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The Doctor, his Patient and the Illness

1968; BMJ; Volume: 25; Issue: 3 Linguagem: Inglês

10.1136/oem.25.3.247-a

1470-7926

H. W. Ashworth,

Empathy and Medical Education

Reviewsmen have a knowledge and competence comparable with those of men educated in the homeland.A second principle is that of equivalence: that is, the right to practise should be on the basis of reciprocal rights granted by the applicant's own country.In the case of France it even states that such equivalence must be on a basis of a one-for-one reciprocity.Most countries require foreign physicians either to qualify for, or to be in process of qualifying for naturalized citizenship.The fourth principle, although not defined in so many words, is simply the protection of practice by limitation of entry.This is seen well in the case of Canada and the United States, neither of which have full internal reciprocity.There are in both countries certain States in which it is particularly difficult for the incoming doctor to obtain a licence to practise.By a curious coincidence those States to which it is hardest to secure entrance are those most favourably situated geographic- ally, climatically, and economically.Of these various principles, one suspectsthat protection is that which usually exercises the greatest influence.It is common knowledge that those countries which for any particular reason are short of doctors tend to relax their medical immigration laws, although it must be admitted that such relaxation has not so far occurred in the United Kingdom.It is easy to be critical but hard to envisage radical improvements.It would be comparatively easy to expand widely the reliable ascertainment of standards of medical education, but a widespread relaxation of the barriers of nationality, reciprocity, and protection would result in a concentration of doctors in the highest market in the nicest places with resulting grave detriment to the deserving and needy lands.The whole problem is at the core of international politics and cannot be regarded as a matter for the medical profession alone.Nevertheless it should try to take a lead because, of all the ways of life that men follow, the practice of medicine probably provides the strongest link that binds men of all nationalities and races.If and when the European Common Market gets on its feet medical reciprocity will have to be free.This may constitute the first crack in the ice which may lead to the breakdown of the many existing well-nigh impenetrable barriers.