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?

doctors are earning mega bucks in the NHS?

😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂

I’ve often wondered why we don’t require newly qualified doctors to commit to x number of years within the NHS as a pre requisite of their training place, in order to get more of a ‘return on investment’ after which doctors are free to work in any place/way they please.

I'd love to train as a GP and I know I'd be good at it. It will never happen though due to cost of training and length of training. It's just not a commitment I can make at this time and probably never will be able to.

Orangepolentacake

yes I thought Boonawoona22 ‘s comment on doctors earring ‘mega bucks’ in the nhs was hilarious too, then I thought must just be a wind up. I think most people are surprised as junior doctors ‘s salaries and how low they are ( even judging by a recent thread on that). Consultants have had the equivalent of a 35% pay since this government came in.

The question is, how healthy are these people, who are happy to see doctors leave the NHS. Why would anyone go through the extensive postgraduate training to become a consultant now when it has been so eroded? I know I wouldn’t if I had my time again.

as for the BMA as avery powerful and terrifying union, that gave me my laugh of the night. While the BMA are great when you need support and advice when the trust is trying to break the terms of your contract, if they were terrifying and powerful, why on earth have we had that 35% pay erosion/ cut, and why have we not balloted for strike on the pensions mess that’s causing many senior consultants to leave NHS to avoid a huge tax bill that takes months of their annual take home pay.

I didn’t realise the pay was so low, it surprised me! For a teacher the starting salary is similar but the training is less and the responsibility a lot less! Obviously doesn’t have quite the same progression though.

As a director in an NHS trust you would earn in-line with a specialist doctor. Most trusts have around 4 directors all earning similar, plus a chief exec I assume earning more. There is money in the NHS, it’s just not on the front line.

It's my understanding that the published figures for doctors salaries are not what doctors are actually paid given that they are paid extra for antisocial hours which the lower grades work - the pay given is the basic pay without these extra allowances.

Can any doctors confirm this?

Passportpondery

and also consider that the directors etc likely have not been through such a lengthy process to get to the higher end scale. The highest level is for a consultant who has worked as NhS consultant for 20 years. Given most only become a consultant after years of training in mid- late thirties, they are only paid that highest ( yet often quoted) higher end of the scale in their mid- late fifties. So they are not paid it for most of their careers, assuming retirement 10 years later. Currently such consultants are getting tax bills of enormous quantity of their yearly take home pay, so can’t stay on for those years anyway. They retire and are often then doing some scaled back private work, but it is not if their choosing. They would have happily continued in same NHS role if HMRC weren’t landing them with unaffordable tax bills ( based on theoretical rise in pension value, not actual value)

wtf at the “lack of hospital places” for new/training doctors. We waited in hospital (not A&E) for 4 hours to see a doctor who had already worked a day and night without sleeping. It’s commonplace. There’s plenty of demand for doctors everywhere - at any level, training or not. I’ve no issue with the foreign doctors - in fact they need to be doubled. Build some more fucking hospitals whilst you’re at it. We are desperate. Patients are choosing to forego essential treatment because the waiting is an endurance test. My db had to piss in a bottle whilst immobile with others in the room in his latest endurance test in hospital. My dm had a mastectomy and had to spend the night on a trolley pushed around periodically as no bed available. Waiting lists are up to 2 years for some things. For a first world country, we are a disgrace.

BMA must be managed by people who don’t have to fight for medical care like the rest of us.

so what if we train a few doctors who can’t get jobs.

i know of 2 kids with 4 A stars at a level who couldn’t get a medical school place. Whilst we sit begging for a GP appointment.

DH works in a large GP surgery (not as a doctor). Out of the 17 GPs only 2 work full time.

It's the shortage of doctors that limits the training places. You can't just throw a fresh new grad into a&e without consultant/senior registrars being available to train them.

There weren't enough initial training places for a record number of graduating doctors this year - and probably most years since the new system began. Some get places found, others give up, move abroad or move away from support networks.

This is only half of the story. The UK electorate keeps voting for parties (note the plural) that do not prioritise healthcare funding to the same extent that many other countries do. The "They" in the statement is the people that the voters have elected - and if "they" don't do what is expected of them, then voters should vote for someone else.

So true, and it applies equally to almost every public service that people gripe about.

"Because people voted for it" is now my stock answer to every gripe about schools/police/NHS/DWP/libraries and every other damn service that has been starved of funding for years.

One of my Tory ILs was moaning about how they had to take the kids out of the local comp and pay thousands per term for them to attend an independent. They were sick of the school lacking staff, equipment, facilities etc. When I pointed out that they had voted for this, they claimed not to have voted for cuts in education.

They seemed to think voting was like a stroll down the pick'n'mix aisle, ffs.

Jtaeapa
we’ve already covered that the BMA is a union. It has no control over medical school places. Have a read of the earlier points made

fivemins

the part time GPS working 39 hours? And the full time ones working 60? Those who you call part - time are not part time in the known meaning of the word. I thought we covered this already, but maybe that was another thread.

a full time nhs nurse often works 3 x 12 hour shifts a week, or thereabouts. Do you also consider all those nurses to be part time, and should do 5x 12 hour shifts a week to be considered full time?

by national and government standards, I believe full time work is over 35 hours per week?

A bit chicken and egg but it's an engineered situation. I have very little sympathy for doctors given they've voted for this. All this talk and complaining about working 70 hours a week. You make your bed...... And then you have doctors leaving the UK because conditions are poor. Unbelievable.

I can't imagine any other profession where you can vote for your own interests. It's disgraceful. We'd all like to protect our interests but that's not generally how life works.

A pp posted the BMJ vote to restrict numbers 14 years ago. I've no idea how long that lasted (likely a few years at least) but given a degree takes 5 years and training the same again (at least), it's quite clear that this leaves a huge hole. The age and experience gap can be significant if allowed to continue and it would seem, like you say, that we now have insufficient numbers to actually train students.

I think this is a very naive viewpoint.

Medical training is not some box that you pop people in and they come out a doctor, it is something that the already overstretched doctors have to support despite their workloads, which are already difficult because of the shortage of doctors.

Also, a newly qualified doctor is not a replacement for an experienced doctor who has left because or poor pay or conditions.

It's pretty much the same as why we can't just "train more nurses".

I think we probably need to tackle the issue from both ends, train more and stop doctors from leaving both to retire (ie fix the pension issues) and to stop them leaving for Australia/Canada ie make the pay and conditions better.

Across many sectors of the UK, the pay and conditions needs to improve. And we probably need to review students fees for those who become public sector employees.

Lunar270

weve already been over this- the BMA is a union. They have no say on medical school places. Or anything else it seems, given we have had a 35% pay cut equivalent , and the pension situation forcing senior doctors out.

Regarding doctors' actual gross salaries, they are paid around 25% more than the salaries in the published pay scales due to additional pay for weekend work and nights. So the published salaries are only the basic salary, the junior doctors actually receive considerably more than this.

This website explains more:

www.juniordoctorfinance.co.uk/junior-doctor-salaries/

There's a quicker fix through retention. DNiece is two years out of medical school and says that a number of her friends are already disenchanted and talking about leaving medicine, leaving the UK, or going into side specialisms that offer less pressures and reasonable working hours. It's a horrendous waste if he don't improve working.conditions so as to retain the people we train.

Yes the junior doctors are paid a proportion more for doing a huge proportion more in addition to full time work.

if you took on an additional 20 hours work on top of your full time job, unsocial hours - would you want to be paid more?

If the bottleneck is providing enough clinical training in hospitals perhaps we need to reconsider how this is provided using technology so that we can train more people.

@Lapland123 of course antisocial hours should be remunerated.
I just think that when most people see doctors salary scales they assume that is what the doctors are paid but this is not the case.

So doctors vote for no reason at all? What's the point in being involved in something that has no say or power to do anything? Sounds a bit odd.

Recently hundreds of medical students missed out because there were no placements to accommodate them. Someone is engineering the situation and I guess the government is to blame? Or perhaps the trust's themselves.

Most of the country has had an 'equivalent' pay cut unfortunately and private sector pension are shocking by comparison, but we're not all fleeing the country or being forced out.

Maybe doctors are paid too little, maybe too much, that's another discussion, I just think we need to be open and honest about what they actually earn.

No newly qualified doctor actually earns the salary on the published salary scales.

Spain has the exact same problem

The training is archaic and in many trusts/specialties the culture is piss poor. Far too many consultants treat juniors and other staff poorly. They use concerns about standards and safety to resist any changes in practice or models of training. There is a bit of "well we had to go through it/suck it up". Honestly changing anything is a bloody nightmare, takes ages, faces rigidity and inflexible thinking. There are a fair few consultants who desperately want to do things differently but it is difficult to take the more reactionary ones along with them.... The rigid ones then just complain about how about it all is. I think the selection process historically favoured slightly perfectionist over thinkers tbh and it's reflected in the culture of our consultant body... So suggesting we changed training pathways to allow for us to train more medics is never going to happen...(or at least not in my career, it'll be a generational shift)