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 think this is for @fortyfifty

What are you talking about?

The thread is about recruiting doctors who are already in the UK first. Of whatever nationality.

A lot of the newly recruited doctors DD works with are from Africa. UK salaries are far higher and very tempting. But there is a huge moral issue of poaching doctors from societies where they really don't have enough doctors to go around. Even less justifiable when we have doctors over here who can't get jobs.

If you read the BMA statement lined in my OP, they take the same line on training positions. There are plenty of overseas doctors already here in entry level jobs, some of who, like some of of our UK trained doctors are very good. Both groups share a frustration at seeing career training denied to them and given instead to doctors brought in from overseas.

What do you think should be done. Should priority continue to be given, to say a bright and ambitious Singaporean who wants training in a specialist London . teaching hospital on his CV so that he can return home to a highly paid consultant's job in a private hospital. Or should we say that we prioritise those who are already here and likely to stay and serve our patients for a whole career. If that is racist (and I have nothing against Singaporeans) then we might as well give up and shut our medical schools. And save taxpayer money by poaching from countries that are already struggling to retain their very needed medics.

Please could you post the link?

No, not fine to keep recruiting foreign staff who would be new to the UK when they would be surplus to requirements.

Investing in young people here who want to pursue a medical career is important as first and foremost, a country's growth is dependent on investing in the education, skills and employment opportunities of its young people. Otherwise, you're just paying to train and upskill foreign workers and boost the economic growth of the countries they come from.

This issue is being discussed now on LBC

Unfortunately it’s on Matthew Wright’s show. 😖

Exactly. Absolutely flabbergasted by this thread and the crazy system described. Why on earth has this happened and how come no one knows about it.

Not a doctor, but I'm a patient and I think it's shocking that UK trained doctors aren't basically guaranteed a UK job (provided they pass and want one).

Could you explain what the deficiencies with the exam is? You call it stupid. Could you say why you feel the system of selection is problematic?

https://www.reddit.com/r/doctorsUK/comments/1ihfb0k/uk_training_posts_parliamentary_question/

Hopefully this works!

If this were a private business having to pay to train up their own doctors via university at actual true cost - there is no way they would not be guaranteed a job afterwards (provided they pass the exams). So the graduates need to be offered jobs in the NHS and the NHS needs to find ways to train them all, bar those failing their exams, which should be reasonable. That is why I suggested all avenues to retention are explored, including the private sector.
Just because they were trained up at the taxpayers’ expense and then are lost at the taxpayers expense, does not make this OK. I think the recruitment of overseas doctors and staff is a separate point. And should be kept separate. Over 40% of doctors working for the NHS come from overseas. That is not new.

A lot of current medical students are also the children of doctors originally from overseas.

@Wooleys because the exam was designed for GPs. But is used for lots of lots of specialities now. So for many speciality training posts it includes 1-2 questions on that speciality. Rest are on more generalist topics. And then there's the SJT which is a bit of a guessing game - take 5 doctors and you'll get 5 different answers.
It's a stupid system.

Based on what was being posted on another thread by an informed poster trying to justify the NHS approach, is that if F2s don't apply they are not counted in the stats. No one is reaching out to see why they are not applying. The NHS apparently do not keep records of home many apply for positions (often in the hundreds, even thousands). Nor do they keep data on how long applications stay open. If it is only a matter of hours, many F2s won't even see the vacancy before it closes.

Some F2s will just want to go to Australia. However in our discussion on another thread last week, it seemed that our F2s are only looking overseas reluctantly. They are only applying for a select number of jobs in the UK because the odds are so long (1000:1 is not unusual). NHS recruitment will score applications based on set criteria. Overseas applicants will often have more experience (because these are entry level jobs the F2s need to gain that experience) and may well be helped with their applications by Agencies who know how to optimise an application against the scoring system. The chances of an F2 who is not completely outstanding getting to interview is very small.

The same applies to training positions. Worldwide competition and rapidly increasing numbers.

DD had planned to focus first on a demanding set of F1 and F2 rotations (her choice - she is learning an awful lot.) . Get the experience and do a good job. Then spend a year as an F3, perhaps as a clinical teaching fellow, perhaps as a locum in the area she wants to go into and use the extra time (these jobs wont be as overloaded as F1/F2) to study for the exams she needs to be considered for specialist training and to do things needed to bolster her CV.

F3 positions in the UK are now out of reach, but she can sit the NHS exams when she is in Australia and apply from there. DD works with several senior doctors who went for a couple of years, gained experience and then came back. But now, unless something changes and priority is given to those who are in the UK or have British citizenship, those leaving will be leaving for good.

I think this "random" allocation is being totally misrepresented by people. It was voted in by 4/5th year students and f1/2 as the preferred option, it wasn't forced upon. It means a far higher percentage of people get their first choice location for jobs than the old system and its not random per se

Yeah the points for high academic achievement now don't sway your area but they weren't exactly fair either as I was in top of years for the first 4y, but cos I had to resit an osce in 4th year it meant I ended in the bottom decile as they based it on a single year of exams and hence ended up 6h from home

It’s still a dog’s dinner.

https://www.bmj.com/content/384/bmj.q720/rr

Whitehall algorithm strikes again… 😱🤯

Well ideally but didn’t think we were allowed to say that without being accused of being racist 🫣. But the current situation of overseas recruitment (for nursing and midwifery staff anyway, not sure about medics) and still training is the worst scenario.

I wonder if one of his researchers glances at AIBU when deciding on topics for discussion!

To be honest I just want the problem out in the open. It affects all of us: doctors, taxpayers, patients. It is a very bad short-sighted approach. It needs changing. I hope4 that Labour MPs are lobbying Wes behind the scenes. I have no problem with the opposition calling it out as bad government.

I just want this mad free for all to be changed. I want DD, and the other DC, to be able to stay in this country and enjoy the careers they have worked so hard for and which they will be so good at.

@Destiny123 it was voted in because the alternative offered was even worse. No one wanted this. They tried to change it but were told tough.

And all the F2s I know who are going abroad do not want to go. They want a job in the NHS. But it's abroad or unemployment

Not getting perfect numbers either…

https://www.bma.org.uk/news-and-opinion/the-luck-of-the-draw

Some of current concerns, as I understand, stem from weaknesses within the NHS's online recruitment system which has, perhaps unintentionally, introduced a bias in favour of IMGs currently abroad and that haven't started working in the NHS. I believe UK based applicants (either UK IMGs or UK medical graduates) are missing out to those global applicants, leaving them potentially unemployed.

One trust employeed nearly 400 nurses from abroad in under a year, meaning the last cohort a lot of nqn's were left jobless. If that number had been reduced by 50%, it would have meant jobs for all of them.

International recruitment, and home grown training is needed, its the volume thats questionable. Im sure this is the case with medic positions too.

I wonder who made money from the recruitment process?!

A question that should absolutely be asked.

I'm not clear how the fact that the exam is stupid favours international applicants?

If the issue isn't addressed now before it implodes, not only will it be politicised for the benefit of certain politicians but it would be a risk to social cohesion. After all, it's not a battle between UK IMGs and UK Medical graduates, just a call for an adjustment to the points based immigration system.

We live in a multicultural society that values everyone 's contributions. Other countries like Singapore which is proud of its multicultural society, has safeguards to protect the employment opportunities of its citizens and permanent residents. Singapore invests heavily in the education of its young people and forward plans for every eventuality. Given that politicians here in the UK have often quoted Singapore, perhaps they could see that multiculturalism is a strength and not a source of division.

No one is blaming foreign doctors, nurses etc. They are blaming the NHS/government/BMA for not recruiting UK trained doctors and instead recruiting staff from abroad, denying home grown talent opportunities and depriving other countries of their own trained staff, not to mention running the risk of employing staff whose standard of English many not be adequate. The first duty of any government is to look after its own people, the British one seems to have forgotten that.

I have been a consultant for 30 years at a London teaching hospital. I was interviewing for the medical school this week. I find it so heartbreaking, seeing these very bright, talented and enthusiastic young people applying for medical school, when I know that a few years down the line, for many of them, their morale and spirit will be broken.

When we have gaps in the rota now, or an unfilled post, our trust sometimes hires locum doctors. I always used to have a slight sense of dread when we had a locum as I worried that they may not know about the NHS, or they may not be able to speak passable English. But now the situation has transformed. The locums are of extremely high calibre, often UK-trained. I am shocked when I chat to them and hear that they say they cannot get a job on a training scheme.

I do think it is harder now to get a training post in many specialities. Honestly, when I see some of the applications, I feel that these resident doctors have better CVs than I did when I applied for my consultant job 30 years ago.

It is crazy that there are GP surgeries with funding for ARRS but they are not allowed to use the money to recruit more doctors. Even though that is what the staff and the patients want, and know is needed.

Anyway, my kids are at university and they are not studying Medicine. I simply would not recommend it now.