I did just out of interest explain the statistics above. There is a degree of us tapping into other countries and some of that could fit into Keith' s concerns.

However, many of the junior doctors on our wards and in our clinics shall practice in their country of origin and should any wish to stay, the visa rules they are here under apply.   With medical students, the universities and deaneries do well out of overseas students.

The problem is planning as ever. You plan the places for 18 year olds on the basis of what we need when they turn 35 or so. Just limiting places to domestic students doesn't work. The object of the exercise is decent clinicians and the skill mix is fairly international.

You may find more fault in grant funded students that we pay for taking off to Australia and The USA once they are on the specialist register.   The numbers of doctors trained in medical schools in poor countries and settling here is a factor but a small one and is balanced by UK trained doctors returning home.

The professional need to help people coupled with the relatively better personal lifestyle makes their home attractive.

Out of interest, the recent tightening up of Article 14 (putting overseas trained doctors on the specialist register) and insisting on communication skills as well as UK practicesiis a reaction to EU standardisation. Politicians with good intent made European qualifications EU wide. Sadly the level of training required to be a consultant in say Romania is woefully short of the mark whilst the India Subcontinent medical schools mirror ours.

That is an issue and was brought into sharp relief when a German doctor not conversant with diamorphine killed a patient on almost his first day as a locum GP. Rules for UK practice have been tightened despite what some newspapers would have you believe.