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.

@Clavinova even with the EU, countries prioritised their own staff in medicine. A Uk doctor could not just rock up in Germany. They needed to be fluent and have the right hours and points.

@Vettrianofan

Again

www.nursingtimes.net/education-and-training/new-nurses-struggle-to-find-jobs-despite-national-shortage-20-06-2024/

Or are they wrong ?

www.independent.co.uk/news/health/nurses-shortage-job-cuts-students-nhs-labour-b2581112.html

Not my daughter's experience at all. Her class is graduating this year in nursing and nearly all have already secured jobs. In fact she was one of the last ones to get sorted a couple of weeks ago for a September start.

I don't understand your problem.

The EU is a trade block which has freedom of movement for labour within it. Medical recruitment within the EU is based on priority to EU citizens. People from the UK, like people from the US, India and Australia can only work in the EU if it such recruitment is compliant with EU law.

(The UK and Ireland have seperate arrangements which pre date the EU but given Ireland produces far more medical students than it has jobs for, finding work at a junior level would be difficult. Another hurdle is likely to be Irish public sector language requirements. Ireland do, however, regularly recruit senior doctors from the UK. )

The UK gives no priority to UK citizens. It allows qualified applicants from anywhere in the world to apply for UK jobs.

You may not see this as different, but it is. Hence the rapidly increasing number of applicants from outside the UK.

The issue is that though there are skill shortages for certain jobs within the health service, this is not true of all positions. Across the various health care professions the key area where we need to give UK resident priority is for entry level jobs and training. Jobs which enable the newly qualified to gain skills and experience. And where they will struggle to compete with applicants from overseas who already have that experience, but are incentivised by higher UK salaries and the scope to settle here with their families.

World wide means world wide. So Eastern Euope, Africa, Asia, Australia Canada and more. People coming in have contributed and continue to contribute a lot. But I cannot see an argument for training midwives, physios, nurses and doctors, allowing them to take on student debt, then hiring overseas applicants into the entry level jobs they need.

My view. Happy to hear alternative arguments.

NHS jobs have always been open to anyone in the world to apply. This is nothing new.

Too exhausted to apply maybe after a set of nights but there are plenty of jobs where people do 60+hrs per week and still manage to apply for jobs. There are plenty of jobs in the NHS may not be where you want or in the speciality you want but to say they are all facing unemployment does not fit with what is on the NHS website.

Medicine is competitive and rightly so, cheap shot to call out the senior doctor claiming no fees - fees came in in 1998 - that means many consultants had to pay fees to get through medical school, the current generation is not the only one

Not necessarily highly qualified as you can't assess them accurately if they receive exam (PLAB) exemptions or have CREST documents signed off by people overseas. There have been reports of doctors without experience in the NHS who start working and find themselves unable to keep up with the pace, unable to converse, due to language issues, with the patients at the depth required to make a proper diagnosis or treatment plan.

Our newly qualified midwives are unable to get work but that's because the trust has no money and cannot externally recruit. That concerns me more tbh

Senior doctors are required to train junior doctors,don't know why you think that's not the case. Every training post comes with funding so the junior doctors are trained, they don't cost so much to the health board. The jobs are so busy currently, lot of rota gaps - so they spend their time doing service rather than training.

Seems like a disgraceful, waste of home grown talent and betrayal of the younger generation...who could believe this from our own governments?

Many of us would love to hear of these vacancies.

Are you taking about specialist posts, eg someone with a training number which allows them to apply for training posts. Or who has trained as a specialist, egGP or a geriatrician or similar. If so the vacancies exist because young doctors are struggling to get this training. 50% of training positions go to graduates of overseas medical schools, many of whom won't stay.

The real bunfight is happening for the short term locum and Clinical Fellow jobs. The sort of jobs F2s want if they can't get a training number. Anecdotally there has been an explosion in applicants numbers. The NHS don't track applicant number for this sort of vacancy. If a group of mumsnetters are hearing the same thing from our DC in different parts of the country it looks as if there is a problem. There are posts on this thread which suggest newly qualified midwives and physios also have the same issue accessing entry level jobs.

Are you really sure NHS Scotland has unfilled vacancies for this sort of job. If they do they might try advertising them to F2s elsewhere in the UK. Scotland is a lot closer than Australia.

The money wasted in training heath care professionals who then have to move overseas for work, might be better used to train fewer and use the money saved to employ them.

The Government seem to think the solution to the problem is to open up more medical school and nursing etc places. Without acknowledging that it's own immigration policies are causing the problem.

No doubt Australia is grateful that we spend so much training the doctors that fill their hard to recruit posts. Perhaps that is what enables them to spend more on their actual health service.

@Needmoresleep check out NHS Scotland vacancies for medical and dental. Loads to pick from. I cannot screen shot and upload to the thread as there are too many.

The training post applications for junior doctor is nothing like the standard NHS jobs application.

There is an expectation of junior doctors to have carried out research, presented at conferences, publications in addition to their ward and clinic work. This is achievable if the applicant can get an honorary post at a university and afford to work part-time for a year. It is not just spending time filling in a form

NHS jobs have as always been open but there used to be rules where existing staff got priority. Look at these figures and tell me nothing has changed.

Why bother training our staff if we are not going to employ them. As for consultants not training them, well they need to be told it's part of their job !

Fast tracking of IMGs who have not set foot in the country appears to be a lucrative business for some. Not sure how much the Trusts are charged but potential IMGs new to the country are being charged up to £32 000.

https://goocampusuk.com/mrcp-mba

How is that a level playing field? Our UK applicants (UK grads and UK IMGs) appear to be disadvantaged here. Being sponsored and leapfrogging UK applicants is surely unfair if it provides a shorter route for overseas applicants and deprives UK applicants of places at a time when there's a shortage.

Recruitment from overseas should only be considered after the applicants within the UK (UK MG & UK IMGs) are allocated posts

This is unusual.

I have been qualified for 26 years ... retention is at an all time low.

When nurses retire their jobs are often not advertised.

Many posts for newly qualified are now temporary contracts, if not the funding is often pulled a couple of years later.

It has never been so bad , but sadly it is going to get worse.

@Vettrianofan there is currently 1 clinical fellow job on NHS Scotland website. That's the only job open to F2s.

If F2s want a clinical fellow job then the way to do it is to speak to the consultants in the specialties they've enjoyed during their F1 and F2 rotations and - if the consultants think they're good and they'd like to have that same person around for a full year - then the consultant will give a heads up as to when any ads are coming out. If the F2 has shown promise then they're likely to be favoured. If they show real promise then any interview may well be a formality.

This is a direct observation from a close friend who is an SHO in a surgical specialty. Most of the registrar-level posts in her department are taken by older foreign-trained medics who were of a senior level before moving to the UK. Several of the consultants openly moan or fuss if asked to engage in the teaching they're required to give to juniors . (This is not universal of course but it is happening).

True, there are issues surrounding it relating to communication and differences in systems. Perhaps not qualified but very experienced; I.e. someone of consultant grade abroad now in a registrar/ trainee grade here, essentially left to their own devices because the consultants trust them while also not having to devote time to do any training.

Not only the only vacancy for our F2s, but also for some of the oversupply of medical school graduates overseas also keen to get their first foot on the ladder, and also well, qualified experienced doctors who see a chance of they and their families moving to the UK. So the job should be attracting lots of applicants.

@Auchencar This happened to one of the DC. Was it @Haffdonga ? Their son knew of a suitable vacancy coming up and so was ready to apply when it opened. Within a day there were so many applicants that the recruitment was abandoned and the Trust was going to have a rethink before re-advertising. Yes consultants will know F2s who they would be very happy to see appointed, and the odds will be good should they get to interview. But how to you get to interview? DD is aware of two jobs coming up in her deanery who might suit. She too could put in an application but again, she will be competing against a lot of other F2s she knows and in all likelihood someone from overseas, or perhaps with better contacts, will get it.

(Those following the Fife NHS Employment Tribunal might enjoy the fact that the F2 doctor has parents who well known and influential locally - the mother works for the NHS, the step father is a Bishop - managed to do all their rotations in the same hospital, which is apparently unusual, and then were able to move seamlessly to a Clinical Fellow post. Despite some controversy going on in the background.)

Applications are supposed to be anonymised and the selection made by using accepted criteria. No credit is given for strong previous performance appraisals within the NHS. Once applications number are in their hundreds it is almost certain there will be applicants who, at least on paper, will look better. It is clear from Google that there is an effective industry designed to help those overseas present the best possible application. Ours don't even get basic careers advice.

One phenomenon is doctors' friends starting looking a bit sheepish. Yes the situation is tough. However their DC, perfectly competent and personable but not obvious world beaters, managed to get an F3 in a very sought after area and this has led to a training place. I am getting a bit of this when I explain what is happening to DD. Doctor friends know she is bright, resilient, hardworking, capable and sporty. The sort of F2/F3 they would be happy to have on their ward and who they would trust. They can see it would be mad for the NHS to lose her. Without me asking three of them have offered to make some phone calls to see if something can be found.

DD would be opposed in that she is idealistic enough to believe that both she and her close friend (working class, first in her family to go to University and very much from the wrong side of the tracks) should be able to make it on merit. Unfortu neither believe that they can, so are busy filling out applications for Australia. (So much easier. One agency application. State your preferences, list your CV, and go.)

I sort of understand what is going on. A trust inundated with applications, with no way of checking whether that astonishing research listed on an application represents genuine academic talent or a parent with good contacts or the money to pay, will recognise that even if you play by current rules you don't necessarily get the right person. And you need someone who can start contributing to a busy department from Day 1. The system does not allow you to prioritise those already in the UK. A phone call from a trusted colleague talking about either their own child who is making good progress through the system, or about an F2 that has been particularly impressive, starts to become the safest choice.

So much for widening access. Access has been widened so much that the ones we wanted to help are falling through the cracks.

@catlovingdoctor and it's disgusting that it's happening. Consultants are paid to train resident focused but few are too lazy. Ladder pulling at its finest.

@Auchencar not that easy anymore unfortunately. Some can make jobs but there's just no funding this year for majority.

It's not the newly trained doctors that have a problem. Those are guaranteed 2 years work called "foundation".
It's when that finishes there's a lack of jobs. These are the ones leaving the UK in droves instead of being able to consolidate their training and progress to being the specialists of the future.

Worth remembering that more of these entry level jobs have been lost to PAs and budget cuts.

I don't blame the consultants. The system, including the exemptions and incentives, allows them to hire consultant level people for entry level jobs. Indeed the scoring system probably encourages them to do this. World wide recruitment allows the NHS to hire good people on low salaries which in a busy department has to be tempting. And given some of these jobs will be short term contracts that need renewing, you can guarantee that staff will keep their heads down and not complain.

There will be senior NHS managers walking around with grand titles saying "workforce planning". I hope it is clear now to @Vettrianofan and others that there is a bottleneck. That the our F2s cannot compete for these entry level jobs. Which means that in five or ten years time when you want to fill other, more skilled jobs, they won't be around. The work force planners are the ones who should be talking to F2s about perceived blockages. They are the ones who should be ringfencing jobs for them to move into. Instead, perhaps, they are sunning themselves in a tropical hotel which on an overseas recruitment trip.