of the dentists was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis to detect themes.

RESULTS

Internationally qualified dentist's professional integration was influenced by factors that could be broadly classified as structural (source country training; registration and employment; variation in practising dentistry) and relational (experiences of discrimination; value of networks and support; and personal attributes). The routes to register for work as a dentist were perceived to favour UK dental graduates and those qualifying from the European Economic Area. Dentists from the rest of the world reported experiencing major hurdles including succeeding in the licensing examinations, English tests, proving immigration status and succeeding in obtaining a National Health Service performer number, all prior to being able to practice within state funded dental care.

CONCLUSION

The pathways for dentists to register and work in state funded dental care in UK differ by geographic type of registrant, creating significant inconsistencies in their professional integration. Professional integration is perceived by an individual IQD as a continuum dictated by host countries health care systems, workforce recruitment policies, access to training, together with their professional and personal skills. The reliance of the UK on internationally qualified dentists has increased in the past two decades, however, it is not known how these trends will be affected by UK's exit from the European Union and the COVID-19 pandemic.

Migration motives and integration of international human resources of health in the United Kingdom: systematic review and meta-synthesis of qualitative studies using framework analysis

OBJECTIVE

The aim of this review was to examine the migration motives, the barriers to and facilitators of integration of international dental graduates, compared with nurses and doctors in the United Kingdom.

METHODS

Electronic databases Ovid MEDLINE, EMBASE, PubMed, Web of Knowledge and OECD publications were systematically searched for English language publications from January 2000 to January 2017. A total of 31 qualitative studies were selected and quality appraised and meta-synthesis of the qualitative data was carried out using framework synthesis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to present the findings.

RESULTS

There were no studies on migration motives and one study on integration experiences of international dentists in the UK. The nursing literature had the highest volume and quality of evidence on nursing workforce, whilst there was limited literature on international doctors in the UK. Migration of health professionals to the UK is determined by personal and professional factors, together with source country-specific and UK drivers. Active recruitment, post graduate training and financial gain act as strong common macro, meso and micro drivers that perpetuate migration into the UK, but the extent to which each of these drivers influence nurses' and doctors' migration is different. Integration experiences for international nurses and doctors differed based on their source country experiences and the work environment they entered. Nurses reported a wider knowledge and skills gap, more multi-level discrimination and less career progression compared to the doctors. The migrants' integration experiences depend on their cultural awareness, discrimination exposure, English language and communication skills, social and professional support networks, social integration and personal attributes.

CONCLUSION

Migration of international health professionals is motivated by macro, meso and micro drivers at the international, national, professional and personal levels. The UK has strong common macro pull factors which attract nurses, doctors and dentists and may impact on the effectiveness of policies to restrict their migration. The integration experiences of nurses and doctors differ and further research is required to understand the integration experiences of dentists, in order to retain these professionals by tailoring policies to each of these professions.