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.

Nothing changed ?

mums you are quite poisonous - yes we do help our juniors hence my comment earlier that all our F2s have moved on with our support to careers they wanted to pursue many different routes to that but I missed the papers I have helped them write, research projects supported, audits created, tutoing sessions, mentoring sessions that I and many of my colleagues provide in our "spare" time.

It has and always will be a cut throat hard career path, different challenges in different ways, some will drop off along the way which is in some cases sad but inothers the step to them realising that this is not what they actually wanted to do.
No one who has gone through it does not understand how hrd it is mentally and physically. Diifference is we do not go on social media and talk about something we know jack shit about - we live this reality - which is why on a Saturday afternoon whilst freezing my nuts off in my car watching my DC play rugby, I went through an FY2s protfolio for them and made suggestions.

Me too. She's a dogged campaigner.

What is really sad is your lack of belief in British graduates in being able to compete with overseas graduates. They can and do make it because thankfully many of us do.

@takeittakeit poisonous ? Name calling is not required. You don't like what I'm saying that's fine but no need to be rude. I'm glad you support all your F2s and they are v lucky if every one of them has got into training this year (how do they as interviews only just starting ?). This is not the case elsewhere but you don't seem to want to hear this. I don't know why.

I ask again, how many of your cohort were without a job as a doctor after foundation years ? I really am interested since the NHS figures I have quoted say only 5% was the previous norm for not training. It will likely be nearer 80% this year. Do these figures not worry you at all ?

@takeittakeit again, they did. You are not an F2 this year, it is different, can you really not see that ?

You are right .I qualified 25 years ago ,benefiting from free education and also a student grant .
During house jobs we worked more hours and we were less supported than juniors are today ,it was brutal ( things have improved and rightly so ) , on the whole we stayed in the UK and we never had the threat of unemployment ,
My house jobs were guaranteed in the locality of my medical school and we interviewed for posts rather than a lottery or by academic achievement.
We could then chose to apply training rotations or “pick and mix”senior house jobs, the non training trust grade posts were often filled by IMGs while they were preparing to take UK qualifications.
Recruiting from abroad (if not needed to fill roles)is a waste of tax payers money already sunk into training and increases immigration at a time when the political consensus is to reduce it .UK trained graduates are also experts in the NHS which is often illogical.
In the last few years we have completely failed our young .

And our F2s are amongst the best in the world, which is why other countries want to employ them. After their own doctors obviously.

mums you really do not read well or just ignorant.
Fees came in in 1998 if you read my time line you will understand this was in fee paying life times. So yes I had a significant amount of debt at the end.
Many people in my day did an extra yr/18 months 2 yrs before getting a training number so again no difference to before not everyone made the magic leap first time.
OMG - there are a lot of doctors who do not get on training programmes ( I was one of them!) and go round getting 6 month /1 year jobs ticking the boxes for CT competencies and yes you can still do that today. It is how many of the international graduates make it. Harder yes, less cossetted yes but still doable.
They progress and getting the same qualification via a different route. One of my more recent colleagues took 4 yrs to get on a training programme and is now a consultant in the NHS

If I am making this up what is the CESR route all about? There are 2 ways to get speicalist training still possible in this country - training programme, - easier once on and training delivered for you to make competencies or DIY harder more stressful but still achievable as evidence by the umber of people who do get there!

If I am making up 6 month one year posts then why did we advertise again last week for junior clinical fellow posts x4

@Boredcat1 thank you. This is kind of what I'm trying to say. Yes, conditions were hideous but came with a guarantee of a job. And no debt. And jobs were awarded on merit (not some weird points system or an exam that contains no questions on your speciality).

All our F2s want is a job. Not even hoping for training for many of them. Just a job as a doctor somewhere in the UK.

We are the only country who don't prioritise our own staff.

@takeittakeit so 4 junior fellows in London ? Brilliant. I will go search now and send to my ex students. Thank you.

Do you read my posts ? Look at the actual figures nationwide ? Can you really not see the problem ?

@takeittakeit I asked how many of your cohort were unemployed. Were there none ? Did everyone get a job as a doctor somewhere ? Were you £100,000 in debt ? Things have changed so much.

To do CESR you need to have a job as a doctor. And it's apparently v v hard to get signed off for all the competencies.

@takeittakeit where are you? I am not aware of any of DDs current consultants undertaking research. She talked about some of the stuff they were doing when she was a student in Bristol and, especially, when she was at Imperial, but not where she is now. Obviously there will be some, and my knowledgeis based on snippets. She has mentioned a 70 year old retire and return, a much respected trooper. Someone who trained in Poland. A consultant newly recruited from overseas with confidence issues - the NHS seems to be quite a different environment. Her previous one went to war on the bed blocking that was preventing her ward from functioning with 40 on trolleys in a relatively small hospital before winter started and so gained the respect of her staff. And the current one gave her an extra day off at Christmas because she heard we were coming over. But no mention of research, or being encouraged to research. Instead it all seems to be about learning how to operate in an underfunded service that struggling to deliver to patients.

DD has been happy with this. She has learned a lot from some very generous people. But was happy to get these two years over with before focusing on applications.

From a doctor

80% won't have a job? Or a training post? Do you have evidence for this as I find it very hard to believe.

You are determined to put negatives - have not said it was not difficult but it is doable some people have to make more effort than others.
No my colleagues were not unemployed but did they go into research, RMO jobs, overseas, non training jobs, - we all had debt relative to the cost of living and salaries of the day - so yes 100K is more than I finished circa £15K with but then my starting salary as a house officer was £16500 and my first F3 equivalent was £20125 and the hours were slightly different

Every generation has a hard time but in different ways - mine had piss poor pay, appalling hours, limited access to training programmes, exams where you expected to fail not pass, interviews that were biased, loaded and discriminatory, no clear goals to get the golden ticket
This generation have better pay and less hours, better access to training programmes, clearer goals, an anonymised selection process to exclude favouritism as voted by trainees but a more expensive lifestyle to maintain and more open competition that drives the standards higher and higher at a faster rate.

Sorry you have called me a troll your sarcasm as you clearly disbelieve what I say.
No not every F2 has gotten into training this year so far but 2 have- last year neither but they all secured jobs of some description to help them along the way.

Our current 6 CT trainees are all British grads who tool 0-2 yrs to get their jobs. Our trust grades are a mix of Brit and overseas doctors

You will find that doctors won’t agree ,we treat each other badly.There seems to be a lot of arguing for the sake of it .
Clearly the juniors are unhappy the system isn’t working and it isn’t working how the majority of the general public would want it either judging by your poll.
We need them to stay and they need jobs ,we have put them in huge debt and as a country we have invested in them heavily.
Our graduates need to come first before employing from other countries as would be the case in Australia.

Is this in London. The super high flyers DD knows aim for London and will do very well. Her preference is to practice medicine elsewhere. More practical, less academic, though oddly she could do the academic if she wanted. She seems to like patients, being busy, and the comradery.

With anonymised recruitment, worldwide competition and NHS recruitment criteria looking for lots of academic stuff, she is unlikely to make it through to a training post. Indeed the first hurdle of a job seems pretty unattainable if current application ratios continue. Yet in 20 years time the hospitals she is working in will be crying out for consultants, and the ones who made it will be in Dubai, Singapore, have lucrative private practices, or be working in nice Home Counties places near golf courses. The ones that haven't left for the City that is. They will not be lining up for the sorts of posts she would like to do.

I get it. A career in medicine can be done. 25% chance is not bad if you are truely determined. NHS bank should deliver a few shifts each month, so fine if you can move back home, and then plenty of time to study. But competition is rising year on year. New medical schools in the UK, even more overseas. What happens if you know you are good enough, but top 30% perhaps. Add on new and real job insecurities for GPs and others. And bottlenecks further up the training path.

The next question becomes. Is it worth it? DD now says she wants to spend a couple of years in Australia to experience a functioning stable health service. Effectively to reassure herself she still wants to be a doctor. Then. Sit UK exams from Australia? Stay in Australia despite reduced scope for career progression? Look for a job in medical engineering?

The taxpayer spent a lot of money training her. She could be a real asset. She would be doing jobs that have been traditionally hard to fill. But no. The NHS wants people with prizes, regardless of quality.

Everything needsmore says applies to my own DD. Will go to Australia and enjoy some travelling. She's been told she can apply for training there after 6 months in her speciality choice. I doubt she'll come back.

25% chance of having a job as a doctor is so v v sad. We have waiting lists years long but we won't employ the people to fix it.

@Boredcat1 these are the NHS figures for 2022 and last years figure was apparently 75% (DV figure), and the NHSE in their report have extrapolated this to 80% this year. This is for not getting into training.

Unemployment seems to have only become an issue in the last 12 months and seems to have caught everyone unaware. So no official data has been collated. But I believe the BMA are now starting. This year is looking very bad due to the sharp increase in applicants from abroad. Hence all the worry.
This true figure will be masked as many are planning on moving abroad.

This

@Boredcat1 here is the GMC document that states 75% of F2s did not get into training last year

www.rcp.ac.uk/news-and-media/news-and-opinion/rcp-responds-to-gmc-2024-workforce-report-and-calls-for-a-review-of-postgraduate-medical-training/?utm_source=chatgpt.com

Many senior doctors see the problems