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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
OneMorePiece · 19/02/2025 22:29

modelT · 19/02/2025 22:27

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

Seen that ages ago. We have had to keep skirting around the issue though!

Finallylostit · 19/02/2025 22:30

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

Again more ignorance - every foundatio job -the doctors give feedback on, tasks they do not feel appropriate, ones they think are a waste of time, the jobs is not supervised enough, no experience etc. Many attempt to improve the experience and working life of the job but 2 yrs of bad press means those jobs are reviewed and often deemed unsuitable for training - directly related to the feedback from the doctors doing the job and they get cut from training. The tasks and care of those patients are still required - hence PAs, CNS take over grow the roles and do the jobs needed.
The foundation doctors said they were not good enough for training, they said they did not want the job - so their decision not to undertake these jobs.

Postgraduate PA training is at best piecemeal in this country. The good PAs will do their work and God forbid do a little bit extra - sit in clinic and learn, go on courses up skill and develop.

Sorry you can not diss a job say it is not fit for purpose but then decide you want it anyway when a group of CNSs and PAs have developed and evolved the job.

modelT · 19/02/2025 22:34

The BAPIO Training Academy (BTA) offers the GMC-approved Two Plus Two Programme. This unique pathway allows international medical graduates to obtain UK medical registration without PLAB or Royal College exams (MRCP, MRCS, etc.).

MixedBananas · 19/02/2025 22:35

I worked in NHS recruitment. We always struggled to fill jobs. And we had no choice but to go abroad.
No one wants to work and stick to work within the areas needed I.e geriatric medicine. All the newley qualified wanted to jump into the exciting work. No deary we have an aging population and hospitals are full of geriatrics get your butt in there and work there.
Nope they start and then leave after 12 months Drs / Nurses alike. I seen some horrific things from HCA. Running away from elderly patients. Those qualified here don't want to do boring work. They want to do paeds and specialities. We had huge receuitment drives abroad. Philippines was our best and every single Nurse recruited stayed put in the job they applied for. Geriatric medicine for years and years when I left they were still in those positions.

OneMorePiece · 19/02/2025 22:39

modelT · 19/02/2025 22:34

The BAPIO Training Academy (BTA) offers the GMC-approved Two Plus Two Programme. This unique pathway allows international medical graduates to obtain UK medical registration without PLAB or Royal College exams (MRCP, MRCS, etc.).

Saw that too.

https://asianlite.com/2023/uk-news/bta-uk-and-link-hospital-gwalior-forge-ties-to-launch-top-class-medical-educational-prog/

Needmoresleep · 19/02/2025 22:45

I am sorry for my ignorance. There is a lot to learn.

When you say jobs are unsuitable for training, are you saying that it was felt they were unsuitable for foundation training. This sounds odd, given the limitations of PAs effectively transfers more paperwork onto foundation doctors.

Given that there are so few jobs available as F3 type posts it seems odd that PA posts are protected, and inaccessible to doctors already in the UK. Whilst jobs available to these doctors are subject to world wide competition.

Doctors presumably have some advantages to a department. They have had more medical education and training. They can be expected to work nights, weekends and long shifts. They can prescribe and carry out more procedures. They are on lower pay.

At the end of the day surely any job from an experience point of view is better than no job. Is it that consultants prefer to work with PAs?

OP posts:
Needmoresleep · 19/02/2025 22:48

modelT · 19/02/2025 22:34

The BAPIO Training Academy (BTA) offers the GMC-approved Two Plus Two Programme. This unique pathway allows international medical graduates to obtain UK medical registration without PLAB or Royal College exams (MRCP, MRCS, etc.).

“Career Guidance & Job Opportunities: Our online platform offers a powerful matchmaking tool. Based on your qualifications and career goals, we'll connect you with personalised job matches within the NHS. We focus on finding reputable NHS employers who are a perfect fit for your expertise and career aspirations.”

Where we started. That there is a perception that applicants from overseas are getting support with their applications including notification of jobs when they appear. Something our doctors don’t get. Not a level playing field.

OP posts:
modelT · 19/02/2025 22:49

You have to hand it to them. They’ve seen an opportunity to make $$$. If the NHS & government are happy to facilitate all this and open up training contracts while UK tax payers fund medical school places with no employment then more fool them. It’s not as if the BAPIO training academy are hiding what they do. What a waste of tax payers money.

bakebeans · 19/02/2025 22:54

Every trust is in debt. The local one to me is over £20 million in debt. nHS professionals bank shifts are being declined in many trusts therefore currently staff cannot get the overtime to work extra shifts.
Each trust has a staffing budget. (Like your household bills) so if there is an overspend ie agency or recruitment from abroad then it adds onto the budget.

amazed by starmers pledge. The 40 million toward the NhS will be swallowed up! Idiot.

OneMorePiece · 19/02/2025 22:55

modelT · 19/02/2025 22:49

You have to hand it to them. They’ve seen an opportunity to make $$$. If the NHS & government are happy to facilitate all this and open up training contracts while UK tax payers fund medical school places with no employment then more fool them. It’s not as if the BAPIO training academy are hiding what they do. What a waste of tax payers money.

True but every time we mentioned overseas recruitment drives in these threads, there was a lot of resistance and accusations of being racist, etc.

Needmoresleep · 19/02/2025 22:58

MixedBananas · 19/02/2025 22:35

I worked in NHS recruitment. We always struggled to fill jobs. And we had no choice but to go abroad.
No one wants to work and stick to work within the areas needed I.e geriatric medicine. All the newley qualified wanted to jump into the exciting work. No deary we have an aging population and hospitals are full of geriatrics get your butt in there and work there.
Nope they start and then leave after 12 months Drs / Nurses alike. I seen some horrific things from HCA. Running away from elderly patients. Those qualified here don't want to do boring work. They want to do paeds and specialities. We had huge receuitment drives abroad. Philippines was our best and every single Nurse recruited stayed put in the job they applied for. Geriatric medicine for years and years when I left they were still in those positions.

I don’t know if you saw posts from a consultant geriatrician a few pages back. Interest in geriatrics has grown tremendously reflecting the overall increase in applications for entry level and training posts. The issue seems to be that those accepted for geriatric training then don’t apply for posts in his deprived area.

The doctors are there and looking for jobs. The problem seems to be linking doctors interested in hard to recruit jobs with these jobs, including opportunities and training.

If you read through there is also a belief that specialist training should be the preserve of the academically most able and dedicated. Fair enough, but they will probably not want geriatrics, especially in unpopular areas. Rather than have unemployed doctors and vacancies that need to be filled from overseas, why can’t there be another career track that might not lead to Consultant but allows, good competent doctors to find a career within the NHS rather than have to change career or go overseas.

OP posts:
modelT · 19/02/2025 22:59

BAPIO have sued many times based on discrimination

OneMorePiece · 19/02/2025 22:59

Needmoresleep · 19/02/2025 22:48

“Career Guidance & Job Opportunities: Our online platform offers a powerful matchmaking tool. Based on your qualifications and career goals, we'll connect you with personalised job matches within the NHS. We focus on finding reputable NHS employers who are a perfect fit for your expertise and career aspirations.”

Where we started. That there is a perception that applicants from overseas are getting support with their applications including notification of jobs when they appear. Something our doctors don’t get. Not a level playing field.

Been asking for clarity from the beginning but none forthcoming. Clearly many just want to preserve the status quo due to their own vested interests.

modelT · 19/02/2025 23:04

Why wouldn’t BAPIO resist it? Of course they would. They’ve spotted an opportunity. They are going to defend their business model. They’re not doing anything illegal. However, the government needs to decide if it wants to continue to invest in funding medical undergraduates when half of training contracts are going to IMGs.

Needmoresleep · 19/02/2025 23:05

Do you think they might take on a contract to help doctors already within the UK find work! Or is the argument still that our young doctors need to do it themselves, despite the support being given to overseas applicants, or they don’t deserve jobs.

OP posts:
Needmoresleep · 19/02/2025 23:07

I assume some of the current tension comes from the fact that their own children, raised and educated in the UK, are facing the same competition.

OP posts:
modelT · 19/02/2025 23:10

not if you have a very influential position but generally yes. you extend too far and you run out of rope. l think they’d prefer not to have this thread and the BMA lobbying etc. Reddit is electric on this. F2s hopping mad.

HostessTrolley · 19/02/2025 23:12

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.

It's not about deciding that an area of patient care is beneath them.

Physicians associates were originally intended to be physicians assistants, before they self-rebranded. Most junior doctors understand and appreciate that a big part of their job will be the routine tasks and that there's a lot to be learned from them. But to be running around full time on these tasks while being sneered at (and while that might not be your experience, it very much does go on) by the PA who has been chosen above them to go to theatre or clinic week in, week out is pretty bad. And then to be told 'we saw and learned so much more in our 100+ hour weeks..' by seniors who are restricting what they can see and do by taking the PA to clinic and leaving the doctor to the discharge letters and 14 sets of bloods because phlebotomy haven't turned up in the hours that they do work....

I'm glad that where you work the JDs are valued and trained and the PAs are deployed appropriately in view of their training and qualifications, but that's definitely not the case everywhere.

OneMorePiece · 19/02/2025 23:19

modelT · 19/02/2025 22:59

BAPIO have sued many times based on discrimination

I imagine the NHS is having to spend a lot on measures to try and ensure they are not the subject of further litigation.

Taxpayers and NHS users would be interested to know how much of the NHS budget, if at all, is used for setting up academies including the ones overseas and how it's affecting the training of UK grads and UK IMGs. Surely if they weren't training ones from abroad, they could be training UK MGs & IMGs that are already here.

modelT · 19/02/2025 23:23

l would imagine Streeting is seeking a legal opinion on prioritisation of UK grads as they know BAPIO will try & sue. Or he could be doing nothing…

OneMorePiece · 19/02/2025 23:33

modelT · 19/02/2025 23:23

l would imagine Streeting is seeking a legal opinion on prioritisation of UK grads as they know BAPIO will try & sue. Or he could be doing nothing…

Honestly, the government should be investing in young people in the UK by funding their education and training instead of fuelling the economic growth of other countries by training their MGs. Apart from training IMGs already here, government need to ensure members of powerful lobbies with conflicts of interests don't have too much influence in workforce planning which unfortunately at the moment they do

Needmoresleep · 19/02/2025 23:47

I wonder how much stem from Boris' courting of India as a trade partner. India would have wanted us to provide entry level jobs and training for newly qualified but not to poach their more senior doctors.

I wonder if their much lower than expected numbers reflects that we now have so few positions for newly qualified doctors who have neither qualifications nor experience. Like with training some of our doctors are getting Clinical Fellow jobs and an equal share are going to doctors from overseas including those prepped and supported by BAPIO. But with PAs and budget cuts there are just not that many jobs out there.

Another question based on what seems to be a frequent view on this thread that other than a small elite, our newly qualified doctors are not dedicated enough and should not expect to be able to pursue a medical career. Why is Australia hiring from here rather than from India?

OP posts:
OneMorePiece · 19/02/2025 23:48

modelT · 19/02/2025 23:23

l would imagine Streeting is seeking a legal opinion on prioritisation of UK grads as they know BAPIO will try & sue. Or he could be doing nothing…

Not in the government's interests to do nothing. He risks other parties taking up the issue.

Marchesman · 19/02/2025 23:53

Needmoresleep · 19/02/2025 19:20

Interesting article. But written in 2017 before the RLMT was lifted. Priority could be given to UK/EU applicants for both training and “F3” jobs. Numbers have exploded since and the outlook for F2s wanting to stay in the UK is far grimmer.

The Oxford research shows how attitudes changed over several decades. It included my medical school cohort - I remember filling it in. (It closed down perhaps when the lead researcher retired, although if you go to his page on researchgate you will find spinoffs using the data as late as 2020.)

For a contemporary picture - medical students from 2023, including therefore current FY1/2s - there is http://dx.doi.org/10.1136/bmjopen-2023-075598

It is noteworthy that even before qualifying, one third of (essentially current) medical students plan to practise abroad.

Finallylostit · 20/02/2025 00:04

so patronising HostessTrolley!

Many years of junior doctors fed back and still do that parts of the jobs theywere doing were boring, mundane repetitive and not educational - that is what made them be cut from training. Their feedback not the consultants.

You can not decide that something is too mundane and then suddenly decide those mundane tasks are now valuable experience. CNS and PAs have worked hard to eveolve the role - if the PAs/ CNS etc do their work and decide to come and sit in my clinic then I will teach, likewise if the residents do.

Sometime we regret with hindsight that the job was more educational than we realised because guess what in FY1 and 2 we are not expert clinicians who know everything and only with bit more experience do we understand why we learned something. Discharge letters being a classic example - ask a GP what a good discharge letter means.

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