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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.

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Needmoresleep · 21/02/2025 14:38

Marchesman · 21/02/2025 14:28

But you can't make the job less attractive to high calibre school pupils and massively expand places in medical schools with lower entrance requirements and reduce their academic offering - and then give them priority over potentially better foreign graduates.

That would be madness.

Apart from anything else, the NHS needs a large number of middle grade staff who do not intend to stay here. Traditionally they came from abroad, where they returned once they gained experience and British qualifications, which more or less made everybody happy.

Woah, that is a bit sharp. Not least because our DC gained entry to medical school before some of the expansion.

I think three in DDs school year went to Cambridge, plus a vet. They were not markedly brighter than the others. She found the same during her intercalation. Others who were at the top of their years at London medical schools found themselves struggling with some of the content.

Equally her friends at medical school were bright, hard working and engaged. It used to be possible for graduates from there to pursue good careers in the UK.

Now the view seems to be, and the approach used in practice that we are better off giving our entry level F3 jobs to "potentially better foreign graduates".

Exactly where we started. Australia seems willing to take them, albeit into hard to recruit jobs. Why them, not us?

OP posts:
Clavinova · 21/02/2025 14:39

Needmoresleep
It should be noted that Pakistan is a WHO red list country.

There are obviously some problems with the MTI programme and things need tightening up in some Trusts - however;

The primary purpose of the MTI is to contribute to improving the quality of healthcare in developing countries. The scheme provides doctors and dentists from developing countries with a period of training in the NHS before returning to their home countries where they can put to benefit the skills and experience they have obtained in the UK.

Needmoresleep · 21/02/2025 14:39

Marchesman · 21/02/2025 14:31

I think they should be avoided. Let the market decide.

But the market with several hundred applicants for ordinary jobs is very imperfect.

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Needmoresleep · 21/02/2025 14:41

Clavinova · 21/02/2025 14:39

Needmoresleep
It should be noted that Pakistan is a WHO red list country.

There are obviously some problems with the MTI programme and things need tightening up in some Trusts - however;

The primary purpose of the MTI is to contribute to improving the quality of healthcare in developing countries. The scheme provides doctors and dentists from developing countries with a period of training in the NHS before returning to their home countries where they can put to benefit the skills and experience they have obtained in the UK.

Thanks.

However not a reason to underpay them unless it is specifically some sort of apprenticeship post where both parties go in with their eyes open.

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Auchencar · 21/02/2025 14:41

Needmoresleep · 21/02/2025 14:26

What would you see as the solution to the current problem. Large expansion of medical school places to meet a real demand for more junior posts.

These posts exist. Yet the newly qualified doctors are struggling to get them and they can't offer the additional experience that some of the overseas applicants have. And because of the sheer weight of numbers applying.

Getting a training slot straight after F2 can happen. However as another consultant on the thread has suggested, doing some "grunt work" (still hate that expression) won't do any new doctor any harm whilst having experience of different areas of medicine will probably do them some good.

What do you think should happen to these doctors, and to others already in the UK.

Do you think that we should prioritise competent doctors already here and enable them to get the experience they need to stay within the profession. Or do you think we continue to work to attract applications from overseas with the aim of selecting the best for that job.

Training is a separate issue. The concern sparking this thread was that some perfectly good newly qualified doctors, albeit not ones who went to science heavy universities, seem to think that they can't get jobs in the UK. Other than one who is hoping to get by on a few bank shifts each month.

Their perceptions may be wrong, but a group of them seem to have come to this conclusion independently and report that their peers feel the same.

So... what is your take on the lifting of the RMLT? Essentially should we give priority to those we have trained.

My honest answer is that I don't have the answers. There's a lot here with a lot of implications and I'm not equipped to supply answers or even moot any tbh.

If you're genuinely interested in my views, I suppose my natural instinct is to back merit based systems regardless of background and to me that includes the accident of which country one happens to be born in. I thoroughly dislike all these anecdotes of incomprehensible foreign accents etc. The UK only has itself to blame for having sold MFL education down the line. One can always ask people to speak a little slower if you don't understand first time around. Vets manage to diagnose and treat animals without talking in dog or cat after all so I'm sure with a different attitude we could all manage.

I'm certainly on the side of all those who say that they see sky high levels of entitlement on these threads (thankfully more diluted now) and not a little ignorance of the bigger picture. I'm also on the side of those who say this generation doesn't have it uniquely tough.

JulietteBravissimo · 21/02/2025 14:41

@Marchesman are we in effect saying that, if a DC is ambitious and thinks they are likely to want to try to pursue a consultant level career, then they should only be considering Oxford, Cambridge, Imperial or UCL? What about medical schools like Glasgow for example, which always comes out well in the rankings? Are all the others really second tier institutions? If that is the harsh reality then there are a lot of untruths being peddled out there, not least by the medical schools themselves.

Auchencar · 21/02/2025 14:46

I didn't mention any Scottish med schools apologies. Glasgow is excellent isn't it? And science heavy still?

Marchesman · 21/02/2025 14:48

Needmoresleep · 21/02/2025 14:38

Woah, that is a bit sharp. Not least because our DC gained entry to medical school before some of the expansion.

I think three in DDs school year went to Cambridge, plus a vet. They were not markedly brighter than the others. She found the same during her intercalation. Others who were at the top of their years at London medical schools found themselves struggling with some of the content.

Equally her friends at medical school were bright, hard working and engaged. It used to be possible for graduates from there to pursue good careers in the UK.

Now the view seems to be, and the approach used in practice that we are better off giving our entry level F3 jobs to "potentially better foreign graduates".

Exactly where we started. Australia seems willing to take them, albeit into hard to recruit jobs. Why them, not us?

Prior attainment counts. Graduates from older medical schools will still get on if they persist and are prepared to move within the UK. PBL may be a disadvantage but not insurmountable for anyone who is bright and determined.

Marchesman · 21/02/2025 14:50

Auchencar · 21/02/2025 14:46

I didn't mention any Scottish med schools apologies. Glasgow is excellent isn't it? And science heavy still?

Don't know about the science content. But I think PBL, which seems curious.

JulietteBravissimo · 21/02/2025 14:51

Auchencar · 21/02/2025 14:46

I didn't mention any Scottish med schools apologies. Glasgow is excellent isn't it? And science heavy still?

Apologies @Auchencar that wasn't directed at you at all. It was a genuine open and unloaded question as I am just trying to understand.

Needmoresleep · 21/02/2025 15:05

Marchesman · 21/02/2025 14:48

Prior attainment counts. Graduates from older medical schools will still get on if they persist and are prepared to move within the UK. PBL may be a disadvantage but not insurmountable for anyone who is bright and determined.

Yes. Exactly what DD and her friends intended to do. Find an F3 post if they didn't get the training post, work hard on their application and try again.

Indeed the same approach planned by other posters on this thread.

The problem is finding the F3 post. Lots of others from across the world have the same idea, and these are going to the "potentially better foreign graduates". In a job market warped by several hundred applications (a consistent anecdote - another example just posted from Reddit)

They may have studied PBL but they are bright and DD and her best friend both took demanding intercalations with plenty of science. I would be very surprised if anyone could claim that the friend's background included any privilege or entitlement. Her desire to return to where she comes from and work within that community ought to be something the NHS actively encourages.

But no. I can understand your doubts about some of the newer courses. It worried me that bright eyed young people are being sold an unattainable dream. But we used to have jobs for those who went to established medical schools. We don't now.

I hope you can agree this needs fixing.

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Needmoresleep · 21/02/2025 15:19

Also @Marchesman is that why PAs are being pushed into roles previously held by doctors. That it is believed that they will be more useful in a junior post, because their training is more focussed, they will probably stay longer and perhaps are less likely to strike?

Is the way to sort this looming unemployment crisis to allow newly qualified doctors a short course route through to becoming PAs? .

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Millaiss · 21/02/2025 15:54

Can @Auchencar or @Marchesman share what the “science-heavy” medical schools are, in their opinion? Is there a way to gauge this using data from the universities, or is it based off personal experience/reputation? Given its link to career progression etc. it sounds like an important think for students to be aware of. My own DC seems to be having a very heavy science workload in their medical school, which is what they were expecting - it’s constantly challenging, in a very good way if you’re that way inclined (which thankfully they are!). It’s not Oxbridge or the London ones, but they have friends at a couple of the London unis previously mentioned and there seems to be zero difference. Also interesting is that there are a lot of children of doctors on my DC’s course - majority of their friendship group have at least one doctor parent, sometimes both. They are learning a lot from them about the NHS and working in it, as we have no knowledge (immigrants and non-medical family here)

mumsneedwine · 21/02/2025 16:45

@Millaiss to be succinct, it's all bollocks. All courses are science heavy. It's medicine. There are just a lot of snobs.

Auchencar · 21/02/2025 17:11

Millaiss mumsneedwine would be right if only it wasn't the case that graduates of the named universities do do significantly better in securing training posts. So on the one hand you could call it snobbery, on the other, if it delivers.... who is anyone to knock it? (especially if the person knocking it is railing against the lack of employment opportunities/ career progression for junior doctors).

But if your own DC thrives on that side of Medicine and is ambitious and prepared to work incredibly hard and not get too bogged down in work life balance at too young an age then those are the same attributes required to progress.

mumsneedwine: heavier on science than other courses if you prefer.

And the more you say it's a snob thing the more I enjoy hearing reports of how the alumni of these despised unis are getting interviews etc. Pudding proof I'd say.

Auchencar · 21/02/2025 17:30

mumsneedwine · 21/02/2025 16:45

@Millaiss to be succinct, it's all bollocks. All courses are science heavy. It's medicine. There are just a lot of snobs.

To be fair to you mumsneedwine I do understand that you're in a tight spot. You've made your usp the helping parents of med school applicants with all sorts of stuff: spreadsheets of the various unis, recommending UCAT materials etc and you've been very consistent in your motivational advice that 'only one offer is needed' 'all unis are equal' 'all medical graduates are equal'. The trouble is that this is painfully wrong and it's those young people who will pay the price. Some should probably have had the hard facts laid bare and trodden a different path. But not a whisper of any of this on those threads. I'm not sure that that's responsible but then I suppose these parents should be capable of working out whether advice is worth following; no-one is pressuring them to take it. My advice would be to leave the young people to do their own applications - but it's none of my business and I'm confident that that advice would go down like a lead balloon.

Needmoresleep · 21/02/2025 17:34

It does appear that they do better when it comes to getting training posts. I certainly know senior doctors who strongly believe that the old six year BMAT courses are primus inter pares.

However I hear that the same panic about finding an F3 job is also affecting Former Cambridge F2s. The numbers applying are so big that even graduates form these medical schools are having to compete against large numbers of potentially better foreign graduates.

They may be good but so are graduates from elsewhere, who may have all sorts of gold medals and competition prizes, and also more post qualification experience.

Things should be OK for the Cambridge lot. They can take a Masters whilst studying very hard for the exams, volunteer in a research lab, enter competitions, undertake some trips abroad to experience other medical environments. And there is no reason why, as long as they have the resources, graduates from other medical schools should not do the same. In a years time the Government will have probably sorted something out on training, but until the Government agrees, like other countries, to give priority to those already in the country (reinstate the RMLT lifted in 2021) the job market will remain grim.

For other HCPs as well.

Really worth writing to your MP.

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mumsneedwine · 21/02/2025 17:39

Don't you buy an MSc at Oxbridge ? Or is that other courses and not medicine. Know I paid £10 a year after graduating and was given one. V v weird but wasn't going to refuse it.

Needmoresleep · 21/02/2025 17:43

mumsneedwine · 21/02/2025 17:39

Don't you buy an MSc at Oxbridge ? Or is that other courses and not medicine. Know I paid £10 a year after graduating and was given one. V v weird but wasn't going to refuse it.

Completely different. All degrees and meaningless. DH just got his. The kids insisted on having a graduation dinner.

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mumsneedwine · 21/02/2025 17:51

@Auchencar did wonder. I was working abroad so got mine in the post. All v odd !

mumsneedwine · 21/02/2025 17:51

@Needmoresleep sorry wrong tag 😂

Marchesman · 21/02/2025 19:11

JulietteBravissimo · 21/02/2025 14:41

@Marchesman are we in effect saying that, if a DC is ambitious and thinks they are likely to want to try to pursue a consultant level career, then they should only be considering Oxford, Cambridge, Imperial or UCL? What about medical schools like Glasgow for example, which always comes out well in the rankings? Are all the others really second tier institutions? If that is the harsh reality then there are a lot of untruths being peddled out there, not least by the medical schools themselves.

@JulietteBravissimo @Millaiss
I cannot imagine practising medicine without a grounding in anatomy, physiology, biochemistry, pathology, bacteriology and pharmacology. However, changes in A level science curricula several years ago caused students to be less well prepared for university than they needed to be (there is considerable literature relating to this). Science faculties adapted and took on what had previously been taught at school, and logically medical schools should have done the same, extending their didactic science curricula. Instead many did the opposite, either with more self directed learning or early patient contact. For new universities this was and is a godsend because the necessary non-clinical academics and facilities are expensive, and impossible for them to recruit and build.

Once, it really didn't matter which medical school you went to, now it will pay to be more careful and consider only ones that are part of universities that have well regarded science faculties. The list is much longer than just Oxbridge and a couple of London medical schools. Having said that, I think now all medical schools introduce students to patients too early and most have latched onto problem-based learning.

"Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study." BMJ Open 2022;12:e054616. doi:10.1136/ bmjopen-2021-054616

Auchencar · 21/02/2025 19:29

mumsneedwine · 21/02/2025 17:39

Don't you buy an MSc at Oxbridge ? Or is that other courses and not medicine. Know I paid £10 a year after graduating and was given one. V v weird but wasn't going to refuse it.

You can have a MA for free but certainly not a MSc.

You've frequently said on various threads that you didn't go to Oxbridge so were you being coy or have you just remembered that you did, after all.

I have to admire your flexibility with detail mumsneedwine :)

Auchencar · 21/02/2025 20:12

https://en.wikipedia.org/wiki/Master_of_Arts_(Oxford,_Cambridge_and_Dublin)

This is for you mumsneedwine.

The wiki page throws up a few small conflicts to the lawyer's eye between your various posts but latitude is a wonderful thing in a liberal world.

Auchencar · 21/02/2025 20:25

'Upon application' v 'given one'/ 'wasn't going to refuse it'/ 'V v weird'

'three years after graduating' v 'a year after graduating'

'MA' v 'MSc'

That's without the repeated denigration of Oxford and Cambridge (obviously some people go and hate it or are sent down - those are the ones who generally criticise the unis as institutions, fair play) and the confusing statements that you didn't go there. Perhaps you went to Trinity? The easiest way to check these things if you've forgotten is to fish out your degree certificate which names the institution.