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, anyone would choose a better doctor irrespective of where they trained. However, the means with which we select our trainees is wrong!
I am saying this as an oversees trained doctor who came to this country in my 20s and currently working in NHS as a senior consultant.

I think it's bad as you say but up until recently I thought the general position on here was we were not training enough

Otherwise yanbu

As I understand it we're training more than ever at the university level (whole new med school have opened recently). The trouble is they're then not going into the NHS, or are hitting bottlenecks if they do.

Thank you - I still don't quite understand - what sort of hoops are they needing to go through? Obviously there is an application process for jobs - probably an application, form, an interview, maybe a competency assessment of some sort, but what else that is easier for applicants from another country? I think suggesting they don't have enough time because they are busy working is a bit ... I don't know, without understanding it just sounds like a poor excuse?

Vacancies for GP training are not surprising. Candidates for specialist training need to pass exams and be selected for training numbers. With a 100% increase in overseas applicants in the past 2 years, marks and supercurricular required have gone sky high. Very few UK based F2s are getting through. They would have done a few years back, but now you have to out compete world wide competition, it is often a choice. Focus on doing your F2 job well, or be selfish, do the minimum and focus on your application. 50% of those qualifying for training will be coming from overseas.

Trouble is that though, say, F2s from Wales would love a training place in Wales, they haven't got a training number. And those who have paid for the expensive courses (one in India and found on Google costs £31,000) to ensure thry had maximum points and a near perfect application, will want to be in an internationally known London teaching hospital, not in Wales.

So the Welsh would-be GP who would have spent their career contributing to the community is having to find work in Australia. The one with the training number may never show up, as the UK application may only be one of several and their best offer was elsewhere. And a post is vacant.

Because the NHS are not looking at retention they will see an unfilled post as evidence that overseas recruitment needs to be further promoted.

on this im on the fence on the one hand i want the best brains possible, on the other hand i want jobs for those already in the country, and then if we still needed x workers then import them

This thread was nonsense the first time round.loads of GP practices can't recruit,there's loads of jobs. Doctors are leaving for Australia because working in the NHS is so awful but because they can't find a job.

We bring people and their dependents in, even though we train professionals on this country.

Madness.

Extra points are given for academic stuff like research papers, academic prizes, presenting at conferences. Most of our medical schools fail to tell their students that this is what is needed. So a student can go through, passing exams and getting great appraisals and being a good team player who is very patient focussed. But appraisals count for nothing. The system instead giving points to academic supercurricular stuff, which an F2 working nights in a busy A&E in a deprived area won't have time to do.

As in my previous post overseas agencies are offering expensive courses to help applicants ace the scoring system.. for a fee.

There is also some concern about quality control. Having research published in the UK is tough. Probably tougher than in some other countries. Ditto winning competitions. To get onto training a young medic would be advised to prioritise entering overseas competitions over getting strong appraisals.

You seem to say F2s here don't have time to get published etc, wheares overseas they do? but it's always been just incredibly tough as an F2S,they've always had it really tough they just have to literally dedicate their lives to their careers for a time,surely thats normal in the medical field.

Certain criteria gets certain number of points and you are shortlisted depending on the points achieved.
for example , presenting a study in a national or international conference gets you 6 points - it’s extremely difficult to achieve this for a newly qualified doctor working in nhs, the standard for any paper or research to be accepted in such meetings are quite high in this country. This is not the case in a lot of countries, so it doesn’t matter where you present you get that 6 points.
PG diploma in training of teaching gets you three points - this costs money( ? 9000 pounds ) and time. It’s a good investment for an overseas doctor who wants to settle in this county.
Organising teaching for 3 months gets you 5 points- our junior doctors rotate from one job to another job every 4 months sometimes at different hospitals. If you want to come to this country, it’s not that difficult to get this done especially there is no way of checking it.
Post graduate degree ( not extra year our medical students who do to enhance their knowledge is counted towards this ) will get you 5 points . Lot of overseas doctors would have had their post graduate training in their country but are willing to work at a junior level can get this point.
MRCP - our post graduate examination is not scored, some of the doctors would have taken at least part of this exam before but this is not counted now.

YANBU. Sounds like there’s a market here for someone setting up a specialist medical recruitment agency to compete. But who pays for that?!

Agree, most doctors sign up to this level of dedication. But it doesn't matter how dedicated you are on the ward or how good you are clinically, how empathetic you are with the patients- they are not assessed by these criteria, are they?

This is the standard NHS approach. That our young people want to leave. This is not so. Certainly up till a few months ago DD and the DC of the other F2 mums expected to progress their careers in the UK. Imdeed most have been sitting exams and applying for (very oversubscribed) vacancies. It is only via the Internet that we have discovered that they all, in different parts of the country, with different ambitions and different backgrounds have independely decided that they have little choice but to leave.

You can't find GPs because uk based young doctors can't get onto GP training so can't apply for GP jobs. Those training slots are in high demand. (I think GP training has 10 applicants for every one place, it is certainly competitive and someone will be able to confirm.) As training is open to anyone in the world it could have well gone to someone who has no intention of working long term in the UK.

Get the UK training and then go and work as a private GP in Singapore or move on to Australia. (Australia prioritises its own residents for training, so easier to get the qualification here first.)

If you had been advertising a non specialist locum post or a Clinical Fellow post you might well have been inundated. Including some very highly qualified and experienced doctors who want the chance to move their families to the UK. With anonymised applications, you would almost certainly be hiring from overseas as transparent selection requires you to hire the best applicant. But these entry level jobs are needed by our newly qualified doctors if they are to be able to stay and build their careers.

There may be an argument simply to bring in experienced doctors from overseas. But if so the NHS should be open. There won't be entry level jobs for UK graduate doctors so no point wasting tax payer and student money by running a medical school system. If people want to be doctors they should be looking at private medical schools and experience in places like Malaysia, Kenya or Bulgaria until they reach a point where they they can compete.

I find the arguments that F1/F2 doctors “don’t know” or “don’t have time” to be competitive a bit weak.

For starters, all the scoring criteria for specialty applications is freely available online and its common knowledge even at medical school that medicine is a competitive profession and the best jobs are hard to get.

Secondly, F1/F2 doctors work significantly less hours now than was expected in the past, not to mention they mostly work just the hours that they are paid for. Our current F1 doctors don’t work nights and put exception reports in if they’re even thirty minutes late finishing their shift!

Twenty years ago when I qualified we worked 12 hour shifts as standard even on the days that we were contracted for eight, not to mention we all worked full shift rotas including nights right from qualification. We still had to fit in all the extra activities needed to get points on our applications and we had much less in the way of online networking, resources, remote learning etc. than current juniors have. Scoring criteria for job applications weren’t uniform and often weren’t widely published. There were no virtual courses and conferences - if you couldn’t afford the travel and accommodation or had kids/caring responsibilities then you couldn’t go. Training jobs were competitive even then - I applied to the Severn Deanery as what would be considered a really strong trainee but didn’t get past the interview stage and had to settle for a post in Wales instead.

I’m not saying it isn’t tough but junior doctors now seem to think they are completely hard done by and everyone before them had it easy, when that actually wasn’t true at all!

We do not need any agencies making money to help people jump through the process. We need to change the process and make it fit for purpose !

I'm a student paramedic and we recently found out that those graduating this year will no longer be given priority within the trust placements were held. Have to go through the same recruitment as anybody else, there's a lot of NQPs struggling to find jobs.

Didn’t we have a massive thread, in exactly the same topic, only last week?

Did something change in the last week ?

"Changed" as though it is as uncontrollable weather and entirely nothing to do with any policy makers.

Perhaps rather than look to overseas agencies to recruit overseas doctors, the NHS could invite those same agencies to work with F2s. Help them with the extra academic bells and whistles (overseas competitions they might apply for etc) help polish their applications so they gain maximum points, set up alerts so they know when suitable jobs come up, perhaps automatically submitting applications. And so on.

More seriously, no one in the NHS seems to be thinking about retention. No exit interviews, no counting of F2s who don't remain in NHS employment. No actually going to talk to them about the barriers they think they face.

Setting up a common app should not be too difficult. Academics have a world wide app that new PhDs input into with their CV, published papers, references etc. A long list is Zoom interviewed and a short list is then flown out for final interview. So an F2 could express interest in certain types of jobs and areas, without having to trawl through that days new vacancies straight after a 13 hour night shift. Knowing full well that with hundred of overseas applicants chances are near zero and that they cant leave it till they have jad some sleep because by then applications will be closed.

Though all a bit hopeless if the Government is not protecting vital entry level and training jobs so that doctors already in the UK can build a career here.

Is a degree of this young doctors wanting to move through the training years too fast?

If they don't have enough extra experience to gain a good training post straight from an F2, is it a problem if they spend a bit longer at that level gaining extra experience?

My DC is a current final year med school, has just sat their finals with one more placement then elective to go. They are 25, living with their long term partner who is employed.

Previously med students accrued a points score during med which had an impact on where their first job would be - they could score points for academic achievement (how high they sat within their uni cohort), intercalated degrees achieved during their training, and for other factors such as teaching, having published research, presenting at conferences etc. A higher points score would increase the chance that they'd get their first job in a geographical area of their choosing. This changed mid way through my DCs course, so her extra year resulting in an intercalated first class honours degree, working to stay in the top 5% of her cohort, presenting at a conference, teaching, being published, and winning multiple academic prizes count for nothing, they get a random number generated by a computer which dictates where in the country they are sent, and many don't find out the town they're going to until very late, making it hard to find somewhere to live.

In addition they are now looking at stats saying that once they've got through two years in god knows where, working mad hours doing service provision with minimal actual training (many stories of the F1/2 spending their days doing admin and discharge letters while PAs are in clinics and theatre being taught...) the chances of getting a training post are minimal. Competing against 30+ years olds from overseas, a significant number who have played the system to get the highest scores. They outnumber the UK trained doctors who have cost the country a massive amount of money to train and their numbers are rising. They take the training posts, then after a few years go back to their own countries into lucrative private practice which will eventually leave us with a glut of inexperienced doctors but not the seniors we need. This would be easy to address by looking at the 'points' system to value NHS experience - many of the IMGs come in with no idea how the NHS works.

Young people like mine who go to med school are our academic brightest and best - straight A*s at A level and strongly motivated to help people, putting in years of work (6 years of med school) and graduating with £100k in debt. They could choose any path.

I'm immensely proud of my DC but I do worry for their future. And implications from posters that our home grown young doctors are snowflakes who are not prepared to work or strong enough to compete are quite frankly laughable.

I read somewhere that there's a thought to start to reduce the score of people doing more than f1/2, so rather than recognising the extra experience gained by doing an F3 year, this would actually make it harder for them to gain a training post...

Think it's changed a lot since you qualified hence the threat of unemployment the latest batches are facing.

Are you aware of this recruitment drive that the NHS appears to be involved in? Not sure if and how exactly the NHS is involved, but came across this online.

What do you think of applicants coming through this recruitment drive or similar?
https://goocampusuk.com/mrcp-mba
It would be great to have your opinion or anyone else's on how this scheme works within the NHS process? How much are NHS trusts paying for these applicants?

The current NHS recruitment system, as I understand it, was designed to make it fair and equitable to all applicants, regardless of their background.

Schemes like this are unfair if they are potentially fasttracking applicants from overseas who are prepared to pay extortionate prices. It's mostly wealthy overseas applicants that can pay up to £32000.

To a member of the general public, it looks like some new International Medical Graduates (IMGs) who are yet to enter the country are potentially getting an advantage over IMGs and UK medical grads already in the country.

Twenty years ago you probably didn't need to work extra paid hours or get a second job to be able to keep yourself clothed and housed and repay student loans