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.

The reference to 'knock yourself out' is disturbing. It's violent imagery at the very least and on this site in particular shouldn't really be allowed to stand

😂 You're not serious?

I am very serious. I take it that you've never been knocked out by anyone else. To be fair, I did make a complete mess of reporting - quoted instead. But it's a very unpleasant exhortation in the light of all those on this space who have experienced domestic violence. I don't think minimising the effect of someone glibly saying 'knock yourself out' is appropriate. Happy to be called uptight but this sort of thing can actually be triggering for some. So basically very serious, yes, to re-emphasize.

I'm assuming English is not your first language? It's a very common phrase.

English is my first language and it's a very ugly phrase. I don't wish to get into the minutiae of domestic violence but it's common for violent men to grab a woman's fist and then ram it against her head so that she
'knocks herself out'. Can we leave it there now please, that was purely a small explanation because this clearly isn't familiar territory for you.

Finally - you admit that it might take a few years to get into a recognised training post - you have moved from your previous position.

As one who does short list for these jobs trust grade clinical fellow etc that you seem think are beneath everyone - believe me UK experience def scores highly and if you look at many of the essential criteria it will be UK employed experience - not an observership -employed experience

I have no words. So in an attempt to get thread back on track.

https://docs.google.com/forms/d/e/1FAIpQLSfcyIlbYdzz1bVJuSnRweFuBdqqkWNEG6Tyvv_KjR7mGsG-cA/viewform

Thanks @mumsneedwine

@takeittakeit i think the issue is that even a decade ago, a young doctor need not be unemployed whilst waiting to get into a training scheme or they could do stand alone jobs that could count towards training (or not) - however, the issue today is that it's a real possibility that doctors may be unemployed.

You seem to think this is not the case. Interestingly some GP colleagues also didn't know that the GP job market had changed significantly until they left their long term role then struggled to find work.

This is what voting Tory gets you. They and their millionaire media supporters should never be forgiven for what they have done to our country.

@Lambington Wes has an opportunity to change this. He's not done anything so far.

I have a background in Whitehall policy making.

My bet is that some is the law of unintended consequences.

More will be about poor, and short sighted, guidance from those whose job is to understand what is going on and needed. There are lots of them. The Department of Health, the NHS, the GMC, the BMA.

None of them seem to have made any effort to look at the retention of F2s, or why entire graduating classes of nurses have not taken up employment. Instead they seem to have decided that there is a crisis and that we need to increase the expand the supply of medical staff but recruiting overseas, relaxing visa regulations, introducing Physician Associates and, according to the BMS last week, expand the number of medical school places.

I can understand to some extent the post Covid panic. Our consultants and GPs were aging, and something needed to be done. However too much has done, and it looks like none of these well paid people who are supposed to either advise the Government or represent our young doctors raised the alarm.

I would say that it is a failure of Government, in its wider sense than any political party, and that both Tories and increasingly Labour should examine their policy making. Wes Streeting spend some time before being elected researching the NHS and its issues. He was good at upholding the Cass findings, despite some BMA opposition. The pay increase in contrast did not make too much sense. If you increase pay, you will reduce jobs, especially when your colleagues are increasing NI contributions. So better for some, but even more doctors, especially those at the start of their careers or those who came in from overseas on a short term contract with promises of more to come, and who then find themselves reliant on the odd shift from NHS bank and having to pay the rent through other zero hours work.

True - 'i speak from someone who is struggling to fill jobs all the time - there are jobs out there. They are not all being filled by international graduates but we rarely see British graduates apply - not for lack of time to apply just don't. We never close an advert early - so there is a disconnect in what people on here are saying and those of us working at the coalface

A long way up thread, I suggested that one solution might be to do what University careers offices do for their non-medical jobs, and have a form of advice service/recruitment agency for UK doctors. Help with alerts for when suitable jobs come up, help with CV writing, interview technique and so on. And by interacting directly with doctors seeking work the NHS will have a better understanding of what is going wrong.

So perhaps the offer of staff accommodation in London, in the same way that overseas doctors often get relocation help? Or an acceptance that requiring increasing amounts of academic stuff, some of variable quality is not actually enhancing the quality of recruits for specialist training.

Overseas applicants will often have help from their private medical schools who see placing of their graduates as part of their role. DD gets regular information about firms seeking bio-medical engineers - some with starting salaries in six figures. You say you have vacancies. Lots of us are curious as to what an where. (For example I don't think a London based doctor friend's son would have been doing NHS bank shifts if he could have picked up a more stable contract.) We would definitely tell our DC. On a larger scale this is what the NHS could be doing.

So perhaps the offer of staff accommodation in London, in the same way that overseas doctors often get relocation help?

So displacing all those nurses and doctors who are currently on the several-years-long-waiting-list?

I think a doctor recruitment agency would be a great idea. Doctors who want a Fellow job could post their CV and requirements such as speciality and location. Hospitals could then match vacancies to available candidates and offer interviews to any they like the look of. All automated so less paperwork. Only good candidates get interviews. No time wasting bots.

If I knew how to do it I would.

It's what Australia and New Zealand do, and it's probably why so many of our doctors choose to go there. It's such an easy process. Not even an interview (except by the initial recruiter).

@takeittakeit You say you are 'struggling to fill jobs all the time' with UK based applicants but mums of the DCs affected say DCs can't find jobs and disagree with you that jobs are available.I was busy yesterday so not followed the thread as closely so just trying to understand.

Can you tell me, since you have been 'struggling all the time' to attract UK based applicants, what attempts have you made to flag this issue of unfilled jobs to your superiors involved in recruitment and if you did report, what position in the Trust did the person you reported the matter hold? Is there any data being recorded about these differences in job take up and any useful discussion that the recruitment system in place is failing time and time again to attract UK applicants?

In these situations you seem best placed to help remedy the problem. If you did report, what changes, if any, took place? How long are vacancies open for?

I can only talk anecdotally about the jobs closing because I've not done it myself. But I know one job in London was still advertised so people applied, to get a response that it had actually already closed as too many applicants. If jobs aren't being filled it is definitely an issue as doctors can't seem to get them. So there is a disconnect somewhere.

I'm having lunch with the big chief of a large London hospital next weekend and I've a list of questions for him - he's a friend from Uni. Benefits of being old are that some of your friends have made it into high places 😊

No. Simply offering the same relocation package that might be offered an overseas doctor (or nurse or whatever) that is thinking of coming to the UK.

Its quite routine for employers in other industries to offer relocation packages to staff that they are asking to move from the north to London.

But again detail, detail, detail.

My argument is that there appears to be a problem which we need look at, identify and discover the root causes. Then perhaps think outside the box to find solutions. You immediately nit-pick. If you find it difficult to solve problems in your own life, this may be the reason. .

He has reached out to me as he knows who I am on here and has been reading this thread. I deal a lot with admissions so he's been very helpful with our school doing outreach work. V nice man (for NHS management 🤪).

@Needmoresleep after last night (I had some v funny chats with MN HQ while at a party) I'm going

Again for anyone new, here are the current facts. We are not employing the doctors we very expensively train. Why ? No one is really sure.

Thank you so much for everything you are doing to help students and medics by raising awareness of these shocking issues @mumsneedwine @Needmoresleep. I dread to think what will happen to the NHS if this is allowed to continue.

I find problem solving very satisfying and I'm excellent at it generally. I'm not nit picking, I'm picking up obvious flaws in the suggestions and questioning them. That is how one gets to sensible solutions. To make suggestions like these you first need to understand the difficulties currently faced by key workers employed in the capital. With an endless budget anything is possible, obviously, but I think I may be more grounded.