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AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs

795 replies

Needmoresleep · 16/02/2025 15:22

Unbelievable but true.

Doctors, nurses and other health care professionals now have to compete for jobs and training with applicants from across the world. No priority is given to those already in the country.

Even ordinary entry level jobs can attract hundreds of applicants within a few hours. Newly qualified doctors and nurses need that first job to get the experience that overseas applicants will be able to offer.

In 2021 immigration law was changed and something called the Resident Market Labour Test was dropped for health and care workers. It means that the UK may be the only country not to prioritise those already in the country.

The previous thread:
https://www.mumsnet.com/talk/am_i_being_unreasonable/5267503-aibu-to-be-furious-that-there-are-no-jobs-for-young-doctors?page=1
included a number of stories. An entire graduating class of nurses unable to find that first job whilst administrators from the local hospital were taking recruitment trips to Asia. An experienced GP wanting to return from a career break only to discovering that she, and others in a similar position, could not find work, a consultant surprised at how well qualified locums seeking zero hours, short notice, cover work are. The number of overseas doctors applying for the limited number of specialist training positions in the UK doubled between 2023 and 2025.

A group of us, who have been on the higher education board since our DC were first applying to medical school, recently discovered that none of our DC, coming to the end of their foundation years (F1& F2) expect to get anything other than the odd shift with NHS bank. Most see moving to Australia as the only way to stay in medicine. They say the same applies to their peers.

Our young doctors have spent seven or eight years getting to where they are, and have £100,000 of student loans to repay. The taxpayer has spent £250,000 on each of them.

Unfortunately the NHS does not appear to keep data on the number of applicants per vacancy, nor on vacancies that, because of the numbers applying, close within a few hours. It also does not appear to question why such a small proportion of F2s are progressing within the NHS. Instead there seems to be an assumption that this wastage is somehow natural, and that the solution is to re-double international recruitment efforts, to increase medical school places, and to replace traditional junior doctor roles with less skilled Physician Associates. Measures that will only increase the problem.

If things are not changed, even more of our skilled and dedicated young people will find themselves without jobs. We would welcome experiences, information and ideas.

Please also spread the word, write to your MP, tell people in a position to influence who may not be aware. We have a shortage of doctors, nurses, midwives, and paramedics. Our first priority is to ensure that those already in the country are able to get jobs.

If young Doctors were asked, and the same will apply to other Health Care Professionals, they would argue that:

  • Busy F2s work long shifts including nights which makes extensive job search difficult
  • Posts often attract hundreds of applicants, and close within a few hours. This level of competition is in itself off-putting
  • Overseas applicants are often supported by agencies who can set alerts for vacancies and ensure that multiple applications are submitted. No such support is offered to UK applicants,
  • These agencies will help with the writing of applications so they score well against NHS selection criteria. Again no such careers support is offered to UK applicants.
  • The Government/NHS offer incentives for overseas doctors including bringing in dependents and scope for future citizenship, as well as some exemptions from some exams and relocation packages. These may motivate overseas doctors to apply for entry level jobs even if they are overqualified. Entry level jobs which our newly qualified young people need.
  • Various extensive and expensive courses are advertised on the internet designed to give participants an advantage when applying for specialist training in the UK. In contrast many UK medical schools do very little to ensure that their graduates have the additional academic super-curricular that, with current levels of competition, are effectively requirements to gain a training place. This year it is predicted that only 50% of the around 4,500 places will go to graduates from UK medical schools, even though it is recognised that for many UK training is simply a passport to well paid jobs in private hospitals in Singapore, Dubai or their home countries. This is poor workforce planning. If we are going to avoid a future shortage of consultants we need to prioritise those likely to build a future in the UK.
Many young doctors will see a couple of years in Australia as a reasonable fall-back. They accept that they will be taking jobs Australians don’t want and will be at the back of the queue when it comes to specialist training, but they will also be gaining experience in a different healthcare environment.

Others, including those with family or caring responsibilities, or those who brought their families over when offered fixed term contracts, simply face unemployment. We should not be recruiting overseas when we have good, qualified, NHS experienced, doctors, nurses and other HCPs in the UK driving Ubers or working in Tesco.

OP posts:
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Auchencar · 18/02/2025 16:16

mumsneedwine · 18/02/2025 16:05

On Twitter today, it's so sad.

Does the Tweet say which uni?

mumsneedwine · 18/02/2025 16:16

@OneMorePiece you have hit that nail. It's so sad that some people don't want to acknowledge the problem, but it's starting to gain some traction. The more people know the more things will change. Let's hope Wes is reading some of this.

Auchencar · 18/02/2025 16:15

mumsneedwine · 18/02/2025 12:53

And for anyone who thinks the University they go to matters. No one cares, or even looks for speciality training. It's points or MSRA.

No the name of the university won't matter at all but the fact that certain universities filter much more carefully than others when making offers will inevitably affect the success of graduates from certain universities. On the whole the academic standard is highest at Oxford, Cambridge, Imperial and UCL. Obviously there are exceptions. Plenty don't get offers from those universities but are very strong academically and go elsewhere. So this is a generalisation. Those same universities are also seen as providing a more academic ('traditional') course which helps when it comes to acquiring points for research, presentations etc. That doesn't mean that everyone from those few unis will avoid all potholes in the road but on the whole they'll be better set up for research, presentations etc. Now that the leadership category has gone, the effect of the more academic side has been enhanced, which favours these graduates even more.

OneMorePiece · 18/02/2025 16:12

mumsneedwine · 18/02/2025 16:05

On Twitter today, it's so sad.

In order to fix the issue, you have to first acknowledge there is a problem.

I think what the discussion on these threads have revealed is that a lot of people have yet to realise the magnitude of the problem and its implications for not only doctors but also for patients. This issue is very damaging to UK healthcare.

mumsneedwine · 18/02/2025 16:05

On Twitter today, it's so sad.

AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
mumsneedwine · 18/02/2025 16:01

Amazing how your DS knows so many students and all their exam results for the last few years. Mine couldn't have cared less what others got. And still lives at home ?

mumsneedwine · 18/02/2025 16:00

@Auchencar you missed my subsequent post.

Auchencar · 18/02/2025 15:50

mumsneedwine · 18/02/2025 09:09

@Auchencar I didn't say 2 years ago ? Where did you read that. He's having a coffee opposite me at the moment - believes he might know your DC !!! He's off to New Zealand as fed up of applying for jobs that have already closed. He agrees it must be because he's lazy and thick 😂.

Asked DS when he came in from golf whether he might have come across this guy and he said nah. The only male top-of-the-Cambridge-year that he knows from the last few years got onto his training pathway just fine, as you'd expect.

This is a slightly odd post if you'll forgive me saying. Since you don't know my DS I can't quite see how you named any distinguishing features which could identify him. I'm glad to report that DS hasn't gained any particular notoriety in medical circles so I don't quite know how you'd describe someone you know nothing about to this young man. It's just an uncomfortably weird thing to assert, whether true or not - especially with all the exclamation marks etc.

mumsneedwine · 18/02/2025 15:50

@OneMorePiece think that would be the easiest and fairest method. 2 years NHS experience gives you priority. DD has a job in Aus the their own staff didn't want.

OneMorePiece · 18/02/2025 15:14

Thanks for your insight. How frustrating it must be for everyone!

On the issue of prioritisation of UK medics, here are some opinions from UK IMGs about prioritisation. There are some good points about requiring NHS experience before starting, not relying on CREST forms signed overseas and PLAB amongst other things.

www.reddit.com/r/doctorsUK/comments/1imdars/to_imgs_on_reddit_what_form_of_uk_graduate/

Transcontinentalcyclist · 18/02/2025 14:34

OneMorePiece · 18/02/2025 13:58

So are you saying that there is a lack of communication and disconnect within the NHS recruitment system? As I understand it, resident doctors are willing to look outside the big cities and the teaching hospitals. They just haven't been able to secure the posts no matter how hard they have tried.

I don't write or submit the job adverts myself but from observing the frustrations of those who do, I'd say there's often a lot of delaying before HR get anywhere near actually putting the advert out. It's the same for other NHS careers, the NHS seems quite a wasteful organisation in terms of its personnel.

Marchesman · 18/02/2025 14:25

Needmoresleep · 18/02/2025 14:09

DD was at a well regarded and long established medial school. She went to Imperial for her intercalation. Attitudes and ambition were very different, and the initial level of snobbishness towards her medical school was ...interesting.

This soon sorted itself out in that the course (engineering) was very mathematical and some struggled. Another noticeable difference was the extent to which some prioritised individual achievement over group work. DDs medical school placed a large emphasis on learning in groups (Project Based Learning?) and so this came more naturally to her.

Given the emphasis on individual academic achievement I would not be surprised if Imperial students did better on the selection criteria used for training numbers. Equally those from DDs medical school might do better on the wards.

The Ellis paper identifies PBL as a determinant of exam success, negatively.

mumsneedwine · 18/02/2025 14:21

@Transcontinentalcyclist thank you. My own DD is fine. She's secured a v highly paid job in Aus in her chosen speciality. Doubt she'll return as they've offered her the chance to apply for training after 6 months, and she'll be a consultant in 4 years.

But I also help many students get into medicine and they are not so lucky as can't afford the visa or relocation costs. For them, I will continue fighting.

mumsneedwine · 18/02/2025 14:18

@Annoyeddd what's your point ? Trust jobs are funded by Trusts.

Marchesman · 18/02/2025 14:17

mumsneedwine · 18/02/2025 14:01

@Marchesman why would looking after the elderly be a joke to anyone ? Most complicated sector health wise. Takes a very special person I'd imagine.

I would say skilled physician and diagnostician, rather than "special person".

A long time ago it was not an acute speciality. If you were clinically orientated and couldn't make it in cardiology etc and didn't fancy general practice it's what a lot of people went into. As did foreign graduates who were often very good but suffered from discrimination when they tried to make the jump from registrar to senior registrar and consultant.

Annoyeddd · 18/02/2025 14:11

The training jobs ST1 CT1 etc are funded by NHS education and training by deanery - not individual trusts.

Needmoresleep · 18/02/2025 14:09

Marchesman · 18/02/2025 13:36

In general the university attended matters for career progression, as one might expect. Mostly but not entirely this is due to prior attainment. For example:

Ellis R, Brennan PA, Scrimgeour DSG, et al. "Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study." BMJ Open 2022;12:e054616. doi:10.1136/ bmjopen-2021-054616

www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=bmjopen.bmj.com/content/bmjopen/12/1/e054616.full.pdf&ved=2ahUKEwjHoLHimM2LAxUJSkEAHdG7CBcQFnoECBQQAQ&usg=AOvVaw0VPmO4xDfEPn4JROVchKCA

There will always be, and should be, winners and losers. The problem is that for many people it will be their first experience of losing.

DD was at a well regarded and long established medial school. She went to Imperial for her intercalation. Attitudes and ambition were very different, and the initial level of snobbishness towards her medical school was ...interesting.

This soon sorted itself out in that the course (engineering) was very mathematical and some struggled. Another noticeable difference was the extent to which some prioritised individual achievement over group work. DDs medical school placed a large emphasis on learning in groups (Project Based Learning?) and so this came more naturally to her.

Given the emphasis on individual academic achievement I would not be surprised if Imperial students did better on the selection criteria used for training numbers. Equally those from DDs medical school might do better on the wards.

OP posts:
Transcontinentalcyclist · 18/02/2025 14:09

@mumsneedwine also end of financial year is never a good time to be hoping for funding for new posts, your DD may have more luck after April when the financial year resets. There's a couple of workforce planning policy documents due soon as well which may offer some hope

Transcontinentalcyclist · 18/02/2025 14:06

mumsneedwine · 18/02/2025 13:09

@Transcontinentalcyclist my DD works in one of the most derived parts of the country. She's fighting hard to stay there, but limited funding for jobs.

Unfortunately the medical budgets in many places are extremely stretched and consultant posts are often going to be the priority above locally-employed/Trust-grade doctors because the consultants are more likely to e.g. reduce waiting lists compared to someone just out of FY training. The funding stream for training posts is quite complex and the final say on those is not usually down to the hospital unfortunately

Marchesman · 18/02/2025 14:05

mumsneedwine · 18/02/2025 13:51

@Marchesman that's just surgeons. A v small part of the doctor workforce. And the Uni still doesn't matter. Some people are better at exams but does not make them a better doctor.

I can't think of any speciality that doesn't have postgraduate exams, and being unable to pass them does quite reliably make you a worse doctor in that particular field.

mumsneedwine · 18/02/2025 14:01

@Marchesman why would looking after the elderly be a joke to anyone ? Most complicated sector health wise. Takes a very special person I'd imagine.

OneMorePiece · 18/02/2025 13:58

Transcontinentalcyclist · 18/02/2025 13:05

I am aware of the current and potential issues. I am a supervisor and trainer for medical students on placement and I'm a clinical and educational supervisor for FY doctors. I've been a consultant for a long time in a specialty which was traditionally unpopular and even derided by other specialties. However in recent years the applications have increased stratospherically and it's now highly competitive with a high fill rate at initial training entry stage. However in my small and less popular hospital in a highly deprived area with very high population needs, we still struggle to fill posts at both resident doctor and consultant level and there is little obvious input coming from both locally and NHS England regarding the longer-term retention of doctors.
We rely heavily on IMGs to fill the posts and participate in the rotas where I am, I'm not saying that's the correct option but until all resident doctors are willing to look outside the big cities and the teaching hospitals, certainly my specialty will continue to have vacant posts which new IMGs will fill.

So are you saying that there is a lack of communication and disconnect within the NHS recruitment system? As I understand it, resident doctors are willing to look outside the big cities and the teaching hospitals. They just haven't been able to secure the posts no matter how hard they have tried.

Marchesman · 18/02/2025 13:57

Needmoresleep · 18/02/2025 13:45

@Transcontinentalcyclist ditto mine. She would love to stay where she is, in an area which has huge unemployment, a huge drug problem, massive wait lists for things like surgery, and big problems with retention of NHS staff.

I wonder which Deanery....

But she needs an F3 post. She had busy F1&F2 rotations and the preparation required to apply for ever more competitive training slots means she needs that extra year. F3s jobs are few and far between, and there is a backlog from those who did not get training this year. The Trust recruits a lot from overseas, all the way up to consultant level, and it is not unusual for more junior staff to need to support new arrivals. They were also using F2s to train PAs, who will then go on to take the jobs they need. Apparently all but two on DDs rotation are looking to Australia.

More would stay if there were jobs and a more straightforward path. Or perhaps if more credit were given to experience of smaller busy and challenged hospitals, rather the need to win the arms race for academic bells and whistles. Most of her peers are from the area and have ties. Many plan to work up their specialist training applications in Australia, though there must then be a risk that the NHS will not look like an attractive prospect when viewed from afar. Indeed one silver lining for DD is the prospect of experiencing a better resourced health care system.

You say that you fill resident positions from overseas. One issue seems to be that because all positions are open to those from overseas, and some are attracting huge numbers, seemingly supported by agencies, the word has got out amongst F2s that it is not worth bothering to apply. Which leads to a vicious cycle. Fewer UK applicants, the NHS assumes they are not interested, and redoubles their efforts to attract overseas applicants, leading to still more competition for entry level jobs.

Oddly the advice on the thread especially from those who claim that this generation is not proactive enough is that it is easier to find a F3 type position, and access to research and the other things needed to enhance a CV, in London. I would have thought that the best chance of consistently filling jobs in less popular regions is to ensure that proper pathways exist for current F2s. They will know about the challenges but will also have friends, perhaps play sport or engage in other local activities, and be aware of the cracking scenery or places to visit at weekends.

I am trying to think of a speciality which other doctors laugh at. How rude of them.

Geriatric Medicine, I should think.

They stopped laughing after it became the last refuge of the general physician.

mumsneedwine · 18/02/2025 13:52

@Annoyeddd apologies. Meant to tag @Auchencar

mumsneedwine · 18/02/2025 13:51

@Marchesman that's just surgeons. A v small part of the doctor workforce. And the Uni still doesn't matter. Some people are better at exams but does not make them a better doctor.

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