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.

https://www.new.ox.ac.uk/oxford-ma

Another explanation.

https://www.cambridgestudents.cam.ac.uk/your-course/graduation-and-what-next/cambridge-ma

These are the rules for Cambridge.

It is very interesting to read that, despite what we have been told, it does in fact matter where you get your medical degree.

And that maybe the more integrated teaching method is not so well thought of ? (although appeals more to DC)

@Auchencar 😂😂 my dear girl, I have never said any such thing. I have 2 degrees but don't like to brag as don't have 6 A stars. Weirdly my comp taught that things other than academics were important. Again, your stalking of me it's a little weird, maybe try and get a hobby ?

@Thisismetooaswell it's only important to those that think it's important. No one other than a few snobby people on here cares at all. Passing exams is one part of being a doctor, although as the complete failure of the MRCP exam fiasco shows, it makes no difference to doing the job well. But the echo chamber voices on here will know better. They are the minority and if they are doctors I really hope they never treat anyone I care about. The lack of empathy and elitist rubbish they display is sad.

@mumsneedwine you must stop saying that passing exams doesn't matter. Any doctor with the ambition of becoming a consultant will quite rightly have to pass difficult professional exams. This is the reality, and saying that you can be a good doctor without doing that is saying that you should remain in the lowest grades forever.
Hoping to be cured by empathy is like hoping to be cured by homeopathy, it only works if you take the medicine as well.

mumsneedwine you've tagged me again.

You have certainly previously said that you didn't go to Oxbridge, within the various tracts about why those two unis aren't to be rated. More than once. You've been very clear. Perhaps you are indeed an Oxbridge graduate but preferred to say you weren't - it's a free world, although I wouldn't be able to see any point in that. And I'm not clear why you're so muddled about the general purpose of and regulations around the MA.

You have however frequently referred to sending hundreds of students to Oxford and Cambridge (you yourself have said hundreds), even though you don't know the entrance requirements for Medicine and became angry when that was pointed out.

As I said before, things like this do unfortunately create a credibility issue generally which is is shame if you're trying to have a meaningful discussion - the very purpose of MN.

Incidentally I haven't any need to 'stalk' (by which I assume you mean use the search function). I never need to use the search function and am not the sort of person who cares sufficiently to 'stalk' (Isn't it against the guidelines to accuse a poster of stalking?). The combination of you being such a dominant/ frequent/ voluminous/ call it what you will poster on these threads and my extremely good memory means that I simply remember (I remember the tiniest details of all sorts of random stuff which has happened and been written decades ago ( in rl I mean, which I'm slightly more focussed on than MN but the memory helps identify inconsistencies here too)). Also, small point, but presumably if I had 'stalked' (which as I say I haven't) then I would have been able to verify that you have not written that you were an Oxbridge graduate.

That's true about exams in all professions.

Nothing wrong and everything right about any system which filters for merit.

Thanks for sharing that study @Marchesman - certainly shows that Oxford and Cambridge grads have an edge in passing part A of the surgical exam in question but not part B? Prior attainment as measured by A level results seems to be the most meaningful, which makes sense. I wonder if a post A-level application makes more sense for medicine (perhaps after a mandatory year as an HCA so everyone is going into it with eyes wide open!) Also, following that study’s data source is interesting (one follows through to a GMC database) - it seems that for those in specialty training, from a random selection of universities (including Oxford, Cambridge, some London unis), broadly the same percentage from most unis are actually in surgical training (about 13-15%), so despite doing better in part A of the exam, it doesn’t seem to result in a disproportionate number of those grads actually ending up in surgical training. The only university that looked to be an outlier was Imperial- 20% of their grads in specialty training are in surgical training. There may be others but I’ve not looked at them all - Nottingham and Edinburgh were at the higher end too, but I’m sure there are lower also. I’ve only looked at surgical as that was what was referred to in the study.
But the GMC data also shows overall % in specialty training by medical school. The London unis come out high here (Imperial and UCL in particular, 37%!) with Newcastle also similar. Was very surprised by Cambridge and Oxford though - 10% and 15% respectively. Perhaps I am looking at the data incorrectly as I’m just doing it quickly on my phone, or there is some flaw in the data which medics are aware of, so happy to be told so (I am looking at GMC data for registered qualified doctors by PMQ who are not currently GPs or specialists, and are either in core, foundation, or no specialty training for the total number for each, divided by specialty only). I would be surprised that the % is so low for these 2 unis

Thanks for the providing that timeline Clavinova.

Dr Chaand Nagpaul was the BMA council chair from 2017 -2022 and is also on a board of the BAPIO Training Academy.

From that article from 2019 that you linked BMA council chair, Dr Chaand Nagpaul, said: “The BMA is delighted that such a respected body as the Migrations Advisory Committee has listened to the BMA and proposed a bold, but much needed, recommendation to place all doctors on the shortage occupation list.

@Millaiss Attendance at a more academically selective medical school has positive effects on entrance to higher speciality training and MRCS part A pass rates, but not on choice of speciality?

The Ellis paper is interesting because individual medical schools are identified, but there are pressures to pussyfoot around this. The GMC - council members typically have little acute clinical hospital experience - takes a particularly relaxed view of the differences between medical schools, and their choice of teaching methods, but they are significant. For anyone interested who hasn't read the Ellis references, it is not only surgical exams that we are talking about here:

"PBL schools have higher historical rates of producing GPs, teach more general practice, have higher F1 preparedness, produce more trainee GPs, have higher rates of ARCP problems for non-exam reasons and have lower entry grades, less traditional teaching, less teaching of surgery, less examination time, lower UKFPO Educational Performance Measure and Situational Judgement Test scores, lower pass rates in postgraduate Foundation exams overall and lower average marks in MRCGP AKT and CSA exams and in MRCP (UK) Part 1. It is clear therefore that PBL schools do differ from non-PBL schools in a range of ways... Even when entry grades and other measures are taken into account, PBL schools (and post-2000 schools) tend to do less well at examinations." McManus et al 2020 (full citation in Ellis, my italics)

For me, the alarming thing here is that "F1 preparedness" is a perception that trainees have (and chimes with their characterisation by BMA representatives as "expert clinicians"). But it correlates with poorer performance by most available metrics.

Furthermore, PBL is more popular with students than traditional teaching, and this feeds into student satisfaction measures, which in turn affect the ranking of medical schools, leading inevitably to less traditional teaching and more graduates finding themselves ultimately confused, out their depths and without jobs.

Thanks for that Marchesman.

Would you be prepared to explain the pressures to pussyfoot around the issue? I could have a stab at it but suspect it might not end well.

Hopefully this is not going to be viewed as a derail, I have some thoughts about a couple of points raised earlier on the thread.

Do consultants prefer to have PAs rather than resident doctors?
I can't speak for all consultants but personally I do not have PAs and there are none in the department where I work, in fact very few in my specialty as a whole as far as I am aware. However there is no doubt that because I enjoy training doctors and have committed to having resident doctors on the team, I have to accept that there are often days and even weeks at a time when my team is threadbare and I barely see my resident specialty doctor. This is due to a number of things such as their rota with its night shifts and zero days, the number of resident doctors who are now less than full time (LTFT used to be for very restricted reasons but now it is much more open for all to apply), the amount of mandatory off-site teaching sessions they attend, the mandatory personal development time they are now entitled to and take. And this is before taking account of their annual leave, my annual leave, any other leave they have such as study leave, sick leave etc. Quite a lot of the time the resident doctors barely know my patients and tell me that they haven't had the opportunity to take a full history from them. As a consultant it means a lot of my time is spent for example doing my ward round on my own, the ward round medical paperwork and admin is then all for me to do and it takes away from the time that I am supposed to spend doing the very many tasks and responsibilities that are expected of me as a consultant.
So I can see why some specialties or individual consultants could be attracted to the suggestion of having a PA, clinical nurse specialist, advanced practitioner or similar rather than a resident doctor. They are permanent staff so once fully trained the department would continue to reap the benefits, in my department they would not be on the medical on call rota so no zero days or night shifts, they could be trained up for a defined area of practice and could provide continuity of care for both inpatients and outpatients.

Second point - Medical student numbers are being increased due to the need for more doctors - again my personal opinion is that this is likely to worsen the problems before being able to solve them as to increase med student numbers you need to have the clinical placements and clinical supervisors (consultants) available for them. My department takes medical students and we wouldn't have capacity to increase the numbers anyway, in addition the consultants are already very busy and anyone who is able to supervise or teach medical students is already doing so. We don't get any financial recompense for having and teaching med students, somebody does get the money somewhere but it's not me and it also doesn't seem to reach my department. I enjoy teaching and training but it takes me away from my consultant-level clinical and administrative work which nobody else will do for me so there comes a point at which I would have to say no to anything extra.
Likewise when these students graduate and need 2-year Foundation placements,this programme is already struggling to meet demand and there's a waiting list/hastily-put-together job tracks every year. I know this because I supervise FYs and I now quite often get an FY who has been a "placeholder" initially unmatched to a job & only finding out at short notice where they will be working. More FYs means more clinical and educational supervisors needed, if these are to be consultant supervisors I don't know where the additional consultants are going to come from. Anyone of my vintage is either trying to cut down their clinical hours or even trying to leave completely, the willingness/capacity to take on even more training and supervision responsibility is just not going to be there. Each resident doctor should have an hour of face to face clinical supervision per week, for me this amounts to a large proportion of my own working week as I have more than one resident on my team and I work less than full time myself. My job plan (weekly schedule) just doesn't have the flexibility to give more time to a greater number of residents.

Thank you Transcontinental - am sure mumsneedwines will be along in a minute to tell you why you are wrong.

WE have got PAs in out Trust because the FY1 jobs were taken away from mainly surgical specialities as deemed not fit for purpose. The departments affected looked at the use of PAs and by and large have integrated well. They looked at the effect on training for the F3 and above grades and found they got more theatre time as the PAs were on the ward. All the surgical consultants I know will not train PAs to perform operations but they do assist if needed.

Many on this thread are unaware of the amount of time and effort senior doctors put into training the next generation, mentoring, guiding etc the next generation. Some do not but the vast majority do much in their own time - but on here anyone not a current FY doctor is a selfish, ignorant unempathetic bastard!

@Marchesman you have stated that “Attendance at a more academically selective medical school has positive effects on entrance to higher speciality training” but I don’t see evidence for that in the study you shared (although I may well have missed it). In fact, the conclusion from the study states “variation in MRCS pass rates between medical schools is largely due to individual factors, such as the academic ability of individuals, rather than medical school factors”. Intuitively it would make sense though, just as grammar schools send more to elite universities than a less academically selective school would.
However, the GMC registration data seems to show something different. Just comparing standard offers for Cambridge with Imperial - former is AstarAstarA, latter is AAA to AstarAA, so one can conclude Cambridge to be more academically selective. However, when you compare numbers in specialty training, given that both universities have similar(ish) numbers in foundation training (544 for Cambridge, 580 for Imperial), Imperial has over 75% more in specialty training than Cambridge (1406 vs 795). Is there a flaw in using GMC registration data that I’m not aware of (am a non-medic so may be reading it incorrectly)?

It's great to have an insight on how consultants think. It helps the public understand the current issues better.

Our experience of a PA was that we were led to believe she was a doctor at first. Unfortunately, it wasn't a straightforward case so she couldn't answer many of the questions and eventually we had to wait for the doctor anyway. From a patient's perspective, that's not great and we lose confidence. If you have waited almost a year for an appointment, then to see someone who lacks the depth of medical knowledge and the ability to deal with the issues is really disappointing. Ultimately, as doctors you run the risk of potential clinical negligence claims and surely that's stressful and ultimately not worth it. I understand that senior doctors are looking at it as a workload issue, but hopefully you can understand that patients look at it from a different perspective having waited a long time for an appointment.

I was really just offering an answer to the question about the discrepancy in higher surgical training. Attendance at an academically selective school was meant as a general marker, not specifically a schooling effect.

However, McManus seems to show that post-2000 medical school graduates do worse in examinations having correcting for prior attainment. Value added is discussed in that paper.

Which paper are you referring to in your second paragraph?

It’s not from a paper (hence my health warning on conclusions!) - just from the GMC database.

gde.gmc-uk.org/medical-schools/medical-schools/medical-schools-and-their-graduates

Onemorepiece - the same was said of nurse practitioners when they started being used for tasks traditionally done by doctors. Healthcare evolves and the US has very good track record of using this group of professionals properly. We still have a long way to go.
If properly set up and managed they are invaluable for both patients and the greater healthcare team. There are undoubtedly issues about some of them pretending they are doctors but then the some can be said for some nurses and other AHPs. There are good and bad ones and they make miatskes just like junior doctors - who get carried by their consultants aswell.

i would prefer a resident over a PA but cycylist has actually articulated how hard it has become to deliver care to patients - so much protected time, teaching, zero days and less hours means the work needs to be done by someone - many consultants now do the tasks they did as a junior doctor because if they did not then they do not get done. In some ways the medical profession has shot itself in the foot, so many portfolio boxes to tick we have lost sight of the goal - treating patients safely.

A wonderful and highly competent nurse practitioner looked after me and my newborn in Kentucky thirty odd years ago. The US system was light years ahead of the UK then - fortunately, or my DD wouldn't be here, nor would I. It never occurred to me to question the expertise of this nurse practitioner merely because she wasn't a doctor.

A great many nurses are vastly more impressive than doctors, in my (relatively extensive patient) experience. I think there can be an issue with doctors sometimes - especially at the junior level - being just a bit too pleased with themselves.

I also posted this from 2019;

(2019) Welcoming the publication of the report Professor Andrew Goddard, President of the Royal College of Physicians said:
We are delighted that the MAC have taken on our recommendations for medical practitioners to be added to the shortage occupation list. This is a welcome step forward which will help in the short term. Only 55% of advertised consultant posts were filled last year due to shortages of doctors, so this recommendation could make a big difference.

Given the current pressures within the NHS, although it may be perceived as convenient to use PAs, there is a potential danger that a PA might over extend themselves beyond their scope, especially when understaffed. That's not fair on patients or the PA. If there is a long wait for the next appointment, there is also a possibility that any problems from misdiagnosis/mismanagement of conditions go unnoticed for a long time. This could be catastrophic for a patient's health.

Yes, I am aware the system has worked well in the US. However, the depth of the knowledge and quality of the training received in the UK, especially under the pressures of the NHS, is not on the same level as the US. Given the lack of depth of their medical knowledge, some of the tasks they have been allowed to do here are a threat to patient safety. Most people I know are not happy with the use of PAs.

Apart from the fact that the general public are not fully aware of the scope of PAs, the words physician's associate have the potential to confuse patients into thinking they are doctors. A further point is that when a referral is made to a doctor, it is natural then for a patient to expect to see the doctor and not a physician's associate. It is rather frustrating after waiting for a year to be seen by a physician's associate if the condition has got more complicated or worsened over that time period. As for nurses and other healthcare professionals, their roles are well established and the public understand their limits.
I get what you are saying about the heavy workload and lack of time and staff, etc to train younger colleagues but weren't the consultants that trained all of you back in the day not having to juggle similar workloads while having to train you? This is not me saying that you're not doing enough. Just trying to understand the issues.

I do appreciate what you say about consultants leaving and that training doctors is difficult under current circumstances. I am sure the support you are providing your resident doctors is highly appreciated. It is still in the best interests of the profession, patients and the NHS that doctors continue to be trained and supported at all levels and additional training places be made available to all those UKMGs and UK IMGs already here. Hopefully, a way forward is found soon that all parties find acceptable.

Finals pass rates are much the same from medical schools with academically very different intakes (despite that graduates resume performing differently in line with their prior attainment in subsequent examinations) - which doesn't square with the notion of a uniform standard for final examinations and is probably the reason the GMC is fairly quiet about it. But I guess the status quo is preferred by government, by universities who are either able to set themselves up in the business or cut costs, by students, and perhaps most importantly by educationalists:

"Traditional medical education consisted essentially of a two year pre-clinical lecture-based course, followed by three years of clinical training which took place mainly in hospital settings. These two phases have also been described in terms of the ‘pre-cynical’ and ‘cynical’ years, referring to evidence that shows the increasing cynicism of medical students as they progress during their medical training.
The pre-clinical course drew on a spectrum of scientific disciplines, with information imparted didactically in a formal lecture theatre style. This formal setting is more conducive to passive styles of learning, rather than active acquisition of information.
The relationship between basic science and clinical departments has been described in terms of ‘mutual condescension’ and ‘strained tolerance’ and the curriculum as being ‘driven by factual content and dominated by departmental rivalries over core knowledge’.
This division between the pre-clinical and clinical aspects of medical training is believed to have inhibited the connection between ‘scientific questioning’ and ‘clinical practice’ - and could ultimately ‘impede innovative solutions to health concerns’." (P. Cavenagh, "The Effects of Traditional Medical Education," in P. Cavenagh, S. Leinster, and S Miles, (eds), The Changing Face of Medical Education (Abingdon, 2011), 10.)

The driving force was a perception that traditional medical courses were off-putting and stressful, but of course all that has happened is that now being stressed and put off occurs afterwards. Who would have guessed it?

@OneMorePiece you posted above:
I get what you are saying about the heavy workload and lack of time and staff, etc to train younger colleagues but weren't the consultants that trained all of you back in the day not having to juggle similar workloads while having to train you? This is not me saying that you're not doing enough. Just trying to understand the issues.

Consultant workload and training responsibilities today aren't directly comparable to when I was coming through the ranks as a trainee. There were no Foundation programmes or EWTD at that time, I was a pre-registration house officer and I was given no inductions, protected teaching or supervision for at least the first few years of my medical career. I was primarily a service provider working very long hours and I saw "my" consultant very little, he (the majority of consultants were "he") was mostly a distant figure who appeared for ward rounds. Yes he and the others would have been busy I am sure. But back in those days (which are not all that long ago really) the consultants had much more status within the hospital, they had a consistent team of the same doctors working with them for 6-12 months at a time so the churn of new doctors in training every few months was less marked, there would have been a functioning Doctors' Mess with perhaps meals provided there and its own domestic staff to look after the doctors. Because the doctors on the team worked longer hours they had more exposure to clinical work and were therefore more experienced at a more junior stage so could perhaps not need the consultant's presence in person to supervise so often. There was also no mandatory training, no appraisal or revalidation, no online portfolios or compulsory reflection all of which consultants now have to do and these all take up so much time. They didn't have hundreds of emails being sent to them marked "URGENT" every day and they were generally a lot more protected, people would have thought twice before disturbing the consultant but now anyone who wants to can and does contact me at the drop of a hat to offload some risk or a clinical situation they're not happy to handle. Admin teams are now often being outsourced, I'm lucky to have my own secretary on site but I know that's not the same for all consultants. Back in the day, the consultant's secretary was absolutely invaluable and was another layer of support and consistency. I also have my own office, again I'm very lucky to have this as I know of consultants in other specialties who are hotdesking or sharing offices, or are moved around at the whim of hospital management because the rooms are needed for someone else.
I'm not saying the old way, the way I started off in medicine, was the right way and in fact we were very much thrown in the deep end & it was often sink or swim, it wasn't all that good for the patients at times either I am sure. When I started working in specialties that did give supervision, it was so valuable to me and I greatly appreciated the time my consultants spent on my training and career development. But my personal opinion is that medicine has been deprofessionalised over the last few decades. Having a hierarchy of doctors over other staff was presumably and understandably not popular so with the flattening of the hierarchy we are now "colleagues" along with all members of staff. The intensity of consultants' work has gone up and the more straightforward stuff is now often cherry-picked for non-medical practitioners or similar to deal with. So my workload & the decision-making, and the questions asked of me by others who don't want to make decisions themselves, are now usually about very unwell, high-risk patients. Yes it's what I was trained for and I have the expertise but I don't think I have the surrounding infrastructure or the support that my consultants would have had when I started my career. We have lost a lot of our independence as clinicians unfortunately.

Yes, I see that different cohorts of doctors appear to have had different challenges.

I appreciate that supporting junior colleagues must be tough when you feel unsupported yourself especially if you are left to deal with a large number of complicated cases. I guess the mandatory training, appraisals, etc that you do now as consultants are measures introduced to improve training and working conditions for resident doctors which is a good thing. It is different from what you experienced but it's well intended and I am sure it's gratefully received.

As for your support, I can understand why you see that it is lacking especially compared to with the experiences of the consultants that supervised you. I expect that having a good secretary makes a big difference. Communication between patients and doctors is smoother and a better workflow. If cases are dealt with within a reasonable period and waiting lists were shorter, you wouldn't be getting as many cases marked 'URGENT'. It is reasonable to assume that the longer the wait to see a doctor, the more likely that a patient's case becomes more complicated or that patients have multiple questions. It makes sense in this situation to have more trained doctors to deal with patients but I do get you when you say it's hard to juggle all the responsibilities that you have. It's clear that more consultants are needed to train these doctors and it's unfortunate for both resident doctors and consultants that there are not enough consultants. However, a solution has to be found to this problem as there are doctors who are finishing foundation training potentially not having training positions in the summer. It would be a waste not to train them to be the consultants of the future. As for the consultants that trained you, they did seem to have a stable team of doctors and were better supported. Hopefully, when they review the training structures they take into account the views of doctors at all levels. I am not familiar with how benefits have changed for different cohorts of doctors over time but I do believe that each cohort of doctors have faced different sets of challenges so it's important to consider their circumstances in the context of the time that they enter training.
In the case, of the latest batches, unfortunately, various factors have meant that there appears to be a shortage of training places. It seems that large numbers could possibly face unemployment unless they change careers or have the means to go abroad. Perhaps it's not reasonable to make judgements relating to their abilities as we are yet to know anything about them. There are factors potentially relating to the current recruitment system and the high number of applicants. You may or may not have benefitted from the free university education decades ago. These young people that are possibly massively in debt have spent 7 years of their career looking forward to the next stage. This is not to say that ones who had a free education had it easy as there were clearly challenges then too. Only that it's important to consider each cohort in the context of what is happening at the time they apply for jobs and how those factors, at home and abroad, and the challenges they face impact them.