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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:
Thread gallery
84
mumsneedwine · 20/02/2025 19:56

Sorry ! Typing while cooking. Plymouth AstarAA, Oxford AAA, B'ham AA.

mumsneedwine · 20/02/2025 19:55

@Auchencar oh bless you. Now calling me a liar 😂.

Oxford requires AstarAA while AAA. Cambs require A*AA. I can provide the full spreadsheet for every Uni if you like - I give it out for free on the medicine applicant threads every year

Clavinova · 20/02/2025 19:52

Needmoresleep
Do you have views on Boris' lifting of the RLMT?

The recommendations that all medical practitioners be added to the shortage occupation list (thereby exempting them from the RLMT) were made before Boris Johnson became PM;

On 29th May 2019 the Migration Advisory Committee published its recommendations that all medical practitioners including GP's should be added to the shortage occupation list (SOL). This means that the recruitment process for non-EEA GPs will be significantly quicker as since 7th October 2019 there is now no need for practices to satisfy the Resident Market Labour Test (RMLT),

https://www.kentlmc.org/tier2visasforpractices
https://www.phstrecruitment.org.uk/recruitment-process/am-i-eligible/uk-eligibility

May 2019

The British Medical Association (BMA) has welcomed the latest proposals from the Migration Advisory Committee’s new review of the shortage occupation list.

The proposals recommend placing all doctors on the list – something the BMA believes will address chronic workforce shortage.

“The BMA is delighted that such a respected body as the Migrations Advisory Committee has listened to the BMA and proposed a bold, but much needed, recommendation to place all doctors on the shortage occupation list.

“This welcome proposal is a victory for the BMA and for the sustained lobbying by the Association to address the chronic workforce shortages which are undermining the delivery of patient care across the NHS."

https://practicebusiness.co.uk/bma-welcomes-proposal-to-add-doctors-to-shortage-occupation-list

Auchencar · 20/02/2025 19:52

I'm afraid that I'm now struggling to believe that you actually have been sending 'lots' of your Chemistry students to Oxford for years if you don't even know the entry requirement, which is not in the least new. It's not a typo since you've made a point about relative standards based on some extremely old info. If you want to be credible, get your facts straight because as it is you are your own worst enemy on the credibility front. Even our History teachers at school know that Oxford Medicine requires A*AA (a fair number of students take a humanities subject for enjoyment/ breadth).

Auchencar · 20/02/2025 19:44

*dimwit muppet is even more dumb than Tim-Nice-But-Dim.

Auchencar · 20/02/2025 19:43

mumsneedwine · 20/02/2025 19:34

However, I can't see a lot of medical schools, that have travelled far in the direction of less science and excessively early patient contact, changing very much

YouTube do realise GMC accredite every course ? It's not up to the Unis what they teach - they all cover the same stuff. But this won't fit the agenda of those who believe that there are only 5 Unis worth going too.

Plymouth requires AstarAA while Oxford only needs AAA so Plymouth is much better I assume as has higher entry requirements ?

Oxford has required A*AA for years and absolutely even the most dimwit muppet knows that the interviewing process that Oxford uses to great effect means that their offers have always been relatively low. There are a few exceptions for certain highly mathematical subjects but this is the general rule.

I do wish it wasn't necessary to have to correct your statements so often mumsneedwine. I'm referring to the statements you present as fact, which they so often are not. Opinion is not what I'm talking about, before you jump on that as get out of jail free card.

mumsneedwine · 20/02/2025 19:40

@Finallylostit I'm afraid it is.

AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
mumsneedwine · 20/02/2025 19:40

@Finallylostit this is the data supplied by NHSE. After 1 year post F2 in 2022 60% of people were not in training

AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
Finallylostit · 20/02/2025 19:38

No mumsneedwine - things might change but currently the evidence is not out

mumsneedwine · 20/02/2025 19:36

Define a good doctor please,

mumsneedwine · 20/02/2025 19:35

@Finallylostit again, for the hard of hearing, things have changed this year. Just look

AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
Finallylostit · 20/02/2025 19:34

And as can be seen from the MRCP fiasco, exams are not important to be a good doctor. 19.5% got the wrong result but they've gone in to be great doctors.

This is a fiasco but it happened at the end of 2023 - it does not correlate that all of them have gone to be great doctors and there is no evidence to suggest that. A lot more years needed of training to give that opinon

mumsneedwine · 20/02/2025 19:34

However, I can't see a lot of medical schools, that have travelled far in the direction of less science and excessively early patient contact, changing very much

YouTube do realise GMC accredite every course ? It's not up to the Unis what they teach - they all cover the same stuff. But this won't fit the agenda of those who believe that there are only 5 Unis worth going too.

Plymouth requires AstarAA while Oxford only needs AAA so Plymouth is much better I assume as has higher entry requirements ?

Finallylostit · 20/02/2025 19:33

As things stand now, around 8 per cent of doctors finishing foundation training didn’t receive an offer after applying for a speciality, according to Billy Palmer, the Nuffield Trust’s senior health policy fellow.

Probably about right - does not mean they did not get a job and did not continue training in an unrecognised training job. So around 800 juniors to fill the non training jobs - there are far more than 800 jobs needed to cover the rotas etc - hence the need for overseas doctors
Some simply just not get a training job and be advised on this - normal belll curve distribution

mumsneedwine · 20/02/2025 19:29

Wes today

AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
Clavinova · 20/02/2025 19:26

Needmoresleep
Why is Australia hiring from here rather than from India?

Australia is clearly recruiting from here and India;

https://www.wagov.pipeline.preproduction.digital.wa.gov.au/government/media-statements/Cook-Labor-Government/Western-Australia-on-show-to-skilled-health-workers-in-India--20240221

Auchencar · 20/02/2025 19:22

😂(Sorry, since I realise you're serious, but I especially like the confining of infection control nurses to barracks)

Please God let there be some equally plain speakers on the working committee/ all relevant committees everywhere.

Marchesman · 20/02/2025 19:14

@JulietteBravissimo and @Auchencar

Higher entrance requirements would help, along with more honesty. Such as Oxford's: "Practising Medicine can be arduous, stressful, frustrating and bureaucratic and is not suited to everyone." However, I can't see a lot of medical schools, that have travelled far in the direction of less science and excessively early patient contact, changing very much.

The other issue, which gets no attention in this context, is consultants' pay and conditions. For all their problems, juniors now don't have as difficult a time as their predecessors, nor are they junior for as long. But it was easy to put up with a lot when you were looking forward to having the sort of professional autonomy and respect that consultants once had. Current juniors don't have that to look forward to.

To get back to it you would have to scrap revalidation (for which Shipman provided a feeble excuse), along with mandatory teaching of any kind, markedly truncate the time wasted on appraisal (including juniors'), confine infection control nurses to barracks, limit HR to their historic medical personnel function, stop fining medical staff for parking in the wrong place, stop charging them for parking, give them back control of their outpatient clinics, stop paying them by the hour, resuscitate medical staff committees, and generally treat them as adults who are not bad at what they do when they are left to their own devices - and then spend the money that you save on expanding services.

None of which will ever happen.

Sorry!

Auchencar · 20/02/2025 19:06

My impression given recent statements it has also taken others by surprise. Wes Streeting, the BMA etc

Absolutely no surprises. Wes Streeting has been asked multiple times about the situation and has thus far only ever answered by not answering (saying that more med school places have been created). The BMA has not wanted to address the issue - I think that was discussed on an earlier thread. No-one but no-one is surprised.

Auchencar · 20/02/2025 19:01

OneMorePiece · 20/02/2025 18:15

That Nuffield Report is from September 2023 before the IMG explosion.

That's very recent in terms of validity for this sort of report.

OneMorePiece · 20/02/2025 18:15

Needmoresleep · 20/02/2025 17:37

From this afternoon's FT letter:
Demoralised young doctors
The Nuffield Trust has calculated that fewer than three in five doctors (56 per cent) in ‘core training’ — that’s the part after you’ve completed medical school and two years foundation training — remained in the NHS in England eight years later.
As things stand now, around 8 per cent of doctors finishing foundation training didn’t receive an offer after applying for a speciality, according to Billy Palmer, the Nuffield Trust’s senior health policy fellow.
That’s incredibly demoralising for young doctors who have already invested seven years of their lives in that career; and wasteful for the British state which now spends £327,000 on getting each student through med school.
That leads to the perverse situation described by third-year med student Eli Sassoon, on X on Tuesday, where his faculty was “encouraging students to look at careers outside of medicine” because of a lack of speciality training jobs.
As Sassoon told my colleague Laura Hughes, he’s now looking at the possibility of going to Australia: “It isn’t rocket science: there really is no point doubling the number of medical students if you can’t train those students afterwards.”
Workforce “refresh”
So without significant investment in training or a change of tack, the situation is going to get worse since the current NHS Workforce Plan (a 2023 scheme drawn up by the last government) has a target of 15,000 medical students by 2030-31.
That’s 5,000 more in five years, entering a system that already can’t cope. That is not sustainable without change.
This week NHS England commissioned a review led by the national medical director Stephen Powis and chief medical officer Chris Whitty into postgraduate training for newly qualified medics.
Labour also knows change is necessary. It is promising a “refresh” of that 2023 Workforce plan which, in the best traditions of recent Whitehall policymaking, was, to put it kindly, not very joined up.
As the Nuffield Trust’s Palmer says: “The ‘plan’ seems to have been to put all eggs in the basket marked ‘lets just ramp it up, turn on the training taps’ and then hope for the best.”
The new Labour government is trying to rationalise the approach when it comes to the NHS, deferring the Conservatives’ unfunded new hospital building programme to realistic levels given the state of public finances and looking to ‘refresh’ the NHS Workforce Plan.
Early indications from health secretary Wes Streeting are that there will be a shift to community health services and more GPs — another area of pent-up demand that requires a significant (but managed) domestic expansion programme.
Because per the Nuffield Trust, on average, nearly two GP training posts are required to get one fully-qualified, full-time-equivalent GP joiner as a result of dropout rates and increased flexible working requirements.
But there is domestic demand — as is demonstrated by the number of UK students who can’t get places in UK med schools so go to European countries like Bulgaria to get their medical degrees before returning to the NHS.
(That’s why I was away last week; you can read my report here. Anyone who likes bashing flaky ‘Gen Z’ kids should meet these students who were prepared to go and study in the Balkans for six years to realise their ambitions. They were very impressive.)
The key, however, if the UK is serious about growing its domestic talent pipeline, will be to manage that expansion across the entire training period which — from undergraduate to consultant doctor — can take 16 years.
In a world where doctors increasingly want flexible working, the Nuffield Trust argues that may also mean more inventive ways of retaining NHS staff — from staggered student loan forgiveness to preregistration employment that offers a paid bridging year between finishing education and being a fully-registered clinician.
Because, as the Nuffield Trust argues, fixing the leaks in the pipe may be as impactful as continuing with a profligate increase in supply.

That Nuffield Report is from September 2023 before the IMG explosion.

Marchesman · 20/02/2025 17:49

Needmoresleep · 20/02/2025 17:43

I am not sure I recognise all of this. Only 8% didn’t receive an offer after applying for a speciality after Foundation training. I am not aware ofr anyone in DDs rotation getting one. The high drop out after core training sounds more likely. Oddly no mention of the fact that jobs are open worldwide which has really bumped up competition levels.

Still there is recognition there is a problem. Lets hope they something can be done so our DC can build careers in the UK.

This "solution" maintains or reduces the current number of hospital beds and therefore senior hospital posts, in the hope that general practice takes up the slack. Good luck with that.

Needmoresleep · 20/02/2025 17:43

I am not sure I recognise all of this. Only 8% didn’t receive an offer after applying for a speciality after Foundation training. I am not aware ofr anyone in DDs rotation getting one. The high drop out after core training sounds more likely. Oddly no mention of the fact that jobs are open worldwide which has really bumped up competition levels.

Still there is recognition there is a problem. Lets hope they something can be done so our DC can build careers in the UK.

OP posts:
Needmoresleep · 20/02/2025 17:37

From this afternoon's FT letter:
Demoralised young doctors
The Nuffield Trust has calculated that fewer than three in five doctors (56 per cent) in ‘core training’ — that’s the part after you’ve completed medical school and two years foundation training — remained in the NHS in England eight years later.
As things stand now, around 8 per cent of doctors finishing foundation training didn’t receive an offer after applying for a speciality, according to Billy Palmer, the Nuffield Trust’s senior health policy fellow.
That’s incredibly demoralising for young doctors who have already invested seven years of their lives in that career; and wasteful for the British state which now spends £327,000 on getting each student through med school.
That leads to the perverse situation described by third-year med student Eli Sassoon, on X on Tuesday, where his faculty was “encouraging students to look at careers outside of medicine” because of a lack of speciality training jobs.
As Sassoon told my colleague Laura Hughes, he’s now looking at the possibility of going to Australia: “It isn’t rocket science: there really is no point doubling the number of medical students if you can’t train those students afterwards.”
Workforce “refresh”
So without significant investment in training or a change of tack, the situation is going to get worse since the current NHS Workforce Plan (a 2023 scheme drawn up by the last government) has a target of 15,000 medical students by 2030-31.
That’s 5,000 more in five years, entering a system that already can’t cope. That is not sustainable without change.
This week NHS England commissioned a review led by the national medical director Stephen Powis and chief medical officer Chris Whitty into postgraduate training for newly qualified medics.
Labour also knows change is necessary. It is promising a “refresh” of that 2023 Workforce plan which, in the best traditions of recent Whitehall policymaking, was, to put it kindly, not very joined up.
As the Nuffield Trust’s Palmer says: “The ‘plan’ seems to have been to put all eggs in the basket marked ‘lets just ramp it up, turn on the training taps’ and then hope for the best.”
The new Labour government is trying to rationalise the approach when it comes to the NHS, deferring the Conservatives’ unfunded new hospital building programme to realistic levels given the state of public finances and looking to ‘refresh’ the NHS Workforce Plan.
Early indications from health secretary Wes Streeting are that there will be a shift to community health services and more GPs — another area of pent-up demand that requires a significant (but managed) domestic expansion programme.
Because per the Nuffield Trust, on average, nearly two GP training posts are required to get one fully-qualified, full-time-equivalent GP joiner as a result of dropout rates and increased flexible working requirements.
But there is domestic demand — as is demonstrated by the number of UK students who can’t get places in UK med schools so go to European countries like Bulgaria to get their medical degrees before returning to the NHS.
(That’s why I was away last week; you can read my report here. Anyone who likes bashing flaky ‘Gen Z’ kids should meet these students who were prepared to go and study in the Balkans for six years to realise their ambitions. They were very impressive.)
The key, however, if the UK is serious about growing its domestic talent pipeline, will be to manage that expansion across the entire training period which — from undergraduate to consultant doctor — can take 16 years.
In a world where doctors increasingly want flexible working, the Nuffield Trust argues that may also mean more inventive ways of retaining NHS staff — from staggered student loan forgiveness to preregistration employment that offers a paid bridging year between finishing education and being a fully-registered clinician.
Because, as the Nuffield Trust argues, fixing the leaks in the pipe may be as impactful as continuing with a profligate increase in supply.

OP posts:
mumsneedwine · 20/02/2025 15:37

To clarify, so no more stalking behind the scenes. My DD has a job Down Under. But she'd rather stay in the UK, but not be unemployed. She has not taken an exam as her chosen speciality doesn't use one.

Clear ? Now please let's keep this away from the personal.

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