AIBU to be furious that there are no jobs for young doctors

[Needmoresleep]

Yes, you read it right!

At the end of their two foundation years (F1 & F2), young UK trained doctors are struggling to find work. They don’t want to go to Australia or NZ but for many this will be the only option. Seven or eight years study and work down the drain.
The UK supposedly has a shortage of doctors, so immigration rules have been amended to encourage overseas applicants. They then complete equally with those who are working in, or studied in the UK for both general entry level jobs (known informally as F3s) and for speciality training positions.

The average hard-working doctor does not stand much of a chance. Anecdotally even quite ordinary vacancies will attract hundreds if not thousands of on-line applications. The NHS does not keep statistics, but it appears that to keep numbers manageable many NHS Trusts will shut applications within a few hours. Tough for the junior doctor who is at work or sleeping off a night shift. The best from overseas will be very qualified with perhaps a decade of experience, and lots of additional bells and whistles, so it probably does not matter. They will score better so the chance of an interview for a young doctor who needs to build their own experience will be vanishingly low.

The expansion of medical school places, and allocation of some of these traditional entry level roles to Physician Associates is only exacerbating the problem.

Training positions are even more competitive. The Government has introduced a number of incentives to encourage applicants from overseas: exemptions from exams, guarantees on training and promises for British citizenship. Medical school places have been expanding without a parallel increase in training opportunities so bottlenecks would have happened anyway. In 2021 36% of new trainees were from medical schools outside the UK. In 2023 it was 41.5%. This trend is expected to be continuing, even accelerating.

A group of us have been on the higher education board since our DC were applying for medical school. They are now F2s spread across the country, working long hours for relatively little pay but enjoying the contribution they are making. None of them expect to get either a short term contract or a training position, so are applying to Australia or accepting that they will be reliant on zero hours NHS bank work covering staff absences.
As taxpayers we should be concerned that we are paying for medical schools, yet the NHS is not supporting their graduates into employment. We might also question why we are not giving priority to those already working in the NHS for the limited training slots. Doctors from elsewhere may be very good, but a significant proportion are then likely to leave to return home or to take up well paid private consultancy posts in either their home countries or in medical hubs like Dubai or Singapore.

Keir Starmer has said he will review sectors seeking labour from abroad to ensure that applications for the relevant visa routes, whether it’s the skilled worker route or the shortage occupation list will be balanced with expectations on training people here in our country. Wes Streeting seems to be refusing to answer questions on the topic. Whilst last week the BMA finally issued the following statement, albeit limited to training:
https://www.bma.org.uk/news-and-opinion/bma-statement-on-speciality-training-application-bottlenecks

Any action will be too late for our DC. When they applied for medicine they did not realise that it would mean having to leave the country. The hope has to be that a way is found to retain those that follow and to allow our impressive young people to be able to return.

States Allowing International Doctors to Practice in the United States Without U.S. Residency Training - The Match Guy search.app/xVzE6R5yM8SQLuYP7

There are new pathways for UK trained and experienced doctors to work in the US.

.@CherubEarrings the ST3 thing was because you noted that if they've 2 years experience in a speciality then you can't whether at ST1 (be a bit silly to do that I suppose). So 2 years in Aus and then ST3 is a possibility.

@mathanxiety but they want to stay here. With family and friends.

Only these doctors who are the subject of this thread don't want to leave the UK, even for Australia.

Should you need healthcare yourself, costs are really high!

One of my best friends in NY is paying for insurance at a rate of 3600 USD per month. She has MS.

DNs in US, despite having medical insurance are waiting for many months just to get treatment, scans, etc as most people have some sort of medical insurance policy.

Also reported her DP was forced to change hospitals although they preferred care where he was admitted to.
You see he had a degenerative disease and had lost his mental faculties so could no longer decide he wanted to stay in the better hospital. His medical insurance papers, that he had completed before he had brain damage, had listed another hospital! Lots of legal complications needed to be overcome to get him the right level of care

Not sure if such upheaval to another country pays off in the end if you really don't want to split up from family.

Ultimately the issues in NHS recruitment need resolving!

It is a bizarre system.

I think the 2 years only applies to those applying for ST1 posts.It does not apply to ST3 posts as they are moving on in their chosen specialty from ST2 so are expected to have two years experience and passed exams to go into higher specialty training..

There are bottle necks at F2 and ST2/CT2 etc that need to be addressed asap

The sort of CV needed to be interviewed for specialist training, even as a GP, is extraordinary.
I have every sympathy for our young doctors and would hate to be starting out now (I qualified in 1994). But your dismissive of "even GP" rankles. GP training is difficult and hard and the job even harder and should not be so dismissed.
But "even GP" jobs now are hard to come by.
5 years ago we advertised for a GP and had 1 solitary applicant. Last year we had 20. Half overseas most didn't have the right qualifications to be a NHS GP. We interviewed 6. Almost all of them had ridiculous demands regarding hours/numbers/pay etc...making them unemployable.
Medicine has always been challenging career wise and I hate to see young UK graduates leaving but they do need to be prepared to bend and compromise somewhat or they will lose out.

That is really interesting. Thanks.

@CherubEarrings there are bottlenecks everywhere. In an NHS that is crying out for staff.

Isn't our country nuts when we can't support our home students who are training and working here and may have a lifelong career here?

This is when you want the Daily Mail to lurk on these threads and pick up the issue and run with it. They can make things change.

Just think about any big upheaval overseas including leaving family and friends, cost of living, accommodation, education and other social and economic factors.

I said this earlier about Australia but it applies whereever you go:

It's not great if you miss your parents in later life. It's a huge sacrifice! Not great if you don't want DPs to miss DCs' milestones. It's not somewhere you could pop over from for a weekend. Travelling to the other side of the world takes a day and is extortionate over the school holidays. Australia is an expensive place to live and if you're not Australian, you're not prioritised. Might have to live in a rural location as cities can be too expensive.
Leaving family and friends behind mean missing parents when they are too old, being helpless to leave dependents behind to help parents navigate their old age when they're ill. Also it risks not seeing them one last time if say a pandemic forces a shutdown.'

@BurnoutGP I did not mean to rankle.

I was talking about training. What I meant was that in the past young doctors might give up their dreams of a competitive speciality like brain surgery but, if they were qualified, competent, and willing to work hard, could be reasonably sure of getting on GP training, because there are a lot more places for GP training.

Now "even" those places are apparently becoming super competitive.

I know nothing about the recruitment of GPs, though there were some posts upthread suggesting that employment can be hard to find if, say you are looking for a job after taking a career break to look after young children.

One of the F2 mums, who was comparing notes last week has a DS aiming for GP training. He does not expect to find an F3 place, but his rent is low so he can afford to survive on NHS bank work whilst he prepares. Perhaps some of your underqualified applicants will be competing against him to get the training to ensure they are qualified to work in the UK.

Entry level jobs (F3s) will be open to anyone with the required medical qualifications. This is presumably why they are attracting these avalanches of applications. It may be that a good proportion are not employable but given the numbers some will be and current and busy F2s believe that they don't stand a chance.

I went through the medical system in the mid noughties - this was always the case.

half of my peers left to go to australia after fy2 and not gaining employment - a few peers were unsuccessful in gp training places. They went abroad too.

we are now 15 years on from this. I think unfortunately its too little too late.

i interview for the local medical school and one of the criteria i am looking for is an awaresness of the postgraduate issues which have been present and worsening for two decades. Unfortuantely a degree in medicine does not guarentee a career.

Students profess to go in with their eyes wide open but sadly they have little idea how bad it is

they are now people who are fully qualified gps who cannot get a job and working at tesco

I can't post the graphs as MN banned photos but up until 4 years ago competition was hard. And then the graphs go exponential, doubling of applicants in last 3 years. Ration of 40:1 for each job. How many F2 doctors were unemployed in previous years ? Be interesting to see a comparison as likely to be 0000s this year.

It's not just training, it's any job. No locum market, very few F3 jobs. Australia is not a choice it's the only way to earn a wage.

The GP job situation is awful and unfortunately some peolple are taking advantage of the situation, offering poor pay and conditions simply because there will be someone desperate enough to take the role.

So basically the reason we don't have enough gps and no one can get an appointment is because of funding and not an actual shortage?

5 years ago we advertised for a GP and had 1 solitary applicant. Last year we had 20. Half overseas most didn't have the right qualifications to be a NHS GP. We interviewed 6. Almost all of them had ridiculous demands regarding hours/numbers/pay etc...making them unemployable.
Medicine has always been challenging career wise and I hate to see young UK graduates leaving but they do need to be prepared to bend and compromise somewhat or they will lose out

2023 NHS statistics:

The highest proportion of IMGs were for GP, psychiatry and histopathology.
with 48% UK graduates for GP training in 2021 and 50% in 2023. Only 55% of UK graduates with offers for GP training accepted that offer.

Difficult to make a call from these sources as to whether there's a real issue with the pay and conditions offered on the back of a buyers market, or whether the young graduates are indeed pitching their bids too high.

Yes

I get your point op.

NHS jobs (and any job requiring expensive state supported training or education) shouldn't be open to overseas applicants until there are no UK candidates.

I can understand if there are unpopular specialisms that we don't have enough UK doctors to fill but it doesn't sound like that's whats happening here.

Reality is the NHS will always want oversupply of doctors as a means of ensuring they aren't forced to raise wages. Those doctors from poorer countries are less prone to grumbling about working all hours for 60k.

It's a shocking betrayal, especially when you consider the money being made available for well-paid EDI (Equity, Diversity and Inclusion) roles in the NHS to push a hard left ideology. Think how many doctors and nurses those inflated salaries could pay for.

Am sure there will be some taking advantage but equally the locum market was saturated with locum GP profiteering from desperate partners. Now the tide has turned. And we can't afford to employ more doctors as our funding ever dwindles. Last year our salaried GPs cost us more than the partners were able to draw in profit/income. Rapidly makes a practice unsustainable. So partners are not taking advantage they are trying to keep their businesses going. It's shambolic. Our accountant tells us we are making 10% less in real terms than we did 10 years ago. A 10% pay cut for working ever more ridiculous unsafe hours. That's why you can't see a GP.

I would love to be overloaded with applications.
I have had adverts out for GP positions for the past 4 months and had limited applications.
Several of the practices I support are training practices and several more would like to become training practices.
Those that have qualified as GP’s keep on going to agencies, who charge at least £12.50 an hour for just placing a GP. And this is on top of the £85+ per hour for the actual GP. And then people wonder why General Practice can’t get salaried GP’s, because a crazy amount of money is going to agencies.
And physician associates are not taking GP positions. They see patients. I can categorically state that in my locality, it is not the case than GP’s can’t get a job because of Physician Associates. We have 2 PA’s cover 130,000 patients and then about 60 GP’s (over 12 practices)

The thing about a medical career in UK is that unless you are in a speciality with a lucrative private practice, UK doctors don't have a good income relative to the responsibility they carry.

I appreciate what someome said upthread about locum GPs profiteering from desperate partners. However, even back then it was hardly lucrative compared to the responsibility.

The issue is the lack of funding or poor allocation of funds.

@Clucket87 interested to know where you are located

It does depend on the individual job/case

I organise our rotas. I have multiple gaps in my training rota this year, both GP and specialty

I then advertised for several F3 posts to fill these. Around 50-60 applications from overseas doctors not in the UK and almost none from UK based doctors. We are based in a large city.

Clearly the juniors still have options

Leaves us paying for very expensive agency locums

What is the answer? Why are GPs going through agencies instead of taking a permanent position? Is it because they can make more money locuming as a GP?