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 never said hoards. I've mentioned this thread to three. That's hardly hoards and perfectly natural to share the more ridiculous things on this thread over supper.

I'm going to bed since it's midnight but I expect you to keep carrying on telling everyone else that they're not what they say they are or don't have family members that they could swear they did etc etc. Not sure I'm the surreal one here!

Missing you already! Thanks for attempting to derail the thread again!

You used the expression rammed but now you say it is three.

Wooleys posts are measured come with some knowledge and do not make fanciful claims to be honest.

I asked my trainees how they were getting on - they told me they got what they wanted / had interviews etc - who am I to fact check that it meets the criteria to keep Cherub happy.

I am a consultant in the NHS am sorry very few people outside of senior doctors in the NHS would have the knowledge that I am quoting. Everytime I think I will leave you to it - there is another rude delusional factually incorrect comment made which can not go unanswered.
Your argument ahs some validity but the points you are arguing are ill informed and your solutions do not promote good training.

I support British graduates getting jobs if they make the criteria and in open competition. What I do not support is every doctor being guaranteed a job in this country because they went to medical school here and have debt and are owed it. that promotes mediocrity and not effort . This country and its health care would be in a worse position if some of those brilliant over seas doctors had not come over, tried and succeeded by various different methods in getting trained -some did "steal" training numbers from "British" graduates but thank god they did we have benefitted from their tenacity to emigrate and fight the system. likewise this country has beneiftted from British graduates training here and helping deliver advances to health care. I have learned so much from both and am the doctor I am today because of that mix the next generations doctors will be poorer if they all come from the same mould and the innovation and advances this country has been responsible would not have happened.

Your lack of empathy for your junior doctors colleagues situation is shocking. The ratios are ridiculous now. At least you are alright Jack.

Having an interview is very different to having a training post/job in August.

@CherubEarrings unfortunately this attitude is why the NHS allows PAs to drill holes into people's skulls. The arrogance of knowing 'I'm right' and everyone else is wrong. Ignoring what hundreds, thousands of doctors are saying because you don't like the message. See we've gone from having jobs to having interviews - not quite the same thing.

Young doctors want to work in the NHS, they want to have careers in the NHS. We will continue fighting to ensure they can do so, regardless of others attempts to belittle the concerns.

“the next generations doctors will be poorer if they all come from the same mould”

Hmmm not sure what this means… our lot are not up to the job?

I’m very grateful that IMGs have been willing to come and fill in missing gaps over the years.

But are we saying that given a situation where we could fill every post with a British doctor, we’d be poorer for having no one from abroad come in?

Why would that be? Do IMGs impart knowledge differently to British doctors?

Exactly. I am shocked by some of their posts.

Exactly. There is something very off with these comments.

Agree that something is very off with these comments. So much at odds with what other doctors are saying both on here and in real life.

Woolley, I asked specifically about your elder DS. As you have said, he is not much older than ours, yet is already a consultant. His example is presumably one that all our DC should be following. It should be possible to anonymise. 2x conference papers in the UK. That sort of thing. No need to give speciality. Just passed exams during F2. Appointed to x level post for a year and so on. The NHS appears to have a clear view of the sort of doctors it wants to see progress. It would be useful if you would share. This thread is about a group of young, bright and hardworking DC who no longer believe they have a career path in the UK.

takeittakeit, you also seem to very kind and nurturing to your F2s. What would your advice be to those F2s whose own consultants don’t have the same capacity. Perhaps because they are on a retire and return scheme, so simply want to do their shift and get home. Perhaps because their hospital is in crisis with 40 sick patients in the corridor and bed blocking all over the place including ICU so their focus is to first keep patients alive and then to push administrators to resolve immediate problems. Their F1/F2s will learn lots of medicine and be given real responsibility but won’t receive the sort of mentoring you so generously provide. Or the consultant is newly recruited from overseas and is needing help and support from their staff to get to grips with how the NHS works so is not in a position to provide much advice.

The game plan in DDs case was to gain bags of experience in F1/F2 which she has done, and then to look for something (CTF, F3 in her chosen speciality) and in parallel focus on her training application. Unfortunately those positions are also attractive to those overseas who see an opportunity to earn a UK salary, bring their families over, and possibly to take advantage of UK training opportunities. Amongst the many hundreds of applications received, some will have more experience than an F2, and some will have had mentoring from recruitment agencies on how best to write their application.

What would your advice be to someone in DDs position. Suggestions of F3 posts where UK graduates have a decent chance of success would be very welcome. One issue is that by moving to Australia for an F3, our DC will still not have the mentoring and support they need to be able to return to the UK and progress.

I said a circle of friends rammed with doctors which is true. I was very clear that the people I've discussed some of the issues (and nonsense) number only three. Even so - unanimous vote.

I don't find it in the least surprising that they're keen not to see less than able F2s move effortlessly onto a training path way, nor that they strongly dislike the middle class entitlement which is on display, nor the suggestions of us and them. All three are very strong characters who don't suffer fools, so I haven't had much mincing of words. The word 'plight' on here at least a couple of times has caused some amusement as has the idea that they lack empathy with patients (all three are in different areas of medicine) because they don't agree that there should be a job for life and a straight line through to consultancy. I think the idea that merit matters has come through quite...er... strongly. Tbf it's only been one long discussion, but these people don't need to mull things over to know what they think and express it clearly. The idea of work life balance in the early years also met with expressions of disbelief.

Woolley, I asked specifically about your elder DS. As you have said, he is not much older than ours, yet is already a consultant

Needmoresleep I'm about to leave the house but how on earth many times do I need to reply saying not yet a consultant (almost tempted to capitalise by this stage). Or to be specific, not yet able to apply for consultant's posts, since DC will need to get appointed to a post before being called a consultant, and that's a little way off.

For some reason CherubEarrings though DC was on a straight through pathway. No idea where that idea came from but then there are quite a number of unfounded assumptions being made by that poster, so this is just same vein.

am I reading it right. Your doctor friends feel that despite having received strong F1/F2 appraisals and having done well in medical school, our DC are entitled and do not deserve any priority when it comes to finding a job after their F2. Your friends will rather see the jobs go to applicants from overseas?

Do your friends have children wanting to pursue a career in medicine? Doctors I know, agree it is tough for this generation. Indeed three I have spoken to recently have had to be active both in mentoring and in engaging their networks in order for their DC to get onto that first step on the ladder.

Outline career path to date. Please.

No good telling us that your other F1 son was told by a nurse that he is kind. Our DC have received those sorts of compliments in spades. We want an example of a young doctor who has been successful. It is something that is missing from the thread.

The energy which is going in to derail the thread is interesting and unusual for a topic which has such consensus amongst medics. Someone or some organisation or company is frantically hoping to hold on to the IMG flood of applications.

Needmoresleep two papers although presented abroad but short haul.Passed exams no hiccups. Not sure what more I can expand on that I haven't already said. I would genuinely say that the most striking thing is that DC has been encouraged right through by the consultants he's worked with, many of whom seem to have given freely of their time to give advice with applications and interview practice. It's not possible for me to say whether that was because they saw a particularly promising young doctor or because they just happened to be a string of extremely helpful senior doctors who help all the young people in the same way.

I'm responding to questions which are absolutely 100% bang on the money of the title of this thread. I don't know how much less derailing my comments and responses could possibly be.

Please re-read the relevant post. Older DC had written feedback (in a department wide thing of some sort afaik) from the Matron in a large London teaching hospital who has spent her whole career there. Very snarky comment on your part. What was said about being the kindest doctor young or old that she'd encountered in her career was probably the comment which has meant the most to him, so you can sniff all you like but it's at the core of why he's doing ok I should think, allied with being extremely good at the science and a very practical but swift thinker.

DC is extremely clever and extremely hard working and very funny and doesn't take time off except in extremis and is clearly exceptional with patients. I guess maybe match that and the path should at least nudge on an upwards path.

@Needmoresleep BBC and BBC Live (Hugh Pym and Chloe Hayward) are spending a day in the Royal Free Hospital today and in their live feed are asking for views from the general public and NHS staff through BBC Voice.I know this topic is niche within the wider question of NHS performance and challenges but it does have a bearing on its future. Could this be a conduit for the issue?

Depends which doctor you speak to, clearly.

Good idea. Ask them to ask the question and let's hear the response of doctors from the Royal Free.

Astonishing not to have a photo of a rock this morning. Perhaps that poster is chastened by being called out on the elementary mistakes that she's made.

I think we may be making some sense of what is going on.

takeittakeit and Wooleys are reporting very different experiences. Both gain their knowledge from London teaching hospitals. I don't think any of the rest of our DC are in London. I know that some are in areas where the NHS is very challenged.

One of those challenges seems to be that senior doctors may not have the time or the experience to mentor their F1/F2s in the same way that takeittakeit is so generously doing. The NHS is a NATIONAL Health Service. I assume that the high flyers that are getting through, will not be looking for jobs in Ennskillen or Middleborough but will want to stay closer to the centres of research, or places where they want to raise families. I also assume that the more ambitious and skilled of the doctors recruited overseas will again want to move with the UK to where they have friends and family.

Medical schools in areas where there is a known recruitment problem, will often make efforts to encourage local applicants. (Linked schools foundations years etc.) The idea being that there would then be a pool of qualified doctors who would be looking for jobs in those areas. With no priority given to UK graduates, those doctors - perhaps not real high flyers but competent and dedicated with a good understand of the local community are not going to make it through. I appreciate that our two London-centric posters may suggest that assuming they would get a job at the end suggests entitlement, but it was the system who encouraged them to think of medicine.

This thread is almost full. When it is I will start a follow on. Ideally we now understand that two posters have a very different experience and perspective, so we will be able to focus on what needs to be done. Perhaps there is scope for experts like takeitakeit to run mentoring sessions in other regions, in the same way as my London consultant friend runs medical training sessions in her speciality.

Everytime I think I will leave you to it - there is another rude delusional factually incorrect comment made which can not go unanswered.

Absolutely. Then come accusations of attempts to derail.

takeittakeit and Wooleys are reporting very different experiences. Both gain their knowledge from London teaching hospitals. I don't think any of the rest of our DC are in London. I know that some are in areas where the NHS is very challenged

I made the point about geographical difference on the previous thread as well as this one. How have you just come to it?