UK medical
postgraduate qualifications can be obtained outside UK(1,2)
without any work experience in UK. This is common knowledge among
the medical profession around the world. This also a rather unique system since
most postgraduate medical degrees and diplomas offered by institutions in many
other countries require a period of training within their own countries. We
were curious to know if the members of the public were aware of the ways by
which UK
postgraduate medical qualifications could be obtained and if it made any
difference to their choice of a doctor to treat them.
A PubMed search did not reveal any such study about the
public perception of doctor’s qualifications and its impact on
consumer/patient’s decision making.
Our objective was to find out:
1) If the
public knew that UK
postgraduate medical qualifications could be obtained outside UK
2) If the
public knew that UK
postgraduate medical qualifications could be obtained without any work
experience in the UK
3) If the
public knew that UK
postgraduate medical qualifications could be obtained outside UK and without any UK work experience would it make
any difference in their choice of a doctor if they needed medical care.
150 members of public in Kuwait from a similar social class and educational
background were given questionnaires in either English or in Arabic. Questions
were designed in sequence as per the objectives defined.
We found:
53% were not aware of the terminology of UK
qualifications such as FRCS/MRCP etc
75% were aware that doctors with UK qualifications were practising
in their city
72% would prefer to see a doctor with UK
qualifications if they had a choice
50% thought that a doctor with a UK qualification would have a
higher level of knowledge
45%
thought that a doctor with UK
qualification would have higher skills
85% said that if they were consulting a doctor holding UK qualifications they expected to benefit from
the doctors UK
experience
54%
expected a doctor holding a UK
medical qualification to have worked in the UK
67% did
not know that a UK
postgraduate medical qualification can be obtained without ever working in the UK
79% said that if they were seeing a doctor with UK qualification and they had the choice they
would prefer to see one who has UK
experience as well
84% said
that if they had a major problem that needs a specialist consultation they
would prefer to see a UK
qualified doctor who also has UK
work experience.
Discussion
About half the respondents were not aware of the terminology
of UK
postgraduate medical qualifications, but three fourths knew that doctors with
such qualifications were practicing in their city. The majority also said that
they preferred to see a doctor who held UK postgraduate qualifications.
Therefore we feel that it is in the interest of the medical fraternity in the UK to promote an increased awareness of the
terminology of the UK
medical postgraduate qualifications so as to enable patients to make a better
informed choice in selecting a specialist medical practitioner.
However, half of our respondents did not expect a doctor
holding UK
postgraduate medical qualifications to have a higher level of knowledge or
skills. But, interestingly we note that a majority would like to consult a
doctor with UK
qualifications. This suggests that there must be other intangible factors at
work, perhaps ‘trust’, ‘glamour’, an ability to induce patient confidence and
so forth which are inherent or implied.
An overwhelming majority said that when they consulted a
doctor holding UK
qualifications they expected to benefit from that doctor’s UK work
experience. Two thirds of the patients did not know that a UK postgraduate medical qualification could be
obtained without UK
work experience. This suggests that patient’s expectations could be let down
due to a lack of information and awareness of the way in which such
qualifications are awarded. Perhaps, more seriously it is possible to speculate
that some patients have the mistaken impression that doctors who hold UK qualifications have worked in the UK when that is
not actually the factual situation.
An overwhelming majority of our respondents said that if
they had a problem that needed specialist consultation they would prefer to see
a doctor who had UK
postgraduate medical qualification and UK work experience. We infer that
lack of information prevents patients from making the choice that they would
like to make. Our respondents were all from a more or less similar social
background of an educated and middle class nature. It may be possible to assume
that in the general population or in a population segment with lesser
education, the awareness of such matters is likely to be much less while the
expectations may be similar and hence prevents them even more from making a
proper informed choice; sometimes, possibly a wrong choice.
In summary, our survey shows that in Kuwait some patients thought that when they
consulted a doctor with UK
postgraduate qualifications the doctor also had UK experience. Many patients did
not know that UK
postgraduate medical qualifications could be obtained without ever setting foot
in the UK.
Patients preferred to consult a doctor who has a UK
qualification and UK experience.
We conclude, that some of the patient’s expectations are not being met due to
the way in which the award of UK
postgraduate medical qualifications are made. We also feel that some patients
could be misleading themselves into thinking that when they consult a doctor
holding UK qualifications
the doctor also had UK
work experience when in actual fact that may not necessarily be the case.
One of our recommendations would be that UK postgraduate medical qualifications be
awarded only to persons with UK
work experience. Alternatively separate nomenclature could be used to indicate
that the UK qualification
was obtained without UK
experience and/or training; the Royal College of Surgeons of Edinburgh has already started some movement
towards such a practise by the award of SMRCS,(3) etc. Perhaps
doctors holding UK
qualifications could be obliged to divulge their training information as a part
of enhanced ethical disclosure, say in their reception or waiting areas of
their office. The institutions awarding such qualifications could have
information campaigns that inform the patient hence empowering them with the
ability to make an informed choice.
The Americans do not seem to confer their clinical postgraduate qualifications to doctors who have not actually worked in the USA.
The survey was conducted in the year 2000, we are not aware if there have been any changes in the public perceptions and understanding on this matter since.
References:
Note: The above material is extracted from the following poster presentation:
A
postgraduate medical qualification from the UK. What does it mean to the public
in Kuwait? M. Hemadri and M. Purva. Hull York Medical School First
Research Conference, Hull. 11th February 2004.
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