Why are newly trained doctors not getting jobs and leaving the UK when we’re so short of doctors?

At our closest hospital 8 doctors were let go leaving two. It's crazy. My GP the senior partner said the government and the BMA are to blame

https://www.bma.org.uk/bma-media-centre/bma-seeks-deal-on-doctor-unemployment-as-survey-reveals-half-of-resident-doctors-finishing-foundation-training-have-no-job-to-go-to-next-month

Are we going to see change now?

Remember they can all talk but until we see it in action....

www.dauk.org/news/2024/05/03/frustration-for-final-year-medical-students-still-to-be-allocated-jobs/

www.nursingtimes.net/news/education/new-nurses-struggle-to-find-jobs-despite-national-shortage-20-06-2024/

What a mess we are in.

I've been scrutinising the manifestos to see if any of the parties have specifically mentioned this bottleneck but haven't found anything yet. Anyone had more luck than me?

What a mess. Things HAVE to change after the 4th. I'm going to remain hopeful (because the alternative involves kangaroos and koalas for me).

It's any NHS job. It's getting to the point that replacing staff that have left is extremely difficult let alone creating new posts if you wanted to expand a service/train more junior doctors/nurses/AHPs. If you need more non-clinical roles to support all those clinical staff you can absolutely forget it.

It's not just doctors. Thousands of nurses are qualifying and can't get jobs.

Plenty of band 5 jobs for nurses with experience. But very few (none) for those newly qualified.

I've heard of nurses about to qualify being contacted by trusts and having job offers withdrawn.

The nhs is a mess.

We are the only country in the world who do not give priority to our own trained staff. So anyone can apply from anywhere in the world, with no experience of the NHS.

We spend ££££ training them but then don't employ them. It doesn't make sense.

All most doctors want at the moment is a job. Any job. F2s are facing unemployment in a few weeks as no jobs for them. In an NHS crying out for more staff.
PAs are taking training opportunities from doctors, leaving them to do the grunt work in some cases.
GPs can't get jobs due to the stupidity of ARSE funding (my name for it).
It's almost like someone wants us all dead, unless we are rich.

My friend a GP bought into a practice took her a decade and 250k of her earnings to get a partnership. This was 15 years ago. Daresay it will be more now.

Who can afford to buy into a practice these days?

This is a complex issue and please be wary of sensationalist headlines / SM discussion. You won't get the full picture.

Going to AU/NZ on completion of foundation training has been popular for a while. The majority return home after a year or two to commence specialty training.

Workforce planning requires multiple stakeholders working together. Well resourced teams and effective systems certainly help but are not there in practice. I believe HEE had to reduce their staff complement by 50%? It's easy to scapegoat admin/management staff but they have v little control in this situation.

The task has become so much more difficult due to LTFT, extensions to training, stat leave, EWTD etc.It is also v region + specialty dependent. There are specialities that do have training bottlenecks + high competion ratios. Others, such as GP might not fill all posts available. London is popular while other regions will be seen as undesirable to many. This will be reflected in competition rates. It isnt as simple as just create more posts.

Concerningly, in GP there are more trainees with multiple exam failures and issues around professionalism. There is also a small group who are clinically v poor and require a huge amount of senior support. You won't see this mentioned in debate but is a growing problem. It certainly contributes to the complexity of workforce planning and is v much a patient safety issue.

The current discussion has focused on GP recruitment. In terms of context, practices have been struggling to recruit for salaried roles/partnerships. Locum market boomed with premium rates that practices could barely afford. Not sustainable. Using PAs to provide cover is obviously inappropriate.It is an unscrupulous minority doing it.

As a patient, I can only express my concern about the toxicity of this debate. So much misinformation and pointless baiting. There are multiple issues at play here. We need to be mindful to keep context in mind: an underfunded healthcare system with ever increasing demand.

'We need to talk about the GP partners who game the system''We need to talk about the GP partners who game the system'www.pulsetoday.co.uk/views/editors-blog/we-need-to-talk-about-the-gp-partners-who-game-the-system/www.pulsetoday.co.uk/views/editors-blog/we-need-to-talk-about-the-gp-partners-who-game-the-system/www.pulsetoday.co.uk/views/editors-blog/we-need-to-talk-about-the-gp-partners-who-game-the-system/

@Willmafrockfit
I don't know . If I didn't know her so well I wouldn't have believed my ears ! She was saying how fed up all the nurses are . They feel cheated of the future they were trained for

Apologies. You are right. I thought the cap had been lifted, but this was hasn’t happened. Universities have asked for it though. It doesn’t change the fact that we don’t have enough places for talented British students to successfully apply for and then we don’t seem to have enough trainee places after graduating, despite a massive shortage of doctors.

I agree, OP, that this issue needs more focus. My dd is about to embark on her medicine degree and at the moment, she absolutely wants to stay and work in the NHS, but who knows whether she will still feel like that in the future when she has seen first hand how bad the working conditions are, and who's to say that she will even get a job at the end of it all. I will be lobbying my new MP to ensure that they start looking at this issue!

From my ds's POV, he doesn't really want to go to Australia but if he can't get a post foundation place here, and he can more easily get a job in Oz that is better paid, with better working conditions, a better lifestyle and where the training he does is recognised in the UK then he will really have no option.
Every political party talks about increasing the number of places at medical school but none have mentioned sorting out the reasons for this brain drain. The junior doctor s' strikes and their dissatisfaction are much more about these issues than money but it's easier to argue about pay rises than overseas recruitment and workforce planning.

It isn't true that a third of medical students are international students. The intake of international students onto medicine courses is capped, I think at 7.5%.

But totally agree that pay and working conditions for junior doctors are disgraceful.

Check out the Additional Roles Reimbursement Scheme for GP Practices. This may shed some light on how clinical roles are recruited.

I dont think you understand how medical recruitment, or visas, work.

The BMA is a union and has nothing to do with training numbers.

To quote previous posters:

“Medical workforce planning has been a disgrace for decades.”

“It’s due to non-sensical medical workforce planning. One of the NHS seems completely unable to communicate to the other part.”

Physician associates were piloted to assist with gaps in the medical workforce as a result of years of poor-planning and terrible management.

They have now become THE problem child
scapegoat for the entire shit-show circus, with the social media warriors conveniently forgetting the issues that led to the role being brought about in the first place. There has clearly been role creep, where in many cases the job has outgrown the original spec. The key question is WHY this is - what are the driving factors?

PA’s are not planning a militant coup to replace doctors. Those I work with just want to work quietly alongside them. We’re missing the bigger picture in a big way here.

Yup - PA training will not be recognised abroad in its current form. That is also poor leadership by those that forced and expanded the roles as a form of cheap labour, laced with false promises.

To increase productivity, we need 'Physician Assistants'. Similar to how health care assistants support nurses. Physician assistants can of course go on to medical school and become doctors

Not fair that someone in need of help (so vulnerable) should have to be assertive. The onus should be on Trust leadership to ensure every single healthcare staff a patient comes in contact with introduces themselves clearly and their role in a way the public understands. And really, a PA should not be the first contact for undifferentiated patients (patients that have not been seen by a doctor or advanced practice nurse). That established the relationship and once a care plan is made, actions or aspects of care can be delegated to assistants - which is what PAs are

And the number of medical
student places and training doctor places is designated by NHS England, nothing to do with the BMA!

Your BIL should take up a substantive GP post (salaried or partner). Locums cost a lot but the NHS has been forced to pay ridiculous sums to locums for a long time. PAs are not a good Development for many reasons - the main one being they don't have the prerequisite base line knowledge to practice medicine and can therefore not safely 'play doctor'. However, GPs (and doctors in general) have milked the locums system too long and that needs to change too

Crap conditions, compromising their registration, bullying, harassment, chronic understaffing, having leave cancelled at the drop of a hat, having to pay insane exam fees, salaries that would be far higher than they are if successive governments hadn't shafted them since 2010 in particular...

Don't believe me? Take a trip to any A and E, especially in the north west of England, and just observe the conditions for ten minutes. Try not to get in the way. If you want the full NHS tourism experience, do it on a Thursday or Friday night before a bank holiday.

You'll mostly (with the exception of a couple of A and Es in Greater Manchester which are generally akin to field hospitals but nowhere near as well organised) see stressed people doing their best with, metaphorically, elastic bands and tissue paper. That level of stress, day in, day out, is not sustainable for anyone. Add that to the lousy weather and rubbish general standard of living and it's amazing we've got any doctors left.

In other parts of the country it's almost as bad but there may be other factors that keep people going - beautiful landscapes or low costs of housing.

Oh, and Health Education England no longer exists as a separate entity, it's been absorbed into NHS England for a while now. Growing our own is a great idea but at some Trusts what exactly happens to at least some of the training money given by HEE has always been something of a mystery, as it certainly doesn't appear to reach medical or nursing or AHP education in any form. Under whoever forms a new government it would be helpful if NHSE could maybe start auditing where that funding actually goes and examining the financial evidence rather more carefully than they currently appear to...

In general for a bit of context around how recent governments have funded the NHS, try this link

https://www.health.org.uk/publications/long-reads/health-care-funding

For those blaming PAs anecdotally quite a few who would like to work in hospital settings can't get jobs as there aren't even any to apply for. There's a handful of GP based roles. At this rate they'll be emigrating too and we'll continue to charge insane visa amounts for overseas trained doctors to come and work here. That's assuming their qualifications are deemed acceptable of course, at least a couple of our friends from the Commonwealth with fantastic experience and qualifications had to redo their entire medical training. And this was an ex colony if you'll pardon the expression with English as the main language...