We are concerned for the professional future of many thousands of international medical graduates who are still in training. The government has shattered their dreams by effectively denying them equal opportunities at critical points in their career: when applying for higher specialist training or a consultant post (Department of Health, 2006; Reference O'DowdO'Dowd, 2006).

For the Royal College of Psychiatrists, which maintains strong links with the international community and has a large proportion of international medical graduates as members, this ruling is especially pertinent. Trainees who have worked towards highly competitive sub-specialty or academic posts will suddenly find themselves having to relocate and rethink their career, possibly moving into career grade posts. This is a repetition of what happened in the ‘60s and ‘80s when many doctors from the erstwhile ‘Empire’ were sent to work in unpopular specialties in remote areas. The current system, which has created many hundreds of unemployed doctors, has to change, but not at the expense of those who have in good faith contributed to the National Health Service (NHS). A better solution would be to effectively manage the entry of more doctors into the country, maybe through scholarships, but also to ensure that doctors who are already in the NHS are not unfairly discriminated against.

Declaration of interest

Both authors are international medical graduates who may be affected by the above ruling.