UK doctors working for charities overseas are being removed from the lists of approved practitioners in the UK because they are unable to attend face to face appraisal, warns a GP in this week's BMJ.
This means that they cannot work as soon as they return to the UK.
Overseas working gives doctors valuable experience that benefits the NHS when they return, writes Alex Duncan, a GP from West Sussex, currently working in Afganistan. But the need for appraisal and regulation may make a stint of working overseas too difficult for doctors to contemplate.
This would be a shame, as it would deprive parts of the developing world of badly needed expertise and the NHS of valuable experience on the doctors' return.
"We need a body that regulates doctors like me," he says.
He calls on England's Chief Medical Officer to set up a body that would regulate doctors who undertake a contract for more than a year's work with a recognised charity or medical organisation and who have a clear intention to return to work in the NHS.
This body should ensure that doctors are fit to practise in the UK at the time they depart for work overseas and at any time they return to the UK.
"At the moment it's all a bit of a fudge," says Duncan. "Those who are supposed to regulate me know little about my work and have no idea about the difficulties of my working conditions."
A regulatory authority for doctors working overseas would have the experience to know what is going on and to spot problems that primary care and hospital trusts might miss. The system would also provide greater transparency for doctors getting back into UK practice, he writes.
All this would benefit the doctors concerned, be helpful to potential employers and - most importantly - protect the public by ensuring that returning doctors are fit to practise.