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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

795 replies

Needmoresleep · 16/02/2025 15:22

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.

OP posts:
Thread gallery
84
modelT · 19/02/2025 20:21

The PA issue isn’t going to go away any time soon unfortunately. BMA case against GMC started today in London.

OneMorePiece · 19/02/2025 20:22

modelT · 19/02/2025 20:13

Aside from the IMG you refer to there has been almost total consensus on the issue, even from current IMGs. Streeting is unlikely to make any agreement before the latest round of talks on the pay dispute though.

That's good is there is progress. Hopefully said IMG realises the way IMG is going about it is damaging to all IMGs already here. Should put self interests aside.

Needmoresleep · 19/02/2025 20:28

modelT · 19/02/2025 20:21

The PA issue isn’t going to go away any time soon unfortunately. BMA case against GMC started today in London.

But crazy to continue to ringfence jobs for PAs when this year’s crop of doctors finishing F2, finishing short term contracts, and those returning from career breaks can’t find jobs.

Easier for our DC who are largely without ties and who can go abroad. Much harder for some who, for cultural and other reasons won’t want to live away from home.

OP posts:
modelT · 19/02/2025 20:30

Yes, this all disproportionately affects undergraduates and trainees from disadvantaged groups.

Auchencar · 19/02/2025 20:39

modelT · 19/02/2025 20:30

Yes, this all disproportionately affects undergraduates and trainees from disadvantaged groups.

When I made an observation about most likely well heeled Eamonn from NI, having been involved in this stuff for some while, OP said that this subject didn't matter.

I kind of think it matters but OP is quite tight on what does and doesn't matter/ can be discussed.

modelT · 19/02/2025 20:43

Also, urge your F1/2s to be active on this issue in the BMA. It’s red hot right now and they have voices.

Marchesman · 19/02/2025 20:46

mumsneedwine · 19/02/2025 19:13

Missed ! No kissing on MN.

If we only employ UK trained staff there will be no unemployment or bottle necks (consultant places are also enough to take the UK grads I'm told - by a consultant so no idea if right).

As I understand it, UK medical graduates have been guaranteed Foundation Year posts since the 2024 round.

If we only employ UK trained staff, how do you reconcile retirement numbers with graduate numbers?

Trainees move up the ladder every few years, consultants and GPs stay in post for decades - this is a bottleneck that is inescapable.

Furthermore, foreign graduates leaving later in their training has been cited as an argument for limiting their numbers. However, any doing so relieve congestion at the point of appointment to consultant, having performed their traditional function as middle grade staff.

Marchesman · 19/02/2025 20:54

Needmoresleep · 19/02/2025 20:28

But crazy to continue to ringfence jobs for PAs when this year’s crop of doctors finishing F2, finishing short term contracts, and those returning from career breaks can’t find jobs.

Easier for our DC who are largely without ties and who can go abroad. Much harder for some who, for cultural and other reasons won’t want to live away from home.

Abolishing Physician Associates is something else that juniors in the BMA should have demanded, rather than a pay rise, if they really wanted to save the NHS.

Needmoresleep · 19/02/2025 21:03

Marchesman · 19/02/2025 20:54

Abolishing Physician Associates is something else that juniors in the BMA should have demanded, rather than a pay rise, if they really wanted to save the NHS.

I am not sure of the extent to which F1F2s had a say over BMA priorities. “Junior” covered a wide range of seniority up to senior registrar. People with a lot of responsibility who presumably were frustrated with only being able to afford a shoebox in London.

I know that DD felt that priorities for foundation years in her deanery should be conditions and, presumably, better prospects. Anyway, she is getting her backdated pay increase, but conditions remain the same and prospects are worse. It can fund her trip to Australia!

OP posts:
Finallylostit · 19/02/2025 21:27

My main issue with the most vocal mothers on this thread is your absolute refusal to listen to actual doctors who say that not every F2 should automatically get into further training because they are F2s and got some nice appraisals. You do not want competition but competition is what drives excellence and further medical developments.

you have an excuse every time that after a 13 hr shift they can not do extra work, can not think of an audit to do, that all consultants need to spoon feed them the next stage if they do not they are arrogant and unempathetic - refuse to accept that every foundation doctor has 2 minimum consultants guiding their careers giving them advice. This generation are the most nutured, supervised nd guided in decades - all done by the evil hard nosed consultants. They can audit their own work - an audit of process or outcome of your own work shows far more insight into your development as a doctor and does not take huge amounts of extra time.

Stop thinking that every doctor needs to do the minimum competencies - everyone has the minimum - I want my surgeon to have gone beyond the minimum of surgeries required to become consultant. I want that person who will go the extra mile.

YOu are advocating mediocrity not excellence - you insult any one who puts an alternate view point - refuse to accept that each generation has it tough in a different way and that only this generation have it hard. I doubt any of this generation would survive the hours of the 80s and 90s - that was physically and mentally as tough but in a different way to the current generation who have more financial debt but less hours and experience.

Roll on 2 yrs and I think you will be surprised how many are progressing where they want to be.

Mumsneedswine and one more sleep - you have absolutely over the two threads blamed this on IMGs and then become more qualified in your protestations - please do not deny otherwise.

Auchencar · 19/02/2025 21:37

Unfortunately, on several levels, this thread has illustrated the absolute worst of MN.

Finallylostit · 19/02/2025 21:41

PAs only need a degree in sports science or geography from any University. The one girl we knew who became a PA was perfectly nice but I doubt anyone would claim she was academic. what a vile post.

There are plenty of very good doctors/ nurse who are not academic but get through with hard graft and good communication skills.

Do you understand one of the reasons why PAs have expanded - not all to do with not enough junior doctors but because feedback from foundtion doctors about jobs they felt were not educational and tasks they considered repetitive and beneath them. Problem is those tasks still need doing - so lets get rid of PAs ( which I disagree with) and give it a few yers a bunch of disgruntled junior who think these tasks are not educational. When used properly and working inconjunction with doctors - many, not all PAs enhance training opportunities for residents, help provide continuity of care and are an asset to patient care. Shame you lot seem to talk about a profession you know nothing about

Clavinova · 19/02/2025 21:42

modelT · 19/02/2025 16:02

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.

What a muddle:

  • In March 2006, the Home Office announced the immediate end of "permit-free training" arrangements, potentially preventing non-EEA doctors from obtaining training posts. Although highly unpopular, this measure ultimately had little impact as thousands of non-EEA doctors were subsequently accepted on to the Highly Skilled Migrants Programme (HSMP), allowing them to compete freely for training posts.
  • In June 2006, the Department of Health asked the Home Office to restrict opportunities for HSMP doctors through changes to the Immigration Rules. The Home Office did not comply with this request until February 2008.
  • Later in 2006, the Department issued employment guidance instructing NHS organisations not to consider non-EEA doctors, including those with HSMP status, for training posts unless no suitable UK or EEA applicant was available. The guidance did not take effect in 2007 due to an ongoing legal challenge.
  • In October 2007, the Department issued a consultation proposing to implement its employment guidance from 2008 onwards. The following month, however, the Court of Appeal upheld BAPIO's challenge to the guidance and declared it unlawful. Thus in 2008, non-EEA doctors were again allowed free access to training posts.
  • The Department appealed against the Court of Appeal's decision and a final verdict on the legality of the guidance is expected from the House of Lords in May 2008. In February, the Department issued another consultation proposing to implement the guidance from mid-2008 onwards, providing it is upheld by the House of Lords.
  • Also in February 2008, the Home Office made changes to its Immigration Rules, originally requested in 2006, preventing doctors gaining HSMP status in future from applying for training posts. The Department of Health acknowledged that this change would not have any impact until 2009 and would only then make a limited difference. The Home Office emphasised that this was a temporary "stop gap" measure...

https://publications.parliament.uk/pa/cm200708/cmselect/cmhealth/25/2509.htm

June 2010
A shortage of junior doctors to start work in hospitals this August is forcing the NHS to try to recruit from India...

"We pulled the plug on overseas recruitment far too quickly," said Professor Derek Gallen, who is postgraduate dean of medical training for Wales.
"[We didn't] realise what the implications of that action would be two, three or four years down the line," he added.
"Particularly with the European Working Time Directive [and the] increased feminisation of the workforce. These are things that have made staffing rotas very difficult."

https://www.bbc.co.uk/news/10202803

modelT · 19/02/2025 21:50

ah! that’s quite a bit of detail there. BAPIO….OP you’re gaining quite the attention on this thread!

HostessTrolley · 19/02/2025 21:55

Finallylostit · 19/02/2025 21:41

PAs only need a degree in sports science or geography from any University. The one girl we knew who became a PA was perfectly nice but I doubt anyone would claim she was academic. what a vile post.

There are plenty of very good doctors/ nurse who are not academic but get through with hard graft and good communication skills.

Do you understand one of the reasons why PAs have expanded - not all to do with not enough junior doctors but because feedback from foundtion doctors about jobs they felt were not educational and tasks they considered repetitive and beneath them. Problem is those tasks still need doing - so lets get rid of PAs ( which I disagree with) and give it a few yers a bunch of disgruntled junior who think these tasks are not educational. When used properly and working inconjunction with doctors - many, not all PAs enhance training opportunities for residents, help provide continuity of care and are an asset to patient care. Shame you lot seem to talk about a profession you know nothing about

The issue is the 'used properly' bit.

My d's observation is of junior doctors spending their days running round the wards chasing paperwork, discharge letters, doing bloods and ecgs etc etc while the PA is in theatre or clinic, when the intention of the PA role was that they would be trained to do the mundane ward work to enable the junior doctors to gain experience and training. Of course there will be an amount of ward work that always needs to be done, but when senior doctors are openly talking about preferring to spend time training the PA rather than the junior doctor because the doctor will be rotating out in a few weeks, then complaining that junior doctors don't have the skills expected for their level it's not rocket science is it?

And of course there are those PAs that are unsuccessful med applicants that have an attitude towards med students and junior doctors that doesn't help relationships between the two groups...

modelT · 19/02/2025 21:59

BAPIO training academy

Finallylostit · 19/02/2025 22:04

when the intention of the PA role was that they would be trained to do the mundane ward work - slightly arrogant to think that any part of patient care is too mundane and beneath them!

Not met a consultant who would prefer to train a PA over a junior doctor and we have a lot of PAs where I work. I feel sorry for them right now - the nurses resent them, the junior doctors resent them but if their jobs are set up properly then they are an asset to the team

Physicians associates are well developed members of the medical workforce in the US - maybe people should see how they can fit in and work towards it but insulting them.

OneMorePiece · 19/02/2025 22:07

modelT · 19/02/2025 21:59

BAPIO training academy

Influential in workforce planning, the BMA, heavily involved in expansion of academies overseas and granted licenses for sponsorship by the GMC

OneMorePiece · 19/02/2025 22:09

modelT · 19/02/2025 21:50

ah! that’s quite a bit of detail there. BAPIO….OP you’re gaining quite the attention on this thread!

https://medicalbuyer.co.in/bapio-to-position-india-as-global-hub-for-medical-talent/

Needmoresleep · 19/02/2025 22:11

When did foundation doctors decide they decide that jobs were not educational enough and that they wanted to be prevented from applying for them?

My understanding is that many PA jobs look quite attractive: more pay; no nights; sometimes better access to training. And that if they were allowed to apply for them they might. Certainly more educational and preferable to no job at all.

OP posts:
modelT · 19/02/2025 22:15

OneMorePiece yes that’s it sadly

OneMorePiece · 19/02/2025 22:21

modelT · 19/02/2025 22:15

OneMorePiece yes that’s it sadly

The elephant in the room

modelT · 19/02/2025 22:27

and have a look at
BAPIO X TERN Partnership
“A New Chapter for
Indian Doctors”

Needmoresleep · 19/02/2025 22:27

modelT · 19/02/2025 22:15

OneMorePiece yes that’s it sadly

Australia must be laughing. We continue to train doctors in ever higher numbers at considerable. I appreciate some on this thread don’t think much of many of them. But Australia seems happy enough to recruit them in large numbers.

In the meantime links are being made to facilitate the recruitment of more doctors from India at a junior level.

Someone needs to sit down and work out what they want. If recruitment from India is the direction of travel medical schools too should be open that only a minority will find employment in their chosen field in the UK,.

OP posts:
modelT · 19/02/2025 22:28

£££££