Country Of Qualification Research Articles

The quality and content of websites in the UK advertising aligner therapy: are standards being met?

Aims To evaluate the quality of information and compliance with General Dental Council (GDC) ethical advertising guidelines for English-language orthodontic websites providing orthodontic treatment with aligners in the United Kingdom (UK).Materials and methods The term 'orthodontic aligners or braces' was entered into the Google online search engine. The first 100 English language orthodontic websites (practice or company) were pooled. Both the quality (DISCERN instrument) and compliance with GDC ethical advertising guidelines were assessed. Frequency distributions and the overall summative DISCERN score for each website were calculated.Results The overall mean DISCERN score was 42.9 (SD = 9.4). The quality of information was only rated as good-excellent for 16% of websites and only 11% of websites showed full compliance with GDC guidelines on ethical advertising. A link to the GDC/authority website (75%), the date when the website was last updated (72%), and the practice complaints policy (66%) were not commonly provided. The country of qualification, a statement of whether practices provide NHS or private treatment or a combination of both, and the date when the website was last updated, were significant predictors for the overall quality based on DISCERN score.Conclusions The quality of information provided on websites providing aligner therapy and their compliance with GDC guidelines on ethical advertising was suboptimal. An improvement in both areas is required.

Applications to medical and surgical specialist training in the UK National Health Service, 2021–2022: a cross-sectional observational study to characterise the diversity of successful applicants

ObjectivesTo compare success of applicants to specialty training posts in the UK by gender, ethnicity and disability status.DesignCross-sectional observational study.SettingNational Health Service, UK.ParticipantsAll specialty training post applications to Health Education...

Immigrant health care workers from developing countries in the US: antecedents, consequences and institutional responses

PurposeThe aim of this paper is to present a conceptual model on foreign-born health care workers from developing countries working in the US. The model covers their motivations for migration, the consequences in terms of the inequality and exclusion they may experience and the role of institutional responses at micro-, macro- and meso-level of intervention.Design/methodology/approachThe paper is based on: (1) in-depth review of key literature studies on the foundation theories of international migration including sociology, economics, anthropology, psychology and human resource management, (2) analysis of theoretical approaches to medical migration across disciplines, (3) analysis of the international and national documentary sources of micro-, macro- and meso-level policies on migration and (4) analysis of evidence on best practices, solutions and aspirational changes across different levels of institutions.Findings(1) Migration of international medical graduates (IMGs) from developing countries to the US can be explained from a micro-, macro- and meso-level of analysis. (2) IMGs who identify as racial/ethnic minorities may experience unfair discrimination differently than their US-born counterparts. (3) Although political/legislative remedies have had some successes, proactive initiatives will be needed alongside enforcement strategies to achieve equity and inclusion. (4) While diversity management initiatives abound in organizations, those designed for the benefit of IMGs from developing countries are rare. (5) Professional identity groups and some nonprofits may challenge structural inequities, but these have not yet achieved economies of scale.Research limitations/implicationsAlthough it is well-documented in the US health care literature how ethnic/racial minorities are unfairly disadvantaged in work and career, the studies are rarely disaggregated according to sub-groups (e.g. non-White IMGs and US-born MGs). The implication is that Black IMG immigrants have been overlooked by the predominant narratives of native-born, Black experiences. In placing the realities of native-born Blacks on the entire Black population in America, data have ignored and undermined the diverse histories, identities and experiences of this heterogeneous group.Practical implicationsAn awareness of the challenges IMGs from developing countries face have implications for managerial decisions regarding recruitment and selection. Besides their medical qualifications, IMGs from developing countries offer employers additional qualities that are critical to success in health care delivery. Considering organizations traditionally favor White immigrants from Northern and Southern Europe, IMGs from developed countries migrate to the US under relatively easier circumstances. It is important to balance the scale in the decision-making process by including an evaluation of migration antecedents in comprehensive selection criteria.Social implicationsThe unfair discrimination faced by IMGs who identify as racial/ethnic minority are multilayered and will affect them in ways that are different compared to their US-born counterparts. In effect, researchers need to make this distinction in research on racial discrimination. Since IMGs are not all uniformly impacted by unfair discrimination, organization-wide audits should be in tune with issues that are of concerns to IMGs who identify as racial/ethnic minorities. Likewise, diversity management strategies should be more inclusive and should not ignore the intersectionality of race/ethnicity, nationality, country of qualification and gender.Originality/valueImmigrant health care workers from developing countries are integral to the health care industry in the United States. They make up a significant proportion of all workers in the health care industry in the US. Although the literature is replete with studies on immigrant health care workers as a whole, research has rarely focused on immigrant health care workers from developing countries. The paper makes a valuable contribution in drawing attention to this underappreciated group, given their critical role in the ongoing pandemic and the need for the US health industry to retain their services to remain viable in the future.

The national and international implications of a decade of doctor migration in the Irish context

BackgroundBetween 2000 and 2010, Ireland became increasingly dependent on foreign-trained doctors to staff its health system. An inability to train and retain sufficient doctors to meet demand is the primary reason for the dependence on foreign-trained doctors. By 2008 the proportion of foreign-trained doctors was the second highest in the OECD. This increased dependence on international medical migration has both national and international policy implications. MethodsRegistration data were obtained from the Medical Council of Ireland (MCI) for a 10-year period: 2000–2010. Data indicate country of qualification but not nationality. The total number of registrants and entrants (n) was determined for each year. Immigration data were also obtained on the number of work visas issued to doctors. Registration and visa data were then compared in order to estimate doctor migration to Ireland 2000–2010. ResultsThe proportion of foreign-trained doctors rose from 13.4% of all registered doctors in 2000 to 33.4% by 2010. The largest increase was in foreign-trained doctors from outside the EU, rising from 972 (7.4%) in 2000 to 4740 (25.3%) of registered doctors in 2010. The biggest source country in 2000 was Pakistan. By 2010, South Africa had become the biggest source country. The number of foreign-trained doctors from other EU countries doubled from 780 in 2000 to 1521 in 2010. ConclusionsRegistration data are likely to over-estimate and visa data under-estimate the numbers of doctors actively working in Ireland. However, they serve to illustrate Ireland's rapidly increasing and potentially unsustainable reliance on foreign-trained doctors; and to highlight the need for better data to measure migratory flows. Improved measurement of health worker migration is necessary both for national workforce planning and to fulfil the requirements of the WHO Global Code on the International Recruitment of Health Personnel.

Experiences of non-UK-qualified doctors working within the UK regulatory framework: a qualitative study

To explore the experience of non-UK-qualified doctors in working within the regulatory framework of the General Medical Council (GMC) document Good Medical Practice. Individual interviews and focus groups. United Kingdom. Non-UK-qualified doctors who had registered with the GMC between 1 April 2006 and 31 March 2008, doctors attending training/induction programmes for non-UK-qualified doctors, and key informants involved in training and support for non-UK-qualified doctors. Themes identified from analysis of interview and focus group transcripts. Information and support for non-UK qualified doctors who apply to register to work in the UK has little reference to the ethical and professional standards required of doctors working in the UK. Recognition of the ethical, legal and cultural context of UK healthcare occurs once doctors are working in practice. Non-UK qualified doctors reported clear differences in the ethical and legal framework for practising medicine between the UK and their country of qualification, particularly in the model of the doctor-patient relationship. The degree of support for non-UK-qualified doctors in dealing with ethical concerns is related to the type of post they work in. European doctors describe similar difficulties with working in an unfamiliar regulatory framework to their non-European colleagues. Non-UK-qualified doctors experience a number of difficulties related to practising within a different ethical and professional regulatory framework. Provision of information and educational resources before registration, together with in-practice support would help to develop a more effective understanding of GMP and its implications for practice in the UK.

A Variety of Patient Factors may Influence Porcelain Veneer Survival Over a 10-Year Period

Clinical records were reviewed for more than 80,000 different patients from the General Dental Services (GDS) in England and Wales. A total of 2562 porcelain veneer restorations were placed in 1177 adult patients (> or =18 years old, 35% male and 65% female) over a period of 11 years (January, 1991, to March, 2002). A number of factors were considered potentially capable of impacting the need for reintervention on teeth restored with porcelain veneers. These included a number of patient factors such as gender, age, and dental utilization practices. Other factors analyzed included the tooth position receiving veneers, dentists' qualifications, and where and when the veneer was placed (eg, month and geographic location). The main outcome was survival over 10 years between initial placement and the first date of intervention for each tooth treated with a porcelain veneer. Information was abstracted from clinical records to create an analytical dataset of porcelain veneers, with their dates of placement and their dates, if any, of reintervention. This dataset was analyzed using a modified Kaplan-Meier statistic and a Cox-regression model. Factors that were found to influence the survival of porcelain veneers included the following: gender, with veneers placed in male patients surviving for less time than those placed for female patients (P = .01); patient age, with poorer survival of porcelain veneers in older (60 years or older) patients (P = .003); changing dentist, with teeth of patients who change dentist surviving for shorter periods of time to reintervention than for those patients who continue in the care of the same dentist (P < .001); patient's treatment need, with patients whose gross annual fees on all dental treatment are higher having teeth with less time to reintervention after receiving veneers than those patients with lower annual fees (P < .001); patient paying status, with patients who are exempt from charges also having veneered teeth with shorter time to reintervention (P <.001). Nevertheless, the factors associated with tooth position or mouth quadrant and with the dentist (gender, age, years since graduation, and country of qualification) did not influence the survival rate. Although dentist factors do not appear to play a part, a variety of patient factors have been found to influence veneer survival to reintervention. Overall, 53% of porcelain veneers in the study survived without reintervention at 10 years.

Workforce participation among international medical graduates in the National Health Service of England: a retrospective longitudinal study

BackgroundBalancing medical workforce supply with demand requires good information about factors affecting retention. Overseas qualified doctors comprise 30% of the National Health Service (NHS) workforce in England yet little is known about the impact of country of qualification on length of stay. We aimed to address this need.MethodsUsing NHS annual census data, we calculated the duration of 'episodes of work' for doctors entering the workforce between 1992 and 2003. Survival analysis was used to examine variations in retention by country of qualification. The extent to which differences in retention could be explained by differences in doctors' age, sex and medical specialty was examined by logistic regression.ResultsCountries supplying doctors to the NHS could be divided into those with better or worse long-term retention than domestically trained doctors. Countries in the former category were generally located in the Middle East, non-European Economic Area Europe, Northern Africa and Asia, and tended to be poorer with fewer doctors per head of population, but stronger economic growth. A doctor's age and medical specialty, but not sex, influenced patterns of retention.ConclusionAdjusting workforce participation by country of qualification can improve estimates of the number of medical school places needed to balance supply with demand. Developing countries undergoing strong economic growth are likely to be the most important suppliers of long stay medical migrants.

Outcome of direct restorations placed within the general dental services in England and Wales (Part 3): Variation by dentist factors

It is the aim of this paper to investigate the survival of direct-placement restorations provided within the General Dental Services in England and Wales, in relation to the dentist factors which may affect this. For this work, survival of a restoration was considered to be the time between the date of completion of the course of treatment in which it was placed and the date of acceptance of the course of treatment when the next tooth-specific treatment was carried out on the same tooth. A modified version of Kaplan-Meier statistical methodology was used to plot survival curves for restorations placed by different subgroups of dentists. The age and experience of the dentist who placed the original restoration were found to be related to restoration survival, with older dentists having shorter intervals from placement of restorations to re-intervention (P<0.001). Country of qualification seems not to be relevant within Europe in terms of restoration survival, but dentists who qualified outside Europe achieve different restoration survival times for the restorations that they place. Dentist's gender has no relationship with time from restoration to re-intervention. Dentist factors such as age, country of qualification, and employment status, but not the gender of the dentist, have been found to influence the survival of directly placed restorations.

The selection of GP trainees in the West Midlands: second audit of assessment centre scores by ethnicity and country of qualification

The new regional GP trainee selection process in the West Midlands aims to be fair, open and efficient in selecting the most suitable candidates for training posts. This paper is a follow-up audit of the results of the first selection round that have previously been published in this journal (Brown et al., 2001). Here we provide an analysis of candidates’ performance in the selection process by ethnic background and country of qualification for the first four selection rounds (n=753). Performance is assessed in terms of the percentage of candidates passing the shortlist stage and being offered a training post in the West Midlands, and by an analysis of shortlist and total scores. This audit finds that UK-trained candidates are most likely to be shortlisted; African- and Asian-trained candidates are the least likely to be shortlisted; and Asian-trained candidates have relatively low success in being placed in the West Midlands.

Determinants of physicians' attitude towards prescribing.

To identify the primary care physicians' (PCP) characteristics that are associated with their prescribing attitude. A validated questionnaire was sent to randomly selected PCPs stratified in three groups according to any higher qualification in family medicine. The best predictor for orientation of quality of care in prescribing was the country of qualification. Duration after qualification was negatively associated with PCP's belief in the use of drugs. Physicians who were female, with higher qualification, sooner after qualification, and working in group practice were less likely to perceive pressure from patients to prescribe, with group practice being the most significant determinant. Different physician factors affect different aspects of PCPs' prescribing attitude. As duration after qualification was an important but negative attribute, quality use of medication should be emphasized in continuing medical education.

The selection of GP trainees in the West Midlands: audit of assessment centre scores by ethnicity and country of qualification

The new regional, centralized system of selecting GP trainees in the West Midlands aims to be fair and non-discriminatory in the processes of recruiting the most suitable candidates and allocating the successful candidates to their preferred posts. This paper provides an audit of the achievements of all (n = 165) the candidates in the October 2000 selection round. Initial analysis suggests that gender is not a significant factor in determining outcomes. In this paper, the data are examined with respect to candidates' ethnic background and their country of qualification. Two levels of analysis are possible, based on average 'success' or placement rates, and average scores achieved at each stage of the selection process. The analysis, using one-sided significance tests, suggests that White candidates, and those qualifying in the UK, are more likely to succeed in the selection process. Possible explanations are offered from a more detailed interrogation of the selection criteria. Finally, the implications for the next selection round are discussed in the light of these findings.

Variations among examiners in family medicine residency board oral examinations.

This study was designed to describe the variation in marking tendencies among different examiners in an oral examination. Marks awarded in a family practice board examination between 1984 and 1996 were analysed, relating to 5328 examination sessions graded by 94 examiners. Examiners were ranked by the rates at which they awarded 'fail', 'pass' or 'distinction' grades. The effects of examiners' gender, experience, academic rank, regional affiliation and country of qualification on examiner behaviour were studied. National Family Medicine Examination Board, Scientific Council, Israel Medical Association. Oral examiners. Eighteen per cent of examiners were classified as 'tough', being in the lowest tertile for 'distinction' rates and the highest tertile for 'failure' rates; 19% were classified as 'mild'; 52% were 'regular', falling in the middle tertile for both distinction and failure rates. Four per cent of examiners were in the top tertile for both distinctions and failures, labelled 'extremists', and 6% were in the bottom tertile for both, and were labelled 'noncommittal'. Higher failure rates were associated with examiners' academic rank, experience and graduation from an English-speaking medical school. Examiners differ significantly in their degree of severity. Those who demonstrate clearly deviant patterns of grading should be withdrawn. Candidates should be presented with a balanced panel of examiners, and a degree of standardization of content should be introduced into oral examinations.

The effect of doctor ethnicity and country of qualification on prescribing patterns: an ecological study.

To assess the effect of doctor ethnicity and country of qualification on prescribing patterns. Ecological study. 90 Family Health Services Authorities in the U.K. Being an Asian doctor and qualifying from the Indian subcontinent contributes to 5% of the observed variation seen in the frequency of prescribing, but not the cost. The major determinant of variation in prescribing is deprivation, which accounts for 14% of the cost and 32% of the frequency of prescribing. Being an Asian doctor and qualifying from the Indian subcontinent contributes to the frequency, but not the cost of prescribing variation. As this study was at the FHSA level, 'ecological fallacy' exists and further research is advocated at the individual doctor level.

Personality profiles of Australian anaesthetists.

Identification of personality traits in anaesthetists has potential implications for selection of trainees, assessment of coping strategies during times of stress and may have a role in the analysis of critical incidents. A 24 question postal questionnaire based on the Cattell 16PF inventory was sent to specialist anaesthetists in Australia. One hundred and sixty-seven replies were received (33% response rate). Personality traits did not differ when the anaesthetists were grouped for age, number of years qualified and country of qualification. City practitioners rated themselves more inquisitive than country practitioners did (P = 0.052). Female anaesthetists self-reported they were calm (P = 0.02), patient (P = 0.02) and tolerant (P = 0.02) more often than their male counterparts, whilst more males reported themselves as highly conscientious (P = 0.01). Although some traits were consistent, personality profiles showed significant heterogeneity. Further examination of how personality and coping mechanisms interact may be central to the management of stress and critical incident generation.

Effect of doctors' ethnicity and country of qualification on prescribing patterns in single handed general practices: linkage of information collected by questionnaire and from routine data

Objectives: To test whether Asian general practitioners who qualified in the Indian subcontinent prescribe items more often, more expensive items, and fewer generic drugs than their British trained Asian and...

Overseas-born doctor migration 1962-66.

Overseas-born doctor migration 1962-66.