Anyone know why there are not enough training places for junior doctors?

[DuckEggBlueToo]

I have DC that is a junior doctor. They have just told me the ratios for applications for training. I am shocked that someone who has 100k in debt from 5 years at medical school has very little chance of getting into training.
Anyone know why there are not enough training places for doctors and why there is so much competition for all specialties?

Sorry I have no idea, but I'm shocked to hear this. I thought the UK was desperate for more doctors

Because the tories have been systematically underfunding the NHS for years. Surely that’s public knowledge?

I am very surprised @DuckEggBlueToo that you have a DC as a junior doctor, yet you've not taken the time to google this article:

https://wonkhe.com/blogs/why-cant-we-just-have-more-medical-student-places/

Everything you need to know is in here?!

Because you need a large cohort of senior doctors to train them, and we don’t have that.

1. Some of the ratios look crazy because you can apply for more than one job. So if 3 doctors each apply for 3 jobs the ratio will be 3:1 IYSWIM.

1. The government recently opened up applications to the entire world instead of just UK/EU.

This is exactly why we can’t just train more doctors/nurses/midwives even though we’re short of them. There aren’t the qualified staff to oversee more nursing and midwifery students and there aren’t enough staff to over see doctors on training places.

It is the places for medicine that are restricted due the lack of training places after they finish the course. Those on courses have access to training

Because senior doctors are so busy treating the 40% increase in demand for treatment for some specialties, and backlog from covid years that they don't have much spare time for ward based experience & mentoring.

Because training places are expensive to provide, and require very specific rotations.

My niece is working as a physician associate gaining experience until her place at medical school next year.

Why did they open up to the entire world? My DC says average ratio is 11:1. Surely UK graduates without training places is crazy. DC thinks they will have to go to Oz for a year if they don't get a training place.

I feel pity for you being so unpleasant.

Our model seems to be recruiting medics and clinicians form overseas, when their government has already paid to train them.

Because as long as they’re getting doctors trained up the govt don’t care if new graduates are left without. I guess maybe they also think people who move to the U.K. are more likely to stay here…..? And maybe a U.K. person might be more likely to move to Australia once trained up?

Because they have channelled money into funding training and jobs for physician associates but nothing to expand junior doctor training.

It's a government plan to create a bottleneck. Get the NHSripe for privatisation

https://www.bmj.com/content/337/bmj.a748

BMA decisions 15 hears ago coming home to roost. Training is a pipeline, now we are feeling the effects.

OP isn’t talking about medical school places - she’s talking about lack of training jobs for fully qualified doctors post medical school/foundation (training pathways to become a consultant surgeon, pathologist, psychiatrist, GP etc). More medical schools without addressing the bottleneck would actually make this problem worse.

To answer the questions - systemic under funding that means there aren’t enough senior clinicians to adequately supervise the training of juniors, it’s easier for the government to poach doctors from the developing world (something it has continued to do despite other countries making pledges not to), no prioritisation given to UK graduates (unlike in Australia etc), throwing money at physician associate schemes (who don’t have a medical degree and qualifications don’t transfer outside the UK so they can’t leave the NHS as easily), historical and continued poor workforce planning within the NHS (an example being obs and gynae - recently this specialty had a 30-40% drop out rate but no extra trainees were recruited to compensate for this so those left just worked harder and harder until they too burnt out and left) etc etc.

If you limit the number of training places you keep doctors as junior doctors for longer - and pay them less. They should either go abroad or insist on being a locum and getting paid locum money. But an oversupply of junior doctors will also push down locum rates.

It's always about the money.

DC does not want to locum. Also thinks that if you don't get a training post you need to build up your CV for training applications the next year and locuming does not look great on CV.

No money in the NHS to fund training posts. I have been working on fixed term contract for the last 3 years because my trust cannot commit to permanent funding for an additional member of staff despite stats showing that our waiting lists keep growing. So every year I go through the stress of having funding re-evaluated and money taken from various unrelated budget categories to continue to employ me for another year. There is not a lot of sympathy for government investing more money into the NHS. I am not sure what the public thinks the money is spent on but I am willing to make a guess that the vast portion of the budget is actually spent on staff. No money = no training posts = no qualified staff = poor health outcomes = greater costs to the taxpayer. One doesn't need to be a health economist to see where this is going.

In years gone by locumming would have looked like 'not good enough to get a training post'

Those days are well and truly gone. I'm at consultant level and only locum. People are just desperate for staff.

There are so many locums that even at junior level it's possible to build up experience for your CV.

Because the NHS is replacing them by Noctors (not doctors) aka Physician Associates to save money probably