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.

I don't disagree. I was saying that DD was lucky. Wooley has been arguing this point, actually I forget what the point was, over several pages.

It does not change anything. F1 & F2 are training roles. They work long busy shifts at a relatively low pay per hour. They are the ones holding the fort at nights, over weekends, and over Christmas. And as you say. They take leave when some administrator in a distant office decides they can.

Having them finish F2 and find themselves unemployed, because the powers that be have opened up the next set of jobs to worldwide competition is really unacceptable.

Oh I see I skipped a post. Yes Needmoresleep's DD did exactly what all F1s and F2s can and should do in the important event situation. They have to help themselves as far as they can and a decent rota co-ordinator will much prefer advance notice.

This is why most of the senior medical staff in the NHS are foreign nationals. Nothing to do with a skills gap - that's bull. In effect, its a form of positive discrimination.

Not at all. I mentioned a wedding and someone decided to take the comment and run. I merely replied.

Needmoresleep the general situation isn't good but you say that your DD hasn't made a single application. If you don't apply then you won't get a job. You also say she's excited by the idea of Australia, so it sounds very voluntary to make the temporary move. She may well love the experience.

I am afraid this is not reality.

Not all F1/F2 doctors have gone straight from A-levels many of them are graduates students in their late 20/30s

And there are doctors in their 20s getting married

It's not just your own wedding you'd be looking to book leave for it's for siblings/cousins/close friends etc

Many junior doctor rotational jobs won't even send a rota until a few weeks/month or so before you start, if you're lucky!

It's worked for my DC and their friends with few exceptions. But obviously much will depend on the person in charge and how they operate.

My DC has also had to miss plenty of things, but for the very important events - ask.

Needmoresleep the general situation isn't good but you say that your DD hasn't made a single application. If you don't apply then you won't get a job. You also say she's excited by the idea of Australia, so it sounds very voluntary to make the temporary move. She may well love the experience.

Wooley.

We discovered that there were five or six of F1s in the same boat. All the others have either applied, actually tried to apply, for jobs or have sat exams. DD has friends who have done the same. None with any success.

I don't know if you mean to sound goady, but as if happens she was on a really interesting but tremendously busy rotation. Yes, to refer back to your earlier posts, one where nights were spent trying to keep very sick people alive. In a deanery where F2s have traditionally been given a lot of responsibility. She therefore was able to see what was happening to others...nothing. All but two of her cohort plan to go to Australia. No one seems to be monitoring this or even caring. Like you they assume that because these young people are now actively pursuing a Plan B, this is what they wanted all along.

DD is a positive and constructive person. She played a lot of sport as a teenager, both team and individual, at a high level. She knows how to pick herself up if something goes wrong. Just the sort of person you would want caring for you if you were very sick.

She may well love the experience. However Australia is a long way away and, unlike the UK, gives priority to their own citizens when it comes to training and other career development. Yes she can work as "a doctor" but is unlikely to progress further. And unless things improve, she probably won't be able to come back. There are no Government initiatives aimed at recruiting UK citizens working in Australia, in the way that there are for Indian citizens in India. It is also a very long way from friends and family, which is very sad. She would not have taken up a career if emigration were a requirement.

Her advice to a friend starting medical school as a graduate was to first avoid the moaners, as they would complain about everything, and in time this would bring you down. And not to be put off by the over achievers, those like on this thread, who work a hundred hours a week and simultaneously study and carry out research. Its fine, or should be fine, to work hard, pass your exams, get good assessments, get on with placement colleagues including nurses and support staff, and also take time out on the sports field (the friend was also very sporty) to let off steam, retain friends from outside medicine and to generally retain balance and perspective.

We ought to have jobs for these bright young hard working people. We do not need to be taking in others from overseas, effectively to replace them.

Wolley may disagree and feel the NHS will be better off with more who are able to mirror the achievements and assertiveness of her DS. But hey. The point of a debate is to sometimes agree to disagree.

Would anyone know what it’s like in Europe compared to the uk for training to be a doctor? And positions and training after?

We have a friend whose DD is going to. European university to study medicine next year. Fortunately she is fairly good at the language as it’s her DF’s tongue. She will do 5 years there from what I understand. The fees will be a few thousand and she is going this route to avoid immense debt after. Is it easier to follow this route in Europe to becoming a doctor? Is the future any better there?

Sorry but your information is outdated and incorrect.

Needmoresleep I would say that your DD, with everything you say about her - the additional degree from Imperial, her clear very high intelligence and incredibly strong work ethic - will sail into her preferred pathway as soon as she applies. For the meantime she seems drawn to the sun for a while without having been rejected from anything. That's a positive thing and will add to her general experience and will probably be fun. I think you're worrying too much. The general statistics aren't made up of high fliers such as your DD. She genuinely sounds as though she has everything going for her.

It can't be that out of date!

But you know, this is minor.

Please stop! Her DC has 50% chance of getting a training place due to the amount of applicants since it was opened up worldwide.

I'm going to have to stop CherubEarrings, due to time constraints. But I'm not going to withdraw my vote of faith in Needmoresleep's DD's abilities, since she sounds extremely impressive on all fronts. The 50% figure is far too stark to be of real value. The best applicants will make their way though and everything that Needmoresleep has written about her DD suggests that she'll be a strong contender when the time comes/ she has the time for exams and applications.

Be real. Would you apply to jobs where there were 1000+ applicants and when you know your friends and peers were getting rejections. Especially if you were in the middle of a batch of very demanding (tho' great experience) placements.

If you are scoring to decide who comes to interview, and they will probably be scored using some form of standardised NHS criteria by some junior admin person, the polished CV which meets selection criteria will win out. (I saw it a lot when I worked in the public sector - we all looked in amazement when one complete buffoon would jump from one job to another senior job, usually just before he was pushed.) No one is recognising that the system is so competitive that busy F2s need help with applications in the same way that applicants elsewhere will get from agencies etc. DD has simply observed the experience of others and learnt from it. A key skill for a good doctor.

Pity the NHS seems to lack the capacity to either observe or learn.

Ok final quick comment. I'm exceptionally realistic. Sometimes that's a good thing, sometimes not.

I might apply yes but not if I wanted some space after a string of especially tough placements and it seemed to me that Australia might provide just that.

You are not in the system and your experience is second hand at best. If you DC is a consultant the information you have is out of date.

Please read the room and have some empathy. OPs DD sounds fabulous but then a lot of her peers will be too. The issue is competition for training places is off the scale.

@Wooleys Exactly.

The problem is the same. There should be entry level jobs in the UK for all of them. However by opening it up to overseas recruitment, there are not. They have all had to find different solutions. Australia seems to figure in most. This is crazy.

DDs approach was a demanding F1/F2, then an F3 to catch up on the study etc. Plus focus on a region where jobs have traditionally been less competitive. Another of the group was advised to choose a lightly loaded fourth placement in order to have time to study for exams and prepare a CV. But they aren't getting anything either.

The focus needs to be on why our well qualified DC, all of whom will bring different things to the table, are not getting the jobs they should. The fact that some have given up before they start is not an argument. It was a recent decision and based on observing how a good sample of colleagues were faring.

I am surprised that middle rank doctors are not supporting the next generation more. These are exactly the sort of Senior Registrars they should want when they make Consultant. Better than someone new to the NHS who needs time to learn the ropes. Ditto current consultants. Who will they want to be treated by when they need help? Or do they plan to fly to Singapore to be treated by NHS trained specialists.

I am starting to doubt a little whether Wooley has actually had a child go through this process. Or whether it was so long ago that her experience is not up to date? Or whether she understands that different places may work in different ways.

I am a consultant with current residents. And it is shit how they get treated by HR and the system. And there is not one thing I seem to be able to do about it. I relate to all you say.

Completely agree I have my doubts too.

Out of touch! Failing to acknowledge what is happening now just because it didn't happen a few years ago or whatever!

It's got much worse since the introduction of the points based immigration system by the Tories and a failure to address weaknesses within it when the balance is now tipped too far in favour of overseas applicants. Hoping this is addressed quickly by the current government.

Suggesting that 50% or more of recent medical graduates just aren't working hard enough and deserve to be unemployed after years of state and NHS investment in their education is extremely offensive. There are perhaps some F1/F2s who want to coast by and are either unaware (very unlikely) or unmotivated to build a beefy portfolio (usually only those who want to leave medicine anyway) but the VAST, VAST majority are genuinely struggling to compete with the more experienced (on paper) IMGs and especially as the pool of candidates not getting a training number on first attempt grows every year. There are many many reasons, by no means all academic, why one person may be more able to obtain additional qualifications/intercalate/undertake a PhD than another... many of them socioeconomic! For someone who doesn't have the finances or family support to add extra years to their studies/training, how do they compete? For those who don't have the connections to gain points via research or attending expensive conferences or entering essay competitions for tiny value prizes, all taking time, money and resources, how do they compete? All whilst working one of the most demanding job there is (and I absolutely don't accept that many other jobs are equivalent beyond the long hours and high expectations). I'm lucky I have prior qualifications already and a research background but it's still going to be hard for me because I'm older, less able to move around and have to be realistic about my options. To suggest that I and others with possibly challenging circumstances may never make it to consultant because we weren't good enough or worked hard enough is staggeringly insensitive and lacking any nuance. And as for saying, trust grade/other jobs will always exist, multiple people are explaining that just isn't true anymore and actually the entire point of this thread. Empathy bypass on display from some posters sadly.

I think Blair and Brown are responsible tbh.

No, not for the recent IMG explosion.

The points based immigration system was proposed and lauded by Nigel Farage and introduced by the Tories after Brexit.

As for the doctors that went abroad, there seems to be many that went because there was just too much resistance to change. The ones who are prepared to stay are currently being demonized by those who don't understand the crux of the matter.

Those within the NHS who could be influential should be supporting younger colleagues but maybe they are just busy or out of touch with the problem.

There appears to be people however, engaging in lucrative side hustles to incentivise further overseas recruitment while the loopholes within the immigration system exist. If they are involved in NHS recruitment matters, this should be sending out alarm bells as it's a conflict of interests that deserves scrutiny especially since the NHS is funded by taxpayers.

The emphasis should be in stopping the brain drain of UK talent instead of turning a blind eye to it! Ultimately, if these issues are permitted to get divisive, it's a risk to social cohesion. We live in dangerous times!

Tweaking the points based system to prioritise UK medical grads & UK IMGs, ahead of new overseas recruits should be done urgently by the government to prevent other groups (not interested in the wellbeing of our young people) politicizing it for their own gain.

Ultimately, the growth, security and prosperity of the UK is based on the investment in the education, skills and career opportunities of its young people. They are the foundation of a country's growth. Seeking to keep importing from overseas is perpetuating the neglect of the residents already here and is shortsighted.