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.

Pleasestopthebunfight
Literally every other country prioritises their own graduates

But not those countries in the EU/EEA who have to comply with single market rules.

Needmoresleep
Dear MP...
In 2012 only 5% of graduates from British medical schools failed to get into specialist training. By 2022 it was 48% and in 2023 it was 75%.

Are you comparing like for like? Some 2012 stats here:

The General Medical Council report, “Interactive reports to investigate factors that affect progression of doctors in training”, shows that for 7,423 Foundation Year 2 (F2) doctors who completed foundation training in 2012, the first cohort the General Medical Council began collecting data on:

- 65.8% of these doctors took up a specialty or general practitioner training place immediately after completing foundation training;

- a further 16.6% took up a training place the following year; and

- 92.5% were in further medical training or working as doctors in the United Kingdom within two and a half years of completing F2.

https://questions-statements.parliament.uk/written-questions/detail/2016-03-15/31210
https://www.bmj.com/content/346/bmj.f31

@Clavinova

But not those countries in the EU/EEA who have to comply with single market rules.

Diet of self selecting as need to be fluent in every language!

@Clavinova NHSE data

@modelT Hoping it's possibly unintended consequences, incompetence and the strength of the existing legislation in the favour of new IMGs still overseas. It's probably best to research the recruitment schemes available overseas and see if you think if they pose uncomfortable reading. Hoping for clarification from others reading the thread who might come forward and shed light on the schemes.

Being members of the public, I think it's only right though to ask for clarity and checks and balances to ensure that there is no misuse/misdirection of NHS funds or a possible abuse of influential positions post Brexit by those involved in the recruitment drive overseas. This point remains unclear. I wasn't saying anyone is guilty of it but it needs scrutiny to be sure as the NHS is wholly funded by taxpayers. It's senseless that doctors are facing unemployment at a time when they're most needed. People can't get appointments and serious illnesses are not being picked up early enough in some cases.

The issue of legal safeguards is long overdue! Changing legislation is tricky but requires urgent address for the sake of NHS users, existing NHS staff and all medical students and doctors already in the country.

@Clavinova

For info

www.cato.org/blog/more-states-move-let-experienced-foreign-doctors-serve-their-patients

Hi,

I will admit I picked it up from the various stats within this thread. I am not a medic so find the various terminology and numbers difficult. The previous thread to a large extent became a bun fight over numbers.

Are you able to rephrase. I wanted to give enough key figures to give a sense of the problem.

The notes above that graph still say;

Two thirds (66%) of the 2012 cohort entered core or specialty training in the year following F2 training

I'm not a medic either (or a mathematician or scientist) which is why I put a question mark in my post.

To add, I think you need to be more secure in your facts if you are planning to write to your MP. You should also ask whether the EU's proposed youth mobility scheme with the UK is likely to have any effect.

The more recent figures are sound as they came from the tables provided by Mumsneedwine, NHS source.

I tried to keep it relatively data light. There was a poster on the last thread @AsTearsGoBy who seemed to be an expert. Perhaps she could help. But generally MPs are used to seeing letters from constituents that outline problems without a lot of data behind them. So people should write anyway.

I think we are agreed there is a massive problem. We are concerned that DC are not able to get jobs in the UK, but weirdly are considered employable in Australia. As promised, and as suggested by Wooley I will do a shorter sharper draft. Give me a day if two.

Flagging up the youth mobility scheme is a good idea. All sorts of things seem to be combining to limit the number of jobs available for this generation.

I had lunch today with an Asian doctor friend. A consultant. She was completely unaware of the problems. She thought it was daft. She also said that senior colleagues are also leaving to return to their home countries. The NHS has become a very challenging work environment.

Keeping an eye on retention and understanding why people are leaving would seem to be a key element of proper workforce planning.

@Clavinova and 92% were in training within 2 years.

In 2022 45% were in training after 1 year, last year it was 25%. This year will be a lot worse as the number of applicants has doubled (but mostly from abroad).

Not at all. The person who was able to interpret the data sensibly and with clear expertise was sendsummer. The latter was able to knock several of the more alarmist headline grabbing conclusions firmly on the nut.

UK DC who go to Australia are 'filling in' though. They either get sent to remote areas or do jobs that home grown grads don't want in the popular areas.

Just as it's been shown across these two threads that many IMGs are also filling in jobs that aren't popular with UK grads.

How different is the reality?

None of this has been done for drama or attention. We are all busy people who would rather not be dealing with any of this. But we saw the issues first hand, probably before others, and would like to do something about it. Our children are not moving to the other side of the world for a bit of fun - they just want to work as doctors. They should all be able to do that in the country that trained them, or else why did it bother.

IMGs are not given the jobs UK grads don't want (as is the case in every other country). They get them depending on the scoring system for that speciality.

UK trained doctors deserve UK based jobs. Any left should then be offered out to others (although the number now coming from red lists countries is a scandal in itself).

mumsneedwine you are singing to the choir. No one could possibly disagree with priority for UK graduates. The lunatics have taken over the asylum. No taxpayers, no medics no politicians want this.

Onemore Piece- totally unnecessary snide comments.
I am not standing up for IMGs over Brit graduates but the toxicity of some of the comments here and the condescending tone to overseas doctors could not in my view go unchallenged. the implication that they are all wealthy and buy their way into jobs, get coached etc could not be further from the realiity that I see when working with overseas doctors. to imply so is deeply offensive - some may come from wealthy families but the vast majority sacrifice a lot to relocate, sit PLAB etc and then try to get a job. That ladies has and is unacceptable and debases the valid poinrs that have been made.

I do not deny life is hard at the moment but the dramas - going to Oz, NZ, taking non training jobs having to wait a year or more have been present for the last 30 yrs this is new, just more junior doctors now.

At no point have i said people are not having to work hard to get jobs and I have sympathy, yes I have that every day at work, whilst I help people polish portfolios, sign PBAS, CBDS, edit audits etc but I have done this for years. The reason for sharing my journey was to show that many people do not get a training post this is not new but they can still train and still progress - just in a different way - which some people seem to think should not have to be done by British graduates.

What I fundamentally disagree with is that every British F2 should walk into a training place by right after F2 - it becomes a treadmill, we see this and we see so many young doctors who want to jump off and have a break do something different but are too scared to do that because getting back on the training rotation is difficult. that is also not sensible. and leads to burn out, wrong career choices for some which can have life long effects on people.
There is a fixation on F3 jobs - there are jobs just not called F3.

I trained with 3 brilliant people - we were all competing for training posts - one got one and set off on the golden path. 12 yrs later he upped and left medicine because fundamentally he did not like the speciality he thought he wanted but by yr 2 knew was not for him but did not know how to get off and change.
1 did not get a training post and never recovered from that disappointment - it clouded everything they have done
1 got a training post after 2 years - OZ and jobbing placements - loves what they do and know they mae the right decision.
1 never got a training post but got to CCT by doing the CESR route took and extra 5 yrs to making and is very bitter about how hard it was compared to others.

My point is there are numerous ways to get where you want and disappointment this year is not necessarily the end of the medical world for many people

I'm sorry, but I disagree. No one expects to 'just get into training'. But they do expect a job, after 7 years and £000,000 debt. And to have a level playing field with the rest of the world, who give priority to their own.

GPs are driving Ubers. F3s are working in Starbucks. Not because it's a career choice but because there are no jobs.

Because you personally can't see this does not mean it's not true.

Nowhere does it say if you go to university and get a degree in medicine, nursing, physio, OT, law engineering, architecture you should expect a job - life is not like that and people with architecture degrees, physio degrees etc are no less worthy than medics.

Does anyone know when this years figures come out ?

The difference is that the NHSis a monopsonistic employer. They have a duty to ensure that the right number are trained. Any the problem is not that there are not enough jobs, but they are being given to others from overseas. No other sector is allowed to ignore skilled residents in favour of overseas applicants.

How do you think things should be approached?

@takeittakeit Never said that 'they are all wealthy and buy their way into jobs, get coached etc'

As I understand it, the current new online recruitment system was intended to make it fair and equitable to all applicants whatever their background.

However its design has failed to do this if some new IMGs from overseas are receiving PLAB exemptions or paying tens of thousands of pounds to be coached or fasttracked and get the jobs ahead of UK IMGs and UK Medical Grads. The unintended consequence of large numbers of unemployed UK IMGs and UK graduates may possibly have been minimised had they been prioritised for those jobs.

BTW as I said before many times the vast majority of overseas doctors already here do a brilliant job of looking after their patients.

What is being objected to is, that at a time when young doctors here (including foreign doctors already here) can't find jobs, new recruits still overseas (and have not yet set foot in the country) are being prioritised of those already here.

Well according to those on this thread they in fact are less worthy, because each and every one of those who goes to medical school is 'lovely'. Not quite clear how the mothers on this thread can assert this with such confidence but they're asserting so much which is paper thin on the evidential front that this wild claim about universal loveliness should surprise no-one I guess.

The reality is that these young people are no more or less lovely or any more or less able than most of their school peers and if they aren't as able as they need to be to get a training post in the face of all competition for those posts then they don't, by definition, 'deserve' one. So much talk of prioritising work life balance at such a young age strongly suggests their cloth isn't cut for the sharp end of the job. They are probably no great loss to the medical profession and may well have a much pleasanter life doing something more suited to their wish for a slow pace of life. That could be in the UK or it could be abroad. I'm slightly taken aback by how reluctant some mothers are to allow their DC to go to Australia for a year maybe two - young people have done this for decades. It suggests a lack of willingness to acknowledge that sometimes young people need to spread their wings for a while and on the face of it seems incredibly oppressive - which may be exactly why the young people in question are so keen to go.

When the RLMT was abolished and the new points based recruitment system was introduced post Brexit, young people in the UK from all sectors, not just medicine, were disadvantaged.

Your comments on these specific individual DCs who are not on this thread is unjust. Not sure what your motivation is as you seem intent on trying to stop any changes that might improve the chances for the doctors that have been affected.

All the way through I have said that the current points based immigration system, introduced post Brexit, is affecting young people in the UK. You have mentioned law before. Believe it or not young people in law and other sectors are affected too. No one said they weren't.

Let's refocus on the issue here:

What is being objected to is, that at a time when young doctors here (including foreign doctors already here) can't find jobs, new recruits still overseas (and have not yet set foot in the country) are being prioritised ahead of those already here.