Locally Employed Doctors and International Medical Graduates in the NHS: Current and Evolving Trends

Locally Employed Doctors (LEDs) are defined as any doctor below consultant grade, appointed within a UK National Health Service (NHS) Trust, who are not working within a national training scheme. They are a cohort significantly increasing in numbers. International Medical Graduates (IMGs) are overseas-qualified doctors who contribute to more than 30% of the workforce-related deficit in the number of UK-qualified doctors required to meet NHS requirements. These doctors can face difficulties when they start to work in the UK, such as inexperience of the UK medicolegal and ethical standards. The Royal College of Physicians (RCP) recently produced new guidance stating the basic principle that all doctors should be considered as being in training. LEDs are junior doctors with educational needs, yet they do not receive the same opportunities as their training-grade equivalents. Moving forward, we would advocate a UK-wide process which will help the NHS develop a strong and cohesive workforce, whether they are locally or nationally employed.