Why don't we just train more doctors?

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The UK has had a shortage of doctors for decades now and we have relied a lot on using doctors trained overseas.

I understand that it's expensive to train doctors but it's clearly a lot more expensive to not have enough doctors and have to pay locums at locum rates.

It's also a lot more expensive when people are unable to work due to waiting sometimes a year or more for medical treatment that will let them get back to work.

Lots of people make the grades for medical school and there is no shortage of applicants, nor has there ever been.

What has been the blocker to training more doctors, I just don't get it?

Depends who'd trained them.

We have a very low number of beds compared to other countries and we still use a traditional bedside training model in this country with 3 years on the clinical placements. If you create new medical schools you need to fund and staff them. Current schools are at capacity after an expansion programme and new schools, which then need the same regions for placements.

It also takes 5-6 years to get medical students to foundation doctor and 5-15 years to get them fully trained. So senior doctors can keep retiring but they cannot be replaced quickly.

We need to shorten the degree (but a lot of NHS funding is premised on the current structure so this will be hard) and to rapidly invest in allied professionals where they can be trained to advanced status in 3-5 years. But again our lack of beds is an impediment as allied professionals train at the bedside too.

Its very tricky.

Are you seriously suggesting the training organisation should own their staff?

How long for given most consultants trained somewhere different to the trust they are working in and often over 20 years ago? How long are they owned for?

The NHS provided the training. I had 20 grands worth of training for a company and had to stay 3 years after. So for 200k worth 30 years should be fine. Or they could pay it back.

@Itsbiasedhere med students graduate with about 90k debt.

The doctors of the NHS provide the training. The trainee consultants ( ‘junior’ doctors) are paid very poorly for their work as detailed above.
NHS consultants have had a pay erosion of 35% over the last 12 years.

what idiotic nonsense to suggest they must be owned in some way by theNHS

anyoneis allowed to do anything they like in their free time, I believe🙄

As another poster pointed out, we’ll need payback from everyone who attended a uk uni, supplemented by the taxpayer who is in any sort of employment then.
id especially like to find a plumber whose training I helped fund in a FE college today…

Actually the NHS didn't. Most kicked off with 5/6/7 years at a university. Should they have to work for the university fir a few years? Should all students?
Then the deanery sorts medical education not the trusts.

Should teachers in private schools pay back their costs?

Do we want to live in a society where everyone's time is owned by the state - very 1984 ?

I'm always amazed at those who think it's such an easy and lucrative number haven't trained themselves. What do you do @Itsbiasedhere ? Do you work for your employer at the weekend, in the evening and during your leave?

As I mentioned previously following a similarly ludicrous suggestion, you will have a massive recruitment crisis.
You will then have to use conscription into medicine

• Funding mainly
• Not enough places at medical school
• It’s a very long course and they will also have drop outs
• Destination surveys have shown that trained doctors go abroad after qualifying, go into academic posts or leave the profession entirely
• In training, there may not be appropriate placements for them to complete all their rotations or their may not be the buy in from teaching hospitals
• Educational supervisors may not want to take on trainee doctors, meaning they can’t get the experience they need

Plenty if reasons really. Remember it’s not just about training, it’s about retention.

A lot of contracts of employment are pretty specific in not allowing the employee to undertake similar work elsewhere. It's been in all my contracts as a chartered accountant. I simply wasn't allowed to work as an accountant for anyone else, anywhere else, and I needed express permission to work in any other type of job. I was also specifically prohibited from undertaking any form of self employment. It was all in the contract of employment which I had to sign to be given the job. That doesn't mean the employer "owns" me, it's the employer protecting their business and I thought it was pretty reasonable really. I couldn't work for a competitor doing the same work, but I could, say, get a part time job in a bar in an evening or McDonalds at the weekend to earn extra money - I never heard of them ever refusing to give permission for that kind of part time unconnected work. As I say, very similar conditions were in every job I had through a few decades of working for other firms - it wasn't just one firm being unreasonable, it was industry-standard.

I'd never even imagine a scenario where it would have been permissible for me to run my own self employed accountancy business alongside my "day job" - whether it was contractually banned or not, the conflict of interest is obvious.

I don’t know if it’s been mentioned yet but the plan is to fill gaps with ARR staff such as GP assistants, physicians associates, paramedics and pharmacists.

technically, it has some merit. You move your more ‘low hanging fruit’ patients towards these roles for minor illness, medication reviews and leave GP’s and doctors more available to work at the top of their licence. It’s going to be cheaper to train these staff and more cost effective.

We do not need more GP’s or doctors to see all the patients with sore throats, with diabetes or who feel depressed, there will be other qualified staff who are better placed for this, and the doctors can then focus on differential diagnosis or complex care. It is just going to take time to train these staff and get them through their prescribing courses. They also need supervision, doctors are good teachers

a lack of nurses is a really big issue. Doctors cannot work effectively without nurses and inpatient wards cannot operate or district nursing teams. Nursing pay needs to be addressed. More doctors doesn’t fix the issue of anything really

More APR staff sounds like a good idea.

So far where I work, it’s working well. They are great at medicines management, minor illness and relatively stable long term condition monitoring. They do find it harder when it is not straight forward medicine but that’s what the GP’s are for, to pick up patients who are more complex.

Yep, should invest more money in this rather than doctors. A relative of mine, qualified as doctor abroad, was amazed at situations where she as the junior doctor had to do "non-doctor" jobs as there was not enough other staff to do this.

Agree. The associate staff will be key. However, due to retirement and attrition, we will need to train more doctors as well. I hope they review the length of the degree. It probably doesn’t need to be 5 years.

Because the problem isnt doctor numbers. It’s the communist system.