This thesis is about International Medical Graduates or foreign doctors, trained outside the European Economic Area, who settle permanently in the Netherlands. From the early nineties the number of foreign doctors residing in the Netherlands either as refugees or as partners/spouses of Dutch citizens has risen steadily. Foreign doctors who wish to practise medicine in the Netherlands must obtain a declaration of professional competence, issued by the Department of Public Health, Welfare and Sports (VWS). A considerable number of foreign doctors received negative decisions by the Health Department. They were not allowed to practise medicine in the Netherlands. As a result, from the mid nineties, a growing number of foreign doctors applied to the medical faculties for admission as medical students in order to obtain a Dutch medical degree. Therefore, in 1995, it was decided to institute the Committee Influx Foreign Doctors (CIBA), a central placing committee. Between 1996 and 2007 the CIBA has processed over a 1000 admission requests. Until 2002, in spite of the imminent shortage of doctors, the Department of Health had done little to enhance the use of the expertise brought in by the foreign doctors for the benefit of Dutch society. The focus of this investigation has been: 1. How is it guaranteed that foreign doctors meet the medical quality standards (knowledge, skills, attitude), or how is the assessment of these qualities measured. And 2. After obtaining permanent residency in the Netherlands, do foreign doctors have access to the profession for which they had qualified before in their country of origin or another non-EEA country? Late 2001 the Department of Health and the medical schools were stimulated to cooperate in order to improve the additional training programmes for foreign doctors. It led to the new assessement procedure for foreign doctors that came into force in December 2005. This thesis contains two reports on the medical careers of foreign doctors. These investigations showed that nearly all foreign doctors had managed to find jobs as doctors in the Netherlands after their graduation. To the question which had hindered them most in their medical careers many reported that the Dutch language was their main obstacle. A comparative study into the policies towards medical doctors in ten EEA-countries shows that there are enormous differences between the European countries. The most important difference is that in Denmark, Norway and Sweden one medical school per country organises additional training programmes for non-EEA doctors on special request by their Departments of Health. Another large difference is the duration of the additional training programmes. The study reveals that the participating EEA-countries are largely unaware of the assessment procedures regarding non-EEA doctors in other countries. The study offers a preview of the preconditions of a successful implementation of the new assessment procedure. New pitfalls are the lack of preparatory courses (Dutch as a second language, Medical Dutch, English, computer skills), the high costs of the assessment procedure and the lack of any link between the procedure candidates with a university. As yet it is not clear whether in the future local social services will allow foreign doctors to study while receiving social benefits. An evaluation study into the effects of the assessment procedure is recommended
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