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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
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TheFairyCaravan · 16/02/2025 17:47

It seems ridiculous to me, especially with the state of the NHS as it is atm, that we’re churning out thousands of newly qualified doctors, nurses and HCPs annually but they can’t get jobs at the end of it. When DS2 & DDIL graduated as nurses 7ish years ago they could practically choose where they went to work afterwards.

If we’re spending hundreds of thousands of pounds per student, and don’t forget they’re paying too, then they should at least get first dibs on the jobs.

Needmoresleep · 16/02/2025 17:50

Northerngirl821 · 16/02/2025 17:17

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!

Your F1s are very lucky. Every time I spoke to DD when she was an F1 she sounded completely exhausted.

Every single one of her F1 rotations involved night. Lots of them. Often with 13 hour shifts. Two were general medicine in one of the most deprived areas in the UK. 10 days at a stretch including longs. Lots of death as people were brought in from care homes.

And no, you rarely finish on time. Just like your experience nights can be so busy that there is virtually no time to pee, and you stay late to do a proper handover. Staff shortages are endemic. Their F1 rota was down 15% almost before they started, 40 patients on trolleys, and one night when a Registrar failed to show, three of them with 18 months experience between them were left in charge of a hospital overnight.

They are not complaining. They just want jobs. Not grand jobs. Just some form of F3 so they can get the experience they need and the time they need to apply for training.

Criteria be published, but this lot are facing competition from across the world. There is an arms race in both exam marks and other things that generate points. The wiser ones will perhaps leave work on the dot, fill out exception reports if asked to stay late and be brutal in prioritising their own needs in jumping through the hoops rather than prioritising the patient.

I am not aware of DD ever filing an exception report. Where she is the culture seems to be that you get on with the job and if you do well you are rewarded with more responsibility. She did have a two day email battle with the rota administrator who wanted her to start a 13 hour shift an hour after coming off a run of 6 nights. She won after threatening to go to the BMA and only because she felt she would be completely unsafe. You may think things have improved. The NHS is in a real state of crisis, and F1s and F2s like other staff are part of the sticking plaster holding it together.

No she is not even thinking of a training job in Severn. Just a 12 month contract in a far less popular bit of the UK. The sort of place where overseas recruits might accept a first job or a training job, but then leave pretty sharpish. Meaning the Trust to has to go overseas to recruit at consultant level. Observation is that given the leadership elements of the role, recruiting consultants without NHS experience, can be problematic. (There is high demand for good consultants in private hospitals worldwide, and at that level the NHS is not normally first choice.) The Trust would do far better ensuring their current F2s can stay and build careers. At moment all but 2 of DDs peers expect to have to find work overseas.

OP posts:
Toddlerhelpplease123 · 16/02/2025 17:50

ProfessorLayton1 · 16/02/2025 17:19

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 !

Well that would be ideal. But one of OPs points is she is saying that due to the long hours they dont have time to even find/ see or apply before posts are closed.

Unless its an internal recruitment programme where people are on file and automatically suggested/ submitted for jobs?

Annoyeddd · 16/02/2025 18:03

Those of us with slightly older DC's have seen the jobs situation deteriorating for medics for a few years.
There is what's known as a competition ratio for each speciality when they apply for jobs and it has been increasing. Quite a few of the candidates will be from abroad - are they the best candidates - not necessarily just look at the pass rates for the MRCP and other exams
The previous government spouted a lot about the increase in the number of medical school places and the fy1/fy2 places but there has been no increase in the number of ST1/CT1 places or the ST4+ places.

OneMorePiece · 16/02/2025 18:17

The GMC needs to stop running the PLAB 1 & PLAB 2 exams for IMGs until it gets a handle on the issue.

For example, IMGs passing PLAB 2 have more than doubled since 2021.

In 2021, 6043 IMGs passed PLAB 2. In 2024, 12,902 passed PLAB 2. IMGs that have passed will be looking for employment in the UK.

There is an ever increasing number of medical graduates from overseas universities who can't find postgraduate training in their home countries and are therefore looking to work in the UK.

https://www.gmc-uk.org/registration-and-licensing/join-our-registers/plab/recent-pass-rates-for-plab-1-and-plab-2

The sensible thing to do is to pause the PLAB exams and reinstate the RLMT and/or address issues within the points based immigration system that is causing a deluge of applicants from overseas

Clavinova · 16/02/2025 18:21

Needmoresleep
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.

Haven't we already established that the previous Resident Labour Market Test included EEA nationals as per EU single market rules? Just looking at the Republic of Ireland - is this the equivalent training stage in Ireland for doctors?

Places in BST are allocated in the first instance to applicants who, at the time of application, are citizens of Ireland or nationals of another Member State of the European Union, Stamp 4 Visa Holders and UK nationals...

https://www.rcpi.ie/Learn-and-Develop/Training-Programmes/Basic-Specialist-Training/General-Medicine-Basic-Specialist-Training/Apply-to-BST

(NB Your op says Resident Market Labour Test rather than Resident Labour Market Test - RLMT)

Needmoresleep · 16/02/2025 18:26

ExtraOnions · 16/02/2025 17:26

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

Did something change in the last week ?

Yes the thread filled up.

OP posts:
Clavinova · 16/02/2025 18:30

Barleypilaf
Before Johnson, employers could only hire from abroad if there was no suitable U.K. candidate.

Clearly not correct when we were members of the EU - not to mention Ireland.

OneMorePiece · 16/02/2025 18:32

A reinstatement of the Resident Labour Market Test would help resolve the issues of concern:

www.fsp-law.com/return-of-the-resident-labour-market-test/

Needmoresleep · 16/02/2025 18:45

Clavinova · 16/02/2025 18:21

Needmoresleep
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.

Haven't we already established that the previous Resident Labour Market Test included EEA nationals as per EU single market rules? Just looking at the Republic of Ireland - is this the equivalent training stage in Ireland for doctors?

Places in BST are allocated in the first instance to applicants who, at the time of application, are citizens of Ireland or nationals of another Member State of the European Union, Stamp 4 Visa Holders and UK nationals...

https://www.rcpi.ie/Learn-and-Develop/Training-Programmes/Basic-Specialist-Training/General-Medicine-Basic-Specialist-Training/Apply-to-BST

(NB Your op says Resident Market Labour Test rather than Resident Labour Market Test - RLMT)

Yes. It used to be that our posts were open to EU citizens.

Now they are open worldwide. Some countries, Malaysia is an example, have a large number of private medical schools pumping out far more graduates than their local health systems can absorb. An industry has built up helping those graduates find jobs and training overseas.

The UK does have skills shortages. But not all jobs in the NHS are hard to recruit for. Specifically our graduates need access to entry level jobs where they can build experience, or training so they can build careers.

The levels of competition are rising fast. The NHS does not keep data on the number of applicants per advertised vacancy, but anecdote suggests that basic entry level jobs can attract several hundred applicants within a few hours. Hence young doctors feeling they have no chance. There are so many applicants. They have no experience and are looking for it. Other applicants perhaps from poorer parts of the world wanting to move their families to the UK, may well have more experience and so will be appointed.

The NHS needs to talk to F2s and find out what is going on. They should want to avoid losing a generation of UK qualified doctors. Those doctors don't want to be forced to emigrate. If the NHS keeps them they will spend their careers here and once trained should be able to take up jobs which we currently struggle to recruit for.

(Sorry about the typo.)

OP posts:
Needmoresleep · 16/02/2025 18:53

Clavinova · 16/02/2025 18:30

Barleypilaf
Before Johnson, employers could only hire from abroad if there was no suitable U.K. candidate.

Clearly not correct when we were members of the EU - not to mention Ireland.

But EU freedom of movement applied only to citizens of Europe. It was not worldwide.

Things are very different now. Applications, especially for entry level jobs, and for training, have exploded. Newly qualified doctors are having to seek work in other countries. There they will have to do the jobs that are hard to fill, and accept that local residents are prioritised for training opportunities.

Whilst we have suitably qualified doctors, nurses and other HCPs looking for work, we should be prioritising them. Just like everyone else does.

OP posts:
Clavinova · 16/02/2025 18:57

Needmoresleep
Yes. It used to be that our posts were open to EU citizens

I am not unsympathetic to your cause but we are clearly not 'the only country in the world' that doesn't prioritise its own citizens, if EU citizens can apply for jobs and training in other member states.

Needmoresleep · 16/02/2025 19:14

Clavinova · 16/02/2025 18:57

Needmoresleep
Yes. It used to be that our posts were open to EU citizens

I am not unsympathetic to your cause but we are clearly not 'the only country in the world' that doesn't prioritise its own citizens, if EU citizens can apply for jobs and training in other member states.

That is splitting hairs.

The EU is a single market of largely convergent economies. It has freedom of movement for labour and for goods. It has a single regime of regulation.

It also protects its citizens by allowing priority to EU citizens in recruitment.

We left the EU so no longer have its protections. The idea was an approach similar to Australia, but for some reason, and despite a known publics concern about levels of immigration, it was decided to open up the health sector labout market entirely. This is proving disastrous and needs to be changed. Eight years training and huge tax payer subsidies, all for nothing.

OP posts:
CerealPosterHere · 16/02/2025 19:24

I’ve got midwifery students halfway through training talking about quitting, they can’t see the point of carrying on flogging themselves when they can’t see jobs at the end of it. They’re unbelievably stressed about the situation.

CareeringintoSpring · 16/02/2025 19:24

Barleypilaf · 16/02/2025 15:40

YANBU - Boris Johnson got rid of the Residency Labour Market Test for all jobs. The situation is madness and the doctor/nurse situation highlights it. The U.K. spends hundreds of thousands to train medical students, but then they are unemployed. It is not because there are no jobs, but because the NHS is recruiting overseas, with reduced standards (exemptions from exams)

Before Johnson, employers could only hire from abroad if there was no suitable U.K. candidate. This should be reinstated.

This isn't correct. Before Brexit, candidates from the UK and the EEA competed for UK posts equally, not just UK candidates. That said, many medical posts were on the shortage occupation list, so were open to candidates from across the world from the offset. I used to work in medical recruitment.

OneMorePiece · 16/02/2025 19:49

Prioritisation of UK based applicants that the country has already trained is the way forward.

In India, in 2024 over 2.3 million students sat the entrance exams for medicine competing for 100,000 places in government and private medical colleges across India. Compare this figure to 2016 when just over 750 000 students did the entrance exams for medicine.

There is a shortage of postgraduate training posts available in India hence why there is an increasing number coming to countries like the UK.

See what I am getting at yet? It's imperative that we prioritise our UK medical graduates as we are going to see an increasing number of applicants competing with UK based applicants each year for posts if we don't.

mumsneedwine · 16/02/2025 21:02

@Clavinova even if you have the right to work anywhere in the EU, you also need to be fluent in the language you want to be a doctor in. So not really free movement.

OneMorePiece · 16/02/2025 21:03

CareeringintoSpring · 16/02/2025 19:24

This isn't correct. Before Brexit, candidates from the UK and the EEA competed for UK posts equally, not just UK candidates. That said, many medical posts were on the shortage occupation list, so were open to candidates from across the world from the offset. I used to work in medical recruitment.

It was on 1 January 2021, during Boris Johnson's term as prime minister, that the Resident Labour Market (RLMT) was abolished. Doctors were added to the shortage list in October 2019, also when Boris was prime minister. The point that Barleypilaf is trying to make is, that after the RLMT was abolished, there was a huge increase in competition from outside the UK which had the potential to disadvantage UK based applicants. This year there is a deluge of applicants for medical posts from outside the UK leaving a huge number of UK based doctors facing a threat of unemployment as UK doctors are not prioritised for these posts. It is the case as it stands that a doctor outside the UK, who has never worked in the NHS or not set foot in the country, could get the job ahead of a UK applicant, whether UK medical graduate or UK IMG.

mumsneedwine · 16/02/2025 21:03

@CerealPosterHere that makes me so sad. Midwives are so so needed in the NHS yet there are not jobs for them. What a mess.

mumsneedwine · 16/02/2025 21:05

If things have not changed, please explain this.

AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs
SlaveToAGoldenRetriever · 16/02/2025 21:12

YANBU. My DD is hoping to start a physiotherapy degree in September - now having doubts as so many new graduate physios are unemployed, there just aren’t enough jobs to go round anymore. It’s really quite worrying. She really wants to work in the NHS when she qualifies to gain the most varied experience (and as a physio of 30+ years I agree with this!) but the reality is that so many are being forced to work privately or head elsewhere in the world nowadays. It’s also a massive disservice to the NHS and taxpayers who fund such a large proportion of healthcare degrees!

Clavinova · 16/02/2025 21:16

Needmoresleep · 16/02/2025 19:14

That is splitting hairs.

The EU is a single market of largely convergent economies. It has freedom of movement for labour and for goods. It has a single regime of regulation.

It also protects its citizens by allowing priority to EU citizens in recruitment.

We left the EU so no longer have its protections. The idea was an approach similar to Australia, but for some reason, and despite a known publics concern about levels of immigration, it was decided to open up the health sector labout market entirely. This is proving disastrous and needs to be changed. Eight years training and huge tax payer subsidies, all for nothing.

It's not splitting hairs - either we are 'the only country in the world' not prioritising our own citizens or we are not.

We left the EU so no longer have its protections

On the previous thread you were complaining about doctors trained in Eastern Europe!

Over six million people have applied to the EU Settlement Scheme, including one million people who were in fact not born in the EU.

How many NHS staff with acquired EU citizenship from other EU countries (who then relocated to the UK - plus their non-EU family members) were in fact born in Africa, Asia or the Americas?

Vettrianofan · 16/02/2025 21:20

lnks · 16/02/2025 15:52

Please can you included the sources you have used to produce all of the points in your post?

I am a mature student nurse in my second year. The vast majority of student nurses at my university graduate having already secured a job. If fact, many of us are already working part-time as HCP whilst completing our degrees.

I agree with you.

NHS Scotland job vacancies has loads of vacancies for various HCPs!

Most nurses will get jobs before qualifying. Doctors have plenty choice in NHS Scotland too.

catlovingdoctor · 16/02/2025 21:36

Just to add a lot of trusts prefer to hire foreign staff for trainee-level roles I.e. as registrars as they are often highly-qualified in their home counties. This means consultants/seniors don't have to take the time or make any effort to train them which they would with a British graduate.

mumsneedwine · 16/02/2025 21:48

@catlovingdoctor but that's their job ! They are paid to train doctors. Ladder pulling seniors are so horrible.