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.

@Wooleys bad rota coordinators are the norm. They don’t care. They’re overworked and there’s no consequences if they ruin doctors personal lives and no rewards for doing their job well.

I’m a registrar and am lucky to have a training number, the OP is right, what is happening to colleagues is appalling. Doctors should not be unemployed. By definition if you are a doctor you have excelled at school, were likely top of your year doing lots of extra curriculars to get into med school alongside getting top grades. These aren’t people we should be leaving unemployed!

Lol this is farcical. Lots of excellent candidates don’t get jobs. Look up the MSRA exam, the points scoring systems for interviews and you’ll see it’s all a ridiculous game and lots of good candidates are overlooked for someone who scored higher in a multiple choice exam that was designed for GP applicant selection but is now also used for surgical specialties!

Meant that the the current points based immigration system (that's causing these issues) was brought in by the Tories post Brexit while in power.

As for Farage, although he didn't propose or introduce this points based immigration system, he did laud the benefits of an Australian style system. Pressures eventually led to a badly planned immigration system by the Tories. With the RLMT abolished and a lack of monitoring of whether the changes were in fact having unintended consequences (say an explosion of net migration), here we are discussing the issue of unemployed doctors.

There waa a drive by NHS England to recruit 5000 more GPs by the year 2000. NHS England paid for my relocation back to the UK as I was working abroad. However, I needed to go through an induction and refresher scheme to get back on the performers list.

I can't understand where it all started to go wrong

Recruitment from the pool of UK based applicants was adversely affected after 1 Jan 2021. That's when the RLMT was abolished. I think we should be calling for an urgent reinstatement of the RLMT to prioritise UK based applicants ahead of IMGs still overseas.

That would be great. Would it need legislation?

You realise a huge number of EDI hires are in fact British?

Nice try though, with the insinuation and the grossly un factual 'well paid' and 'inflated salaries' bit.

This may be why Keir is talking about a white paper, and Wes does not seem to be saying anything.

A quick fix would be to offer support to F2s going through job search. The sort of thing that a recruitment agency might offer to an overseas applicant or a University careers office will give to final year students. Identifying suitable jobs - perhaps access to alerts, help ensuring applications are focused to maximise and scoring, help with interview technique. Hospitals might reorder their selection priorities to give more weight to NHS experience or understanding of the needs of the local patient body. Perhaps over papers published in obscure journals.

What is with the obsession with research. Yes room for this in major regional hospitals but for jobs in Enniskillen, Blackpool or Grantham, the ability to roll up your sleeves and get stuck in, working alongside colleagues both senior and junior, as well as being able to understand and communicate with patients has to be as important.

I live in the US and the issues with health insurance are familiar. Most people get the healthcare they need when they need it all the same, often at low or no cost. For better or for worse, it's a culturally accepted thing that you need to pay for health insurance. The ACA has made a big difference in the market.

My DS is a doctor doing a residency in an underserved US region. He has two colleagues from outside the US.

Yes, NHS recruitment is a mess. DS has dual citizenship and could work in the UK but would never consider it seriously as things stand.

Weird post. Are you a doctor. Are you even in the UK. You seem to have a very pro American slant.

The post you quoted was not talking about who is British of not. It was about relative recruitment priorities. According to reports the NHS is continuing to hire EDI chiefs at salaries three times the level of junior doctors. And a failing to hire those doctors or nurses.

Shutting off a valid debate by insinuating racism is not constructive.

Ha. Cross post, and I got it right.

From this side of the pond, and DS just spent six years in Chicago there is an awful lot wrong with America, and it is getting worse.

Stephen Kinnock, after being appointed in 2022 to be shadow immigration minister, had suggested that Labour would reintroduce the Resident Labour Market Test (RLMT). Now that Labour is in government, there are plans to prioritise the domestic workforce. However, it's a complicated issue given that abolishing the RLMT (although serving the interests of the domestic workforce) would not necessarily be in the interests of businesses. I expect though it will be back in some form, especially due to explosion of net migration. See this:

https://www.osborneclarke.com/insights/uk-government-proposes-linking-skills-and-training-sponsoring-migrant-workers

Note comment re RLMT.

Perhaps we should be demanding that RLMT or some form of it needs to be reinstated asap!!!

The removal of the RLMT in 2021 has clearly exacerbated these issues. Note the safeguards in place for UK applicants before!

www.fsp-law.com/return-of-the-resident-labour-market-test/

Thanks for that. Training places need to go to UK graduates and if a training vacancy Deanery to apply for a visa and non-UK doctors to have to do PLAB/membership exams like UK graduates.

Well would they need to be unemployed? They might need to take a sideways step. Just like all those thousands of young people each year who dream of being lawyers and spend about as much as medical students do to get to the point of needing a Training Contract or pupillage to continue with their chosen career but can't secure anything. Probably in the same sort of tranche on the school front. I'm not sure that their dreams are of any less validity.

Not great about the rota coordinators. I wonder what the essential/ desirable attributes are on the job spec?

Genuinely interested to know in what ways you think the selection process is deficient.

I'm absolutely not saying it's sufficient or even efficient (I don't know), but a claim that it's farcical is fairly strong. OP's DD feels that she hasn't enough time to work for these exams but if they select on a completely random basis she surely has no need to worry.

Yes. I think @Needmoresleep or someone else was in the process of drafting a letter

The urgent need for reinstatement of the RLMT or some form it should form part of the argument. Hopefully the UK based medics lobbying for prioritisation are using the RLMT reinstatement argument.

It would stop those (within the NHS) that have set up academies fasttracking overseas applicants (with PLAB exemptions, etc) into these posts. I guess there are possibly too many people in the UK already benefitting from these lucrative side hustles. Not only should they be subjected to scrutiny as to whether, and if so how, the NHS budget is used to parachute in overseas applicants, they have forgotten that they owe a moral duty to prioritise their younger colleagues.

BtW I was expecting one of the forces of resistance to come along soon after your post and suggestions. It happens every time there is support for change that might remove the barriers that are disadvantaging the UK based medics. I wonder why it happens! 😆

I thought you claimed expertise.

Two issues. Entry level jobs. F3s which DD was going to apply for.

Training positions. An arms race with super curricular: research, then a random toss of the coin with SJT.

Ask your son. No high achiever likes SJT. Five doctors will give six answers.

@Wooleys I am also surprised that as someone who knows young resident doctors you think they can just move sideways. To what ? Can't stay as F2 as all jobs end early August, V few training posts, v few Trust jobs so where should they move sideways too ? Be v interested what jobs you think are available.

No I don't claim it for myself. Silly people try to claim that I claim it which is rather different.

@Wooleys why is it farcical ? Well the MSRA has 2 questions on Obs/Gynae yet it's the only thing used for interview selection. Others are the same . Points for other specialities are based on things that most F2s can't have at that stage of their lives - so jobs meant for them become unavailable to them.

And you must know every doctor's views on SJT exams if you have a doctor in the family. They do a lot of them (UCAT, Foundation exam, MSRA).

Sideways to a different but possibly allied career. In the same way that those disappointed would be lawyers have to shift their expectations. I'm not clear why medical students are so lionised in comparison with other equally hard working young people. It's slightly odd. Lots apply for Medicine precisely because it's competitive. This is exactly the same with Law. There's a lemming like attraction if your grades are good at school.

You know what our DC should be doing.

You regularly tell us there is not a problem because your son did not have a problem. Effectively that our DC deserve their fate.

@Wooleys ah so they should leave medicine ? After 7-8 years already invested, £000,000 debt. That's your plan ? Forget being a doctor, become a plumber. Wow.

A law degree takes 3 years. If you can't get training you can go work for lots of other employers.