While a privileged part of the Netherlands was grumbling at a baggage claim at Schiphol, 24 highly motivated foreign doctors sat in a room. They were general practitioners, general practitioners or neurosurgeons, pediatricians and gynaecologists. Some had fled years ago and have now become status holders through an endless asylum procedure. But with such a status you don’t have a job yet.
My colleagues from outside the EU have registered for a training course to be able to jump through the last hoop of their path to recognition of their ‘being a doctor’. Then they can be registered in the ‘BIG register’ and they are again a basic doctor. Do they know enough? Can they get along with Dutch patients? In this training for their clinical skills exam, I participated as a simulation patient.
Don’t think you can just work here if you’re on the run from war or persecution. This could endanger the Dutch patient, because safety is the assessment standard of the Commission which is about that. There is something to be said for that, but the obstacle course is long and unnecessarily complicated. It is logical that you should be able to speak Dutch well, but I am not sure that Jan Blanken will die because you have not demonstrably mastered the basic medical knowledge again.
I looked at the sample test and saw that I would fall. Because, for example, I have no idea whether raising your arm to 45 degrees makes your shoulder joint roll, slide, or do both. Still, I check a shoulder a few times a week, apparently without realizing exactly how it works there. Just like that I no longer know what the function of catechol-o-methyltransferase is. The Eastern European gynecologist who delivered thousands of babies will have forgotten that too. Just like the majority of Dutch doctors.
That basic knowledge is just one of the obstacles; they have to take language courses, understand English at a level, do internships and finally take those exams. That clinical exam is relevant: the way in which doctors and patients talk to each other in the Netherlands is certainly different from that in Syria or Russia. Although ‘deciding together’ is not yet common practice in the Netherlands, it takes some getting used to for them. In many countries the doctor is in charge, acting defensively and the patient dutifully doing what he is told. I played a twenty-something who didn’t feel like having a colon test done with a little blood loss from his hemorrhoid. Confusion everywhere.
Fortunately, Dutch educators help through the foundation for refugee students UAF or the Education for Foreign Doctors Foundation (OBUA† General practitioners provide training, internists go through the basic material and there are webinars and internships. I believe that through simpler regulations, testing on actually relevant parts and, above all, help from the profession with more internships and training courses, much-needed care providers can get to work much faster. Good for them and good for patients.
Soon I would like to be operated on by a former neurosurgeon from a distant country or have such a doctor at my bedside in the nursing home.
Joost Zaat is a general practitioner