Why are newly trained doctors not getting jobs and leaving the UK when we’re so short of doctors?

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Just read a worrying thread in education re newly trained doctors being treated really badly and unable to get posts after training. Leaving for Australia/ New Zealand seems to be quite popular.

From my recent dealings with the NHS it seems to be a shortage of doctors that is a huge issue. So what is going on and why isn’t this being focused on more in the election?

What is the point of us as a country training doctors only to not give them work leaving them to emigrate whilst we then recruit from abroad? It’s not cost effective.

This will inevitably start another Physician Associate-bashing thread, we seem to have at least one a week. Stirring up an already very difficult, problematic debate whilst managing to denigrate an entire profession, causing well-established PA’s to fear for their job security and undermining public confidence in the role. Yes there are issues, but the social media toxicity is completely counterproductive.

The junior doctor training programme is far from perfect and there are and have been many other issues at play, from medical student places all the way up to availability of training rotations.

Because NHSEngland and Health Education England aren't talking to each other- yes it's nuts.

NHSE have told all Trusts they are broke and to spend millions less and reduce numbers of employees/the pay bill.

HEE have trained up 100s more Foundation Doctors and now have nowhere to place them all.

Trusts don't actually need this increased number of foundation doctors. The shortage is actually for specialised doctors and GPs. With the financial constraints in place they aren't hiring these young doctors so they are all leaving. If they did hire them then obviously in a few years we might have some more specialised doctors.
That said HEE haven't increased training number places in these shortage specialties either yet.
You couldn't make it up.

That combined with relatively poor pay, the rising numbers of other healthcare professionals (eg physician associate) has left the young doctors feeling undervalued after their long and expensive education.

ahaclinics.com.au/2023/02/22/british-doctors-should-i-move-to-australia/#:~:text=What%20are%20your%20financial%20needs,less%20mental%20stress%20and%20fatigue.

As always it comes down to;
A: money
B: poor workforce planning

The newly qualified Drs are our future Consultants.

This absolutely isn’t about PA or are you saying they’re being replaced by PA? I know very little about PA other than I don’t want to be treated by one for issues that are normally dealt with by a doctor. If there is an issue with PA shouldn’t that also be discussed more particularly in the run up to the election?

It’s all such an important part of the NHS debate and seems nuts but so little of it is coming up in debates.

Yes they anre our future consultants!One mum was saying her dc was well respected but didn’t have his contract renewed by the trust who hired somebody from abroad to replace him. What a waste of money!

Because NHSEngland and Health Education England aren't talking to each other- yes it's nuts.

Pretty impressive, given that Health Education England ceased to exist last year and its role was taken on by NHS England.

Trusts don't actually need this increased number of foundation doctors. The shortage is actually for specialised doctors and GPs.

You can't produce specialists and GPs without first producing foundation doctors. Unless you import them from other countries.

HEE/NHSE have repeatedly said core & specialist training would be updated to accommodate increasing numbers of junior doctors, but nothing meaningful has happened. With the intended massive expansion of medical graduates over the coming 12 years, there will need to be a major redesign of postgraduate training but I don't think anyone is confident NHSE has the ability or the resources to do this. The long-term workforce plan doesn't propose large increases in specialist posts as it wants more doctors to cover general service delivery, presumably so those on specialist training programmes can actually do some specialist training, which is difficult at present. But changing the intended postgraduate training & career pathway needs a substantial change to the employment framework, otherwise the increased numbers of non-specialists will have very limited career advancement prospects and will continue to choose to emigrate. At present, I can't see anyone being honest with current & prospective medical students about what kind of job they can expect.

The shortgage isn’t for junior / trainee doctors. It’s for specialists.

The shortgage isn’t for junior / trainee doctors. It’s for specialists.

So tell us how you would produce specialists without first producing junior doctors.

Errrmm yes but what do newly qualified Drs become eventually? That’s why you need to do workforce planning, so that you have what you need for the future.

But why is Australia and New Zealand seemingly able to accommodate the huge numbers moving there when we can’t?

And why are we still training doctors who have no place to go after their training is finished and we seemingly can’t do anything to get them to where they need to be to fill much needed places? It’s ludicrous!

And it’s estimated that about 35% of Consultants in the NHS will retire in the next 5 years. Ticking time bomb…..

And why isn’t this being discussed on a wider platform?

There’s not a shortage of gps either. Just ones who have a job to be available to see you. Lots of them can’t find work. Unbelievable but true. A gp friend told me and I saw this article on it the other week….https://amp.theguardian.com/society/article/2024/may/12/england-locum-gps-doctors-work-surgeries-british-medical-association

They are absolutely 100% being replaced by PAs. My GP BIL who has been a locum for many years has had his shifts dramatically reduced because of the use of this cheap labour.

You cannot say this isn’t happening. I won’t be seen by a PA and until everybody stands up against this practice we will continue to see our junior drs leave in their thousands.

one of our night carers for our disabled child is finishing her second year of training to become a nurse. She told me last week that non of this years graduating nurses can get a job in the NHS because there is a recruitment freeze at present due to lack of money. No bank staff can be employed either to plug the many gaps in a groaning system.
The graduating nurses have been told to get jobs in the private sector and come back to the NHS when there is money to recruit again. As if that's going to happen!
She said by the time she graduates next year she will have approx 80 000 in debt ( single parent) and no job ! She is lucky in that she can stay working as a carer full time in her existing job which is what she will do! So what is the point ? She may as well.have saved herself the 3 yrs of hard work and debt!.
It is madness!

How do you ensure you do see a doctor and do you have rights to insist you do? In hospital and at the GP surgery?

If we don't train our new doctors there will be no specialists. But there are not enough training places on speciality training so after foundation years you can now end up unemployed. While waiting lists keep increasing. It's bonkers. In 5 years, as consultants are retiring, there will be a very limited amount of staff to replace them. Because the NHS has the worst workforce planning in the world. 1,000 medical students did not immediately get a job after Uni this year, despite the NHS knowing for 5 years how many of them were needed. Nurses can't get jobs this year out of University too.

And yes, PAs are trying to replace doctors in some trusts, and are paid a lot more so it's not about money.

Add this to the ridiculous pay (£15.53 an hour after 5 years training and £100,000 in debt) and you have a bunch of very sad doctors. It was not like this when they applied 6-7 years ago. This government hate the NHS and doctors in particular. Wonder how Rishi's GP dad feels about there being 2,000 unemployed GPs.

@flapjackfairy that must be unheard of in nursing?

is the freeze because of the election ?

The answer is cold hard cash or a lack of it and a lack of support.

It seems to be far more than that.

They're undercut by cheaper foreign imports, mostly. Why spend money training people when you can just import a cheaper fully trained doctor from a country with similar training standards? That's how the government does things. Import, import, import.

This is because of the growing practice of PAs.

Unless you have a boo-boo on your pinky, you must refuse to be seen by one to stop this growing practice.

But apparently we need to cut immigration!😳 It’s all bonkers. Why aren’t they being held to account? Starmer should be all over this like a rash.

NHS England and Health education merged recently but still don’t seem to be talking to each other. The NHS 15 year forward workforce plan calls for almost doubling of doctor and nurse undergraduate places. But there’s not information about where the money for jobs will come from once they have graduated. Doctor training is complex as part of their salary comes from the Trust who employ them and part from Health education as well as a fee from health education to cover the costs of their education. Until they are permanently employed as consultants they are training grades and require heavy supervision, portfolio work and teaching that consultants and others have to deliver and stuff to backfill when they are at training, this is what the fee covers (as well as OH support). The doctors in training also provide a lot of service work to the trust seeing patients on wards and clinics so it benefits everyone.

How? How do you make sure you are seen by a doctor in hospital and at the GP and what are your actual rights? You lie there in hospital waiting for a crowd to show up on ward round when ill and vulnerable conscious of a pressurised NHS. It’s not easy to be assertive.