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.

What does it matter whether he comes from a well off background or not. If he is better off, family wealth is probably tied up in farmland and he has spent a childhood helping with morning milking. However it is equally possible that the top student in an obscure small town serving a rural community could be from a poorer family.

There are a huge range of jobs. I was riffing off posts by a geriatrician yesterday, working in a deprived area who described recruitment. Training places in an unpopular speciality now absolutely inundated with applicants. Yet their hospital is really struggling to recruit. The same will apply to other deprived areas, as well as much of Wales, NI and Scotland.

If you were in one of these areas, you might find that by the time you needed a geriatrician you would not be in a position to decided to be treated by someone in any top 15%. The high flyers, no attack on them, will be in prestigious posts in London, Singapore or Dubai, or in affluent southern Cities with good golf courses. (Bristol, Oxford etc). The consultant you see might well be a locum recruited from a WHO red list country possibly struggling with NHS systems, language, culture and climate. They probably will have come in the top 15% of their medical school (one poster who used to interview for training posts suggested all the overseas applicants she saw claimed to be top 10%) which might suit you. If I were in Enniskillen I would prefer to be treated by Eamonn.

We are not talking about people making way for Eamonn. We are talking about ensuring that suitable candidates are able to make their way through to jobs that need filling.

You say you recognise there is a problem. Can you suggest constructive ways to resolve it. Have you written to your MP?

I do live in such a place but we don't have recruitment problems as it happens. My MP would have zero interest I'm afraid. Our area has long welcomed outsiders in; it makes for a wonderful community. The multitude of golf courses also help the quality of life, even if not of championship level.

OneMorePiece, jobs for everyone.

My friends who are consultants are tough and down to earth. Not necessarily empathetic. A surgeon friend, not in the UK, tried to show me photos of cancers being eaten by maggots that she had taken during some clinics in remote villages. When she had a Caesarean her colleague, who had opened her up, happily pointed out her appendix and different bits of her innards to her husband. Would I be treated by her. Absolutely. Would I fly out to be treated by her. Quite possibly, depending on the alternatives, given the way the NHS has gone in the last few years and my last couple of experiences with GP locums. .

@OneMorePiece if you think all doctors are empathetic you clearly haven't met many doctors. It doesn't matter, the deal is they get paid and in exchange they try to cure you. If they're nice it's a bonus, but it's the curing that counts.

As an aside could you please send me the links for the courses and conferences that give access to points but don't cost any money?

Of course I am one of the privileged middle class white mommies that know nothing about the nhs that people on this thread are so dismissive of. Thats why I just saw your post - I was working an NHS night shift in a low paid job, that I had to go back to (after I left due to bullying and toxicity) in order that my state educated untutored offspring could spend 6 years in London in their hard fought med school place. Where they've been consistently in the top 10% and often the top 5% academically with great feedback etc.

But this is mumsnet. I'm not allowed to be proud, my child is a lazy privileged snowflake and I am out of line to expect the minimum of a level playing field and a fair, fit-for-purpose process as they take their next career steps.

And to answer your previous question - yes of course nepo babies and those with contacts get a far smoother and less stressful ride through. If you think otherwise then you either have little experience of the nhs (or the world of work in general), or you're in denial for reasons of your own.

HostessTrolley well I'll take your word for it that DC of doctors get training posts even if they're not above the cut off. I just find it hard to believe.

I'm sorry but there won't be such a link in the nature of things. There are pockets of money which are available - you'd have to do the research for those because it will depend on the F1/2s situation - but the fact is that attending conferences can be extremely doable even if abroad and not in the UK near home. If you want to fly BA or stay in the Ritz Carlton possibly not, but plenty can be done on a shoestring. A real shoestring.

I sympathise with being a parent of a state educated, untutored, no contacts DC but I'm wary of triggering any more unsolicited comments which seem to have flown freely on this thread.

'if you think all doctors are empathetic'
I don't think that all doctors are empathetic.

Marchesman said empathy is overrated. I disagree.

Not sure how you then linked that with me thinking that all doctors are empathetic or whether or not I have met any doctors.

Agreed. None of those things depend on juniors having money, apart from exam fees which are not expensive in relation to income; and as to audits being "down to who you know", that is very uninformed.

Elsewhere in the thread in a similar vein, reference has been made to nepotism. I have looked but failed to find data on UK medical students with a medically qualified parent or parents, although there is literature from the US and several other European countries. I haven't known any colleagues' children go into medicine in the last two decades at least, and I assume that the numbers are too small to merit research here.

@OneMorePiece well you did say 'if you think empathy is overrated you are clearly not a doctor' That does imply to most readers of English that anyone who is clearly a doctor would think that empathy is not overrated. From experience that is not the case.

Please can we keep to the topic all you emphatic posters!

And please write to your MP if you agree that changes to the RLMT to enable more of the 85% to find jobs.

I think we are agreed that the top 15% are fine. We should remember that medical school graduates are a fairly selective pool and that most will make good doctors.

What more is there to say Needmoresleep?

You may not have anything more to contribute.

Others would like to see health care professionals, whether doctors nurses physios etc, receive some priority when it comes to jobs for which there are a number of eligible UK applicants.

Others would like to see an expansion of the number of training positions with, again some priority to those in the UK and likely to stay in the UK.

Some would like to see a review of pathways into hard to fill jobs. (Eamonn!)

Some would like to see consideration of the mismatch of graduates coming out of medical school/F2 and the available non training jobs.

Probably lots more.

I will try to get some bullet points together as well as a list of people that might be written to. We are observing a problem. Our observations may be incorrect, but we would like those responsible to look into it. My understand is that the NHS is not even keeping stats of key phenomena such as numbers of applicants per vacancy into entry level jobs. Or the length of time those vacancies stay open. Issue which we believe are discouraging F2s from applying. Not do they seem to be looking into retention of F2s and reasons why they are leaving.

When they look into it they may discover that the problem is that most of the younger generation are not good enough and that we do better by recruiting abroad. But if this is the case we should be reviewing the need to run medical courses.

Can we keep the thread on topic.

👍

My understand is that the NHS is not even keeping stats of key phenomena such as numbers of applicants per vacancy into entry level jobs

Well, on the original thread in Higher Ed which was hopelessly derailed onto this very subject, a senior medic suggested how current F2 DC could help contribute to the collation of data and was given very short shrift by one of the more vocal posters on the three threads ('After a shift! Why should they!' [this is from memory; the quote might not be exact]). The senior medic said yes: if they're prepared to stand outside with placards asking for money then she'd hoped that maybe they'd do this too for younger colleagues.

But no.

After a 13 hour shift I'm not sure when they'd collect this data ? Are you willing to do it as you seem to have lots of time. I've been at work and heading home but know I wouldn't even know where to start. Maybe the BMA could set up some kind of spreadsheet and everyone could contribute ! Not my area.

Be good to have evidence although you'd think the competition ratios would speak for themselves as to the problem.

Go back to the original thread mumsneedwine and you can revisit the suggestion yourself.

I'm not in a position to do it, obviously. I'm not in the market for a JCF position. I'd have to forge all sorts of degree certificates first. Empathy towards certain colleagues could also well be an issue.

I've so far wfh for eight hours today - making good progress with a particular issue I'm delighted to say.

Derail.

The point is that we have observed something. We think there may be a problem. We think we might know what is causing it. We are asking for it to be looked into.

Sort of like if you have a symptom. You go to your doctor, you may suggest a possible cause. But they then run the tests to give the diagnosis and suggest possible treatment.

I am asking for this thread to be kept on topic. No reason why you should not start another thread to air your own views.

Please. Can you keep this thread on topic. If you want a lengthy discussion with the other poster perhaps you could PM each other. Threads about threads are banned on MN.

Needmoresleep it's not legitimate to shout derail every time someone quotes part of your post and comments on that quote. That is not what a derail is. That is absolutely on topic unless you yourself were deviating. And if you were, you probably have no standing to object.

I do see that you want to very closely control the narrative but that isn't what MN/ AIBU is about.

In this instance you mentioned collation of data re entry level jobs and I pointed out that on a previous thread a way to chip away at this at deanery level had been suggested (and rejected). Bang on topic.

Ok. But this is a follow on thread from a follow on thread (that's my understanding), so inevitably that means the lines here are slightly blurred.

O.P it isn't derailing disagreeing with you.If you only want to hear from people who agree with you you would have to have quite a different thread title.

I've been at work most of the day so not really read anything since I was last here ?

I think constructive ideas that produce evidence could work. As such, I've contacted the BMA rep near me to suggest something could be set up. Might be useful might not. But I believe everything is worth a try to gain evidence. If there are lots of jobs available and not being filled then this could highlight where and why.

Off home now.

www.bma.org.uk/bma-media-centre/bma-welcomes-nhs-england-s-recognition-of-need-to-take-action-on-broken-training-system-for-resident-doctors

I very much value the contributions that large number of posters have made, whether I agree with them or not. I think that most people have enjoyed people taking views and being open to discussion.

I guess it is difficult when I can't really understand what the poster's issue is. Rather than state their position, which as I understand it is that there is potentially a problem but it does not affect them. And that it would be solvable if our DC were harder working and more proactive. We have a lot of posts not leading very far.

The most recent, a reference to a consultant on another thread, who apparently suggested that data could be collected at Deanery level. Great. One observation is that a group of F2s see problems with the sheer numbers of applicants applying for jobs, so see little point in applying. (These are the sort of jobs they need to get the experience that some overseas candidates are already offering, with no priority for tho9se already in the country.) If we can persuade the NHS to look at issues affecting retention they perhaps can look into stats like this, and, essentially look at their "diagnosis". That same poster, interestingly, seemed to suggest that the NHS just assumed that a huge wastage after F2 was inevitable and that the solution was more medical school places and more international recruitment with more incentives.

I hope that most taxpayers and most potential NHS patients can see that there is some logic in terms of trying to get the NHS to look at retention rather than just focus on recruitment.

l’m not sure if anyone can remember but this same same situation happened leading up to 2006 and a cap was placed on the number of IMGs and overseas doctors that could come to the UK and prioritisation had to be given to UK applicants. Also, EU applicants were given priority to Indian doctors. We’ve been here before.