AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs

[Needmoresleep]

Unbelievable but true.

Doctors, nurses and other health care professionals now have to compete for jobs and training with applicants from across the world. No priority is given to those already in the country.

Even ordinary entry level jobs can attract hundreds of applicants within a few hours. Newly qualified doctors and nurses need that first job to get the experience that overseas applicants will be able to offer.

In 2021 immigration law was changed and something called the Resident Market Labour Test was dropped for health and care workers. It means that the UK may be the only country not to prioritise those already in the country.

The previous thread:
https://www.mumsnet.com/talk/am_i_being_unreasonable/5267503-aibu-to-be-furious-that-there-are-no-jobs-for-young-doctors?page=1
included a number of stories. An entire graduating class of nurses unable to find that first job whilst administrators from the local hospital were taking recruitment trips to Asia. An experienced GP wanting to return from a career break only to discovering that she, and others in a similar position, could not find work, a consultant surprised at how well qualified locums seeking zero hours, short notice, cover work are. The number of overseas doctors applying for the limited number of specialist training positions in the UK doubled between 2023 and 2025.

A group of us, who have been on the higher education board since our DC were first applying to medical school, recently discovered that none of our DC, coming to the end of their foundation years (F1& F2) expect to get anything other than the odd shift with NHS bank. Most see moving to Australia as the only way to stay in medicine. They say the same applies to their peers.

Our young doctors have spent seven or eight years getting to where they are, and have £100,000 of student loans to repay. The taxpayer has spent £250,000 on each of them.

Unfortunately the NHS does not appear to keep data on the number of applicants per vacancy, nor on vacancies that, because of the numbers applying, close within a few hours. It also does not appear to question why such a small proportion of F2s are progressing within the NHS. Instead there seems to be an assumption that this wastage is somehow natural, and that the solution is to re-double international recruitment efforts, to increase medical school places, and to replace traditional junior doctor roles with less skilled Physician Associates. Measures that will only increase the problem.

If things are not changed, even more of our skilled and dedicated young people will find themselves without jobs. We would welcome experiences, information and ideas.

Please also spread the word, write to your MP, tell people in a position to influence who may not be aware. We have a shortage of doctors, nurses, midwives, and paramedics. Our first priority is to ensure that those already in the country are able to get jobs.

If young Doctors were asked, and the same will apply to other Health Care Professionals, they would argue that:

• Busy F2s work long shifts including nights which makes extensive job search difficult
• Posts often attract hundreds of applicants, and close within a few hours. This level of competition is in itself off-putting
• Overseas applicants are often supported by agencies who can set alerts for vacancies and ensure that multiple applications are submitted. No such support is offered to UK applicants,
• These agencies will help with the writing of applications so they score well against NHS selection criteria. Again no such careers support is offered to UK applicants.
• The Government/NHS offer incentives for overseas doctors including bringing in dependents and scope for future citizenship, as well as some exemptions from some exams and relocation packages. These may motivate overseas doctors to apply for entry level jobs even if they are overqualified. Entry level jobs which our newly qualified young people need.
• Various extensive and expensive courses are advertised on the internet designed to give participants an advantage when applying for specialist training in the UK. In contrast many UK medical schools do very little to ensure that their graduates have the additional academic super-curricular that, with current levels of competition, are effectively requirements to gain a training place. This year it is predicted that only 50% of the around 4,500 places will go to graduates from UK medical schools, even though it is recognised that for many UK training is simply a passport to well paid jobs in private hospitals in Singapore, Dubai or their home countries. This is poor workforce planning. If we are going to avoid a future shortage of consultants we need to prioritise those likely to build a future in the UK.

Many young doctors will see a couple of years in Australia as a reasonable fall-back. They accept that they will be taking jobs Australians don’t want and will be at the back of the queue when it comes to specialist training, but they will also be gaining experience in a different healthcare environment.

Others, including those with family or caring responsibilities, or those who brought their families over when offered fixed term contracts, simply face unemployment. We should not be recruiting overseas when we have good, qualified, NHS experienced, doctors, nurses and other HCPs in the UK driving Ubers or working in Tesco.

Yes this one. The poster clarified that their uni doesn't have a PA course but hasn't yet said where they're studying.

It's so difficult to read reports of nepo babies being ok and sod the rest, or implications that 'the rest' are weak/lazy...

Do doctors' DC really get through the bottlenecks these days thanks to nepotism?

A bit premature - the student is only in his third year.

Looks like Nottingham to me - BMA student rep Nottingham?

Isnt it more the point that Foundation training is not fit for purpose?

People used to do 2house jobs - 80-120hrsper week.not a thing I would wish to return to but what ti did do , is get you up to speed very fast. - approx 4200 hours of work per annum
into an SHO job etc again on100hrs per week - 4200
2 yers of training 8200 hrs of learning

FY1 allegedly the equivalent of old house jobs - 40-66 hrs per week. 2100hrs pa
FY2 - 40-65 hrs per week gets you 2100hrs pa
2 years of Foundation Training - 4200 hrs of learning.

Current doctors are being failed by a system that says your training and experience in 2 years is the better than the old school - which it patently is not. You will have seen more strokes, fractures etc in 8200hrs than you will in 4200.

Whilst I would not advocate returning to the gut wrenching shit of 100+ hrs per week - it is simply obvious that Foundation training does not deliver a doctor ready for the next stage in 2 years and should probably be extended to 3 years.

Amazing how the old school managed to apply for 6 month jobs, write papers, do higher degrees etc and not whinge quite so much.
So much rubbish written on this n the other thread. Blaming iMGS many of whom apply form abroad and have no hope of getting shortlisted shows a fundamental lack of understanding of how the system works.
No one here has shown evidence that the training jobs have gone to "foreigners" just allegtions.

Having to be quite the sleuth here but I assume that this is the post you said that I'd missed?

It makes no sense at all and yet is typed in the clear light of day. It's extraordinary. Would you care to explain what you meant?

A specific DC that you can know absolutely nothing about thinks they're better than everyone else. Initially a Cambridge top of the year graduate who hasn't managed to get a training post interview said he knew this DC !!! (sic) but now you've rowed back and said that what you in fact meant was that this DC represents all those doctors who are overly pleased with themselves?

That's all the meaning that I can extract from the nonsense.

mumsneedwine I won't report this if only because it will fry the heads of those manning MNHQ but please do get a grip. This isn't ok. It's rambling and it's certainly intended to be personal for no reason that I can think is possibly justified.

Discussion on MN does not have to descend into weird and nor should it.

I'm completely lost about the anaesthetics bit. That may or may not be my own DC's specialty, I've not specified.

Overdue for a reset if you're serious about sensible discussion on a serious topic.

There could well be something in the idea that the Covid years softened those at school or uni at the time and were a tough call for those thrown into the baptism of fire that was F1/ F2 in 2020/ 2021. We do hear a lot of moans from those who were by and large sheltered from the fire.

BMA reps said "junior" was misleading because they "are expert clinicians who are responsible for a huge bulk of the medical care given to patients across the NHS every day – performing operations, leading medical teams, saving lives."

But this is blatantly untrue and if any of them actually believed it, they would be a serious danger to patients.

Prior to Calmanisation, training to be a consultant took about 50% longer than it does now. SRs who were in their thirties had no objection to being called junior because it differentiated them from consultants that they would in due course become. The term resident was rarely used, but when it was, it applied to HOs and SHOs, who were obliged to sleep overnight (if that was possible) in hospital residences when on call.

Now of course they work shifts, and are not resident - anywhere - for any length of time, long or short. They are known by a term that was traditionally used only for very junior ranks until they become consultants, which is not only misleading but semantically incorrect, annoys anyone who understands the present system and what came before, and adds to the befuddlement of the general public who are overloaded with medical word salads. The BMA only got away with the new nomenclature by cynically incorporating the change in their pay negotiations.

You are a silly billy. Don't you know they are all expert clinicians now?

Do try to keep up.

Yeah right- they learn everything by magic and any way they are owed a job with minimal extra effort because thy trained as doctors!

Nothing bitter - just slightly tired of "invested mums" refusing to listen to what people who actually know about jobs and work in the NHS re saying.
Offended by the tone of the conversation towards IMGs and they are the root cause of everything
Tired of claims of white privilege when current medical school intakes in many med schools has white students in a minority
Tired of being told we need to feel sorry for current F2s who have not bothered to apply for jobs because they have decided not to.
Every F2 finishes with a medical degree, appraisals etc - if you want to stand out you have to go the xtra mile.
Tired of mums whinging that F1/f2 are apid different amounts if they do less hours!
Tired of Mums claiming their children are so tired to apllly, write a paper, do some research but then in the sme breath say they have all their weekends free and are on a clinic only rotation.
Tired of listeinign people who think all F2s should get a training post simply because they are doctors and have debt
Tired of Mums blaming London, teaching hospitals, unpopular rotations etc etc
Tired of reading pure unadulterated tripe that is being trotted out.

Medicine is hard work, you need to work hard to progress in all aspects of the profession nothing different to the last 20 years. It never stops.

Yes, a lack of empathy too. Are they as dismissive of their patients' concerns as much as they are of their junior colleagues I wonder?

Some seem to be out of touch with reality and downright rude. Feel sorry for their patients.

I am not one of the mums affected by these issues but Finally lost it should know that no one here is blaming IMGs for the problems. Just calling for a pause of new IMGs who have yet to start working in the country until the current recruitment issues are sorted. Also it's sensible to stop PLAB so that IMGs are not wasting money on it when there is no certainty that they'll get posts.

@OneMorePiece if you look at the posts from early yesterday morning you will find that IMG's were definitely being blamed by at least a couple of posters for the problems that their own children were having finding employment.

That would possibly have been with reference to new IMGs who have not yet set foot in the country. I think this year's applicant numbers are so high that it's only right that UKMGs and existing IMGs should be prioritised ahead of those who have yet to enter the country.

A reinstatement of the RLMT and changes to the current points based immigration system would help as there is an ever increasing number of new IMGs for a limited number of posts. The GMC should pause PLAB exams so that IMGs still abroad don't waste their time and money if there's not hope of posts available. These measures are in no way anti-IMG. They are sensible given that demand far outstrips places available. For posters reporting vacancies in their hospitals due to a lack of take up, perhaps they need to flag up this issue to their superiors so that if there is some sort of disconnect or other issues within the recruitment system, these can be addressed asap and potential UK medics found for these posts instead of recruiting from overseas.

Here is some insight from IMGs on why they leave the UK. These IMGs report that once trained in the UK, they prefer to return and be consultants in their home countries.

They describe the UK as a country in economic and social decline with 'shit weather, social isolation, micro aggression, and on top of all that knowing the regulatory body doesn’t like you very much.'

As they say 'The reason why we are in the UK, is simply because our countries are hopeless not because UK is paradise because it is not and it never was and it never will be.'

'So IMGs will train learn & benefit themself then go back home to their families even if the money is less. Home is home people, nothing is like home.' says another.

It certainly is an eye-opener and should serve as a wake up call to those in charge that make decisions on workforce planning. IMGs going home after becoming consultants is a contributing factor to the consultant shortage.

The way forward should be investment in the UK workforce instead of an over reliance on new IMGs. Otherwise the UK is just training up doctors for foreign countries. I think it's time to stand by the young people in the UK by prioritising them instead of new IMGs as doing the latter appears to be a false economy.

https://www.reddit.com/r/doctorsUK/comments/1hml2vw/overworked_and_underpaid_indian_doctor_shares_why/

As has been stated, giving priority to staff with 2 years NHS experience would be a good way to ensure doctors and nurses who understand the NHS and will likely stay in it have priority. No one has ever attacked IMGs, but to train our staff here and then employ from abroad (including from red list countries) is both a waste of money and immoral.

As a teacher in a deprived, largely BAME school, who has encouraged and supported students into medicine, I am sickened by the assumption that this is all about 'white, middle class mums'. Majority of the rich kids will be ok as can afford to try locums. Or move abroad, both these things take money.

The most disadvantaged this year will be those who can't just move anywhere in the country. Who don't have support systems but who are bloody good, empathic doctors who some people here seem to want to throw on the scrap heap.

The lack of empathy shown by some on here, who claim to work with doctors and nurses, is unbelievably sad.

Thankfully the RCP have agreed it's wrong (finally). As have DHSC. And pretty much every doctor, admissions tutor and NHS manager I've spoken to in the last few weeks.

www.rcp.ac.uk/policy-and-campaigns/policy-documents/left-in-the-lurch-royal-college-of-physicians-describes-resident-doctor-recruitment-crisis-in-new-statement/

It's not just 'a bunch of mums'. Although I still fail to see what's wrong with mums - slightly mysoginistic take by a few. We are also people.

Good to see a reset mumsneedwine. Appreciated.

That said, as you yourself must know only too well (as will anyone who works in widening participation initiatives), students at medical schools in the UK are disproportionately middle class. The numbers of disadvantaged students is woefully low, even now.

There's absolutely no disguising that the outrage on these threads issues from self interest about particular DC. As soon as this was pointed out there were attempts to make it a more universal 'campaign'. But self interest was demonstrably the genesis.

The consultants who are posting fairly pithily are merely delivering a few home truths which may be unpalatable to the mothers of medics on this thread but they're recognisably true. Doctors can lack empathy for those they think are undeserving without compromising their ability to be excellent caring doctors themselves. Doctors need to discriminate sensibly, not just hug every Tom, Dick and Harriet who comes their way.

Again, you have to bring it back to personal. I am fighting for ALL young doctors, many of whom are amazing and caring. But can't afford the luxuries of conferences, contacts or portfolio building exams. As these all cost money. They can't afford extra MSRA training packs as too busy paying rent and bills. And these are who I'm fighting for.

And yes I'm a mum of an F2, as are a few of us. This is the only reason we know about the problems, because we were talking on another thread and realised it wasn't just a small issue. Is this not how things work ? You become aware of an issue through personal knowledge then attempt to make change for the better good.

I have no idea why you think 'best' doctors are the ones who can do exams (& afford extra support to do so). Best doctors to me are those who can do their stuff on the wards or theatres and care about others. Not who can tick portfolio boxes because they have contacts to help them.

Many of my ex students have flown through training in the past. But things are different this year, and the privilege of some people who know nothing of how WP works is showing through.

And every consultant, registrar and senior NHS manager I've spoken to over the last few weeks has been very supportive. They seem to understand why this is an issue.

Why have I spoken to do many ? Because once I became aware of a problem I reached out to my contacts (yes, I'm lucky as I know lots of lovely medics because I either taught them or use them to help the kids I teach). I wanted to educate myself on the realities of the problem, and understand if what I was hearing was correct.

Statistics don't lie, evidence based medicine is important. Over 50% of doctors doing speciality training were from abroad last year. Which would be fine, if it wasn't leaving UK based staff unemployed.

mumsneedwine I've been involved in widening participation for many years, as it happens. This is partly why these threads interest me. I happen to know just how middle class Medicine in particular is, unfortunately. And of course the Higher Ed threads on MN are well known for being peopled by those who are comfortably off on the whole.

My post was not personal and I'd really appreciate it if your responses could be clinical, in the sense of responding directly to what posts say, not what you convert them into saying.

Just one example: this thing about the best doctors being the ones who can pass exams. I haven't said that anywhere at all.

I'm puzzled by the repeated linking back to affordability, as though there's a link between money and getting a training post. I do understand that it's intended to up some sort of moral case but I just don't recognise it as being correct. If you can explain why you're under that impression that would be good.

I'd like to add that I've also never said that I don't think that there's any problem with the numbers and the bottleneck as there very clearly is.

@Auchencar because going to conferences, getting things published, doing extra courses and degrees etc costs money. And these are what gain you portfolio points to get into some training. Having the opportunity do audits can be down to who you know.

Others rely on MSRA which you can pay to get question banks, courses etc.

So if you can afford the above it's easier to get a training post.

Were you at the WP conference 2 weeks ago ? You must have heard the anger presented by doctors there ? From all Medical Schools.

I saw that statement from the RCP and thought it was ironic, given that some areas within the RCP have enthusiastically supported the use of Physician Associates. Currently a very hot discussion topic for many many reasons

But this an issue for me as a teacher of many years who had supported v poor, v hard working students into medicine. Who are now £000,000 in debt and having the prospect of unemployment this August. Yes really. Not made up although I do wish it was.

It is not just about training. It's about a lack of F3 type jobs (whatever you call them). Because of PAs or international recruitment.

It's about nurses not getting jobs, consultants being out of work and of GPs desperate to work as GPs but unable to do so.

We train staff. It costs money. People mosn that 'they should work for the NHS for x years to pay us back'. Well they'd love to do just that, so employ them.