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.

Having helped many students become doctors, including in here, I find this all so very very sad. My own DD currently facing the choice of unemployment or Australia. Not because she wants to leave the NHS, but because they don't want her 🙁

Not so for entry level post F2 jobs. (And even less so for training positions.) By chance the F2 mums who were comparing notes on the HE board, all have DC is less popular parts of the country. DD and others all had their University education disrupted by Covid. As a result DD and quite a lot of her bright, dedicated and outdoorsy friends decided to doge London and head for the Celtic fringe. It has meant that she got her first choice of rotations, which in her enthusiasm were seriously demanding posts. (Lots of nights, lots of very sick patients.)

She wants to stay where she is, as do the other MN DC. Last week one DS tried to apply for a local F3 position in the speciality he is interested in. There were so many applications within a few hours that the Trust is having to halt the process and reconsider how they approach it.

Our DC could be the hard working doctors and consultants of the future in these hard-to-recruit areas. But no, they can't get the first foot on the ladder. Ironically DDs Trust does not have a single consultant in a major specialty, whilst another consultant, recruited from overseas without NHS experience is needing a lot of handholding.

I wonder who working on NHS workforce planning. Surely rather than recruit overseas in order to replace home grown doctors, they could actually ask home grown doctors why they feel the need to leave.

I agree about the physican associates.

same as nursing associates. I was arguing with one on TikTok last week. She’d done a video sniggering that as a nurse she’d never needed to do critical analysis so what was the point of uni teaching it to her.

someone pointed out she was a NA not a nurse. She told me she was exactly the same as a nurse and did the same stuff. I listed the nmc differences and said if she was doing those things she was working out her scope of practice. She deleted the video.

problem is the differences are a bit subjective. They can give care but not plan it or evaluate it. Both can give drugs. A ward will happily employ a shift full of NAs with one nurse overseeing them before long. Possibly already happening. Saves money

PM me too if there is anything I can do to help. My dd will be facing this in a few years time. It is utterly nonsensical and immoral for the NHS to poach experienced doctors from countries that desperately need them, while the British taxpayer pays to fund medical training for Australia and New Zealand. If there is a campaign, I'm in.

I was already planning to go and see my MP about the lack of funding for 5th year medical students. I am happy to add the other issues to my agenda!

You can do it by phrasing it in a way that is of concern to us. Not against IMGs already here. Just wanting the issue to be addressed and balance to be restored by calling for priority being given to existing UK medics. IMGs already here are valued. It's not a battle between UK medical graduates and UK IMGs.

Just an urgent call to reinstate the Resident Labour Market Test at least for now and address the problem within the online recruitment system because if you scrutinise it, therein lies the problem!!!

@Needmoresleep <waves> I have no DC in medicine but I know two young medics. One graduated the same year as your DD and left the NHS after foundation to work in med tech. Every single one of his immediate peers have failed to get training posts and all but one have gone abroad.
The waste and the cost is depressing.

One of my DC's partner's finishes med school this year and will be posted at random anywhere in the country. Her training has been dogged by PA students getting priority on skills training and being given access to places the real med students are forbidden.

Its the same across all NHS clinical roles in the majority of trusts. They did massive recruitment drives from abroad, then recruitment freezing. Theres no jobs. Not for newly qualified, or those not newly qualified looking to move roles. Drs, nurses of all scopes, midwives, HCA's are all struggling to finmd positions. Its not the fault of those who came from abroad, they were very much needed at the time these drives were pushed, however, they filled all vacancies, and were more expensive than internal recruitment due to the incentive of paying for them to immigrate and the additional training so then freezes were actioned. The drives didnt account for the fact that places in university had also increased, meaning we had more qualifying than previously too. This has left so many people jobless. I myself have a nursing job in an area i love, however, for various personal health reasons, i struggle in the role. Working 13 hour shifts in a busy inner city trauma centre A&E is a hard heavy job, i look daily for a job role i can transfer to, theres nothing at all. So i am stuck, thankful to have employment, but stuck in an unsuitable role affecting my health with no choice but to try and power through shifts, each one getting harder than the last.

I started a thread on here a couple of weeks ago after our mother’s death was certified by a doctor who’s English was extremely limited. She was better at speaking English but couldn’t understand anything what we were saying. I had to mime if she could close my mother’s eyes as she couldn’t understand any of us asking her to. She also got us to write down (using our mime) details on a scrap bit of paper as she couldn’t understand our responses (live in the South East, with professional jobs…)

I presumed we were essentially forced into hiring from overseas as we didn’t have the work ethic in this country to produce our own graduates. I felt sorry for her, but grateful that at least she was willing to put herself in these situations as we didn’t have the home grown talent…

I used to be extremely left wing but I am starting to internally mutter that immigration can’t be used instead of paying/replacing/training British citizens.

They are re-evaluating the NA role in my trust, as with in the areas that employ the most NA's, they arent allowed to give even oral medications, due to the complexity of the patients. So what has happened is all these NA's are now HCA's with the ability to complete neuro obs. Thats literally the only difference, our HCAs do venepuncture and obs, neither is allowed to cannulate so majority of the time its nursing staff doing the bloods as we cannulate at the same time. So we are employing multiple NA's every shift, at a higher cost than HCA's, to perform the same job, and the same amount of nusing staff per shift as we had to prior to NA training. The whole NA role needs looking at, its an expensive waste of time, paid more than the HCAs to do the same job, not cheaper nursing staff within my trust.

<waves back> One of DDs F2 friends, who again expects to have to find work overseas, was expected to help train PAs. Into the jobs that at one time would have been available to her.

Mine is "lucky" in that she has a strong intercalated degree in biomedical engineering so that is the path she will probably have to follow. . But she wants to be a doctor. I am also a bit worried that with so many applying there will not be enough jobs in Australia. Her final placement is very busy so not much time for job search.

Towards the start of her F1, a Registrar failed to turn up leaving an F2 and 2xF1s with less than two years of experience in charge of a busy city centre hospital in a very deprived areas. A 70 year old consultant told them to phone them at home if necessary. Luckily it was a quiet night and the three of them were all very competent for their grade. Our young people have spent the past two years being the sticking plaster that holds the NHS together. Then nothing. I hope Wes understands just how cruel the system is.

The F1 allocation system as well. New doctors can get sent anywhere and at very short notice. It used to be based on a points system. If you had lots of points you would be safe in applying to London, if not you could pick places you were likely to get. They have now done away with merit based points, for "equality" reasons. You can end up anywhere, sometimes at very short (a few weeks) notice. A new place on your own with a demanding job, and a punishing schedule which does not make it easy to build a social life. There are plenty of tears on allocation day. All but one of DDs placements have involved lots over overtime, nights, weekends, and 13 hour long shifts. Visits to DD have always been punctuated with calls from Funeral Directors - not many of us deal regularly with death and grieving relatives. These young people are great. Why can't we look after them.

And our local hospital spends a lot of money on overseas recruitment drives. Recruitment Staff fly abroad for this. People come, need a lot of support and training to then pass some sort of osce test. And are notorious for not staying long term. They go to bigger hospitals or maybe back home.

and our students were firstly told no vacancies as all filled from abroad and now no money to recruit anyone.

We should only be giving visas for posts unfillable nationally.

I'd hate to be a non-British NHS doctor reading through this thread.

There are so many different things contributing to this (lack of training places, an outdated system for distributing and allocating those training places, the use of physician associates acting at F1/F2 level, etc etc)... but sure, blame the foreigners.

Aws we realised last week on a different thread, this is a problem that needs fixing, and fast. Not just for those doctors facing unemployment, but all of us, whether tax payers or patients or both.

We are researching suitable people to approach, and working up a draft letter for MPs and others which people can amend and use. I will respond to requests for PMs, though it might take a few days.

If anyone has any media or other contacts, please either point them in the direction of this thread, or explain the problem to them or let me know who might be written to.

I feel we should give the campaign a name. Any suggestions?

It definitely should include other Health Care Professionals.

Having made a decision not to try for a UK based job because the odds are so low, DD is now quite excited about the prospect of a couple of years in Australia. She relishes the chance to experience a health care system that is not on its knees. The plan is for her to come back. She has done everything the NHS has asked of her to first get a medical school place, pass her exams and then the demands of F1 & F2. I hope that when she wants to return she will be able to.

Its not blaming foriegners. Its blaming the government backed trust recruitment drives that blew budgets and resulted in recruitment freezing, and over filled vacancies not accounting for those about to qualify. Its not the fault of those who applied and gained employment and moved, no one is saying it is, but it should have been restricted more. Instead now we have a situation where medics and HCP's who trained under the NHS, and are thousands of pounds in debt can not find employment.

Law graduates are facing increasing levels of competition for legal jobs due to weaknesses in the new points based immigration system post Brexit. Not just law but in other highly competitive sectors such as STEM too. If the Resident Labour Market Test isn't reinstated, it's not fair on those UK based applicants who have taken on students loans, etc.

UK growth involves investing in UK residents, including their education, skills and career opportunities. Upskilling foreign workers is shortsighted, even for economic reasons. Countries abroad prioritise their own citizens and permanent residents for employment. If you don't do that here, it leads to decline and a breakdown of social cohesion.

I'm pleasantly surprised that the tone of this thread has not become 'blame the foreigners' Where have you detected that? It's very much blame the system and expect the UK to prioritise it's own graduates for graduate jobs, in the same way other countries do.

@PoloMum many non British doctors are British graduates. They trained here. And are as angry as Uk born graduates. We are the ONLY country in the world who don't prioritise the doctors who have trained in their system.

IMGs are great. But after our own trained graduates

I think it's better to ask how many DCs who didn't have a say in Brexit, is suffering from the brunt of Brexit.

Sorry as I will read the full thread later after work, but there is a post on reddit where someone has had a positive reply from a letter to her MP. Might be worth a look. @mumsneedwine @Needmoresleep

Edit - they have shared their letter, encouraging others to write to their MP too.

Sorry if someone has already said!

There is no doubt we need international doctors to fill skills gaps.

But if your job was opened up to a global playing field and there were no chance for you to continue to on a in your chosen career because international graduates had been given your post instead, how would you feel?

this is what is happening.

Health is fundamentally important to all of us. It’s the backbone of a well functioning society.

If the government wants to recruit foreign trained staff that’s fine. But stop the uk training, it’s not fair on people to get them into that debt and dump them.

Are the F2s that have applied for jobs in Australia able to apply for speciality training in the UK too?

If F2s only apply for jobs abroad, will the government just say there are no stats to back up that our UK medical graduates want to stay in the UK?

@PlopSofa my DD is an F2. Currently waiting to be rejected from training due to a stupid exam that had 1 question on her speciality. So Australia it will be.
I am beyond angry at IMGs getting jobs that our graduates should. She gets jobs Aussie graduates don't want.