AIBU to be angry that Government policy means young doctors, nurses and other HCPs cannot find jobs

[Needmoresleep]

Unbelievable but true.

Doctors, nurses and other health care professionals now have to compete for jobs and training with applicants from across the world. No priority is given to those already in the country.

Even ordinary entry level jobs can attract hundreds of applicants within a few hours. Newly qualified doctors and nurses need that first job to get the experience that overseas applicants will be able to offer.

In 2021 immigration law was changed and something called the Resident Market Labour Test was dropped for health and care workers. It means that the UK may be the only country not to prioritise those already in the country.

The previous thread:
https://www.mumsnet.com/talk/am_i_being_unreasonable/5267503-aibu-to-be-furious-that-there-are-no-jobs-for-young-doctors?page=1
included a number of stories. An entire graduating class of nurses unable to find that first job whilst administrators from the local hospital were taking recruitment trips to Asia. An experienced GP wanting to return from a career break only to discovering that she, and others in a similar position, could not find work, a consultant surprised at how well qualified locums seeking zero hours, short notice, cover work are. The number of overseas doctors applying for the limited number of specialist training positions in the UK doubled between 2023 and 2025.

A group of us, who have been on the higher education board since our DC were first applying to medical school, recently discovered that none of our DC, coming to the end of their foundation years (F1& F2) expect to get anything other than the odd shift with NHS bank. Most see moving to Australia as the only way to stay in medicine. They say the same applies to their peers.

Our young doctors have spent seven or eight years getting to where they are, and have £100,000 of student loans to repay. The taxpayer has spent £250,000 on each of them.

Unfortunately the NHS does not appear to keep data on the number of applicants per vacancy, nor on vacancies that, because of the numbers applying, close within a few hours. It also does not appear to question why such a small proportion of F2s are progressing within the NHS. Instead there seems to be an assumption that this wastage is somehow natural, and that the solution is to re-double international recruitment efforts, to increase medical school places, and to replace traditional junior doctor roles with less skilled Physician Associates. Measures that will only increase the problem.

If things are not changed, even more of our skilled and dedicated young people will find themselves without jobs. We would welcome experiences, information and ideas.

Please also spread the word, write to your MP, tell people in a position to influence who may not be aware. We have a shortage of doctors, nurses, midwives, and paramedics. Our first priority is to ensure that those already in the country are able to get jobs.

If young Doctors were asked, and the same will apply to other Health Care Professionals, they would argue that:

• Busy F2s work long shifts including nights which makes extensive job search difficult
• Posts often attract hundreds of applicants, and close within a few hours. This level of competition is in itself off-putting
• Overseas applicants are often supported by agencies who can set alerts for vacancies and ensure that multiple applications are submitted. No such support is offered to UK applicants,
• These agencies will help with the writing of applications so they score well against NHS selection criteria. Again no such careers support is offered to UK applicants.
• The Government/NHS offer incentives for overseas doctors including bringing in dependents and scope for future citizenship, as well as some exemptions from some exams and relocation packages. These may motivate overseas doctors to apply for entry level jobs even if they are overqualified. Entry level jobs which our newly qualified young people need.
• Various extensive and expensive courses are advertised on the internet designed to give participants an advantage when applying for specialist training in the UK. In contrast many UK medical schools do very little to ensure that their graduates have the additional academic super-curricular that, with current levels of competition, are effectively requirements to gain a training place. This year it is predicted that only 50% of the around 4,500 places will go to graduates from UK medical schools, even though it is recognised that for many UK training is simply a passport to well paid jobs in private hospitals in Singapore, Dubai or their home countries. This is poor workforce planning. If we are going to avoid a future shortage of consultants we need to prioritise those likely to build a future in the UK.

Many young doctors will see a couple of years in Australia as a reasonable fall-back. They accept that they will be taking jobs Australians don’t want and will be at the back of the queue when it comes to specialist training, but they will also be gaining experience in a different healthcare environment.

Others, including those with family or caring responsibilities, or those who brought their families over when offered fixed term contracts, simply face unemployment. We should not be recruiting overseas when we have good, qualified, NHS experienced, doctors, nurses and other HCPs in the UK driving Ubers or working in Tesco.

Yes, but the removal of RLMT and the introduction of the current points based immigration system on 1 Jan 2021 exacerbated the situation and led to an explosion in IMG numbers. Now, there needs to be a reinstatement of the RLMT or similar. Also there should be a pause of PLAB exams until the doctors already in the UK (UK grads and UK IMGs) are allocated positions. Given that it is estimated that more than 11000 UK doctors will be unemployed, reinstatement of the RLMT or similar, changes to the current points based immigration system and the current NHs recruitment system are urgent.

Needmoresleep
I thought your DCs medical school education was in Eastern Europe

You mentioned Eastern Europe first - my ds1 is a recent Oxbridge graduate but not medicine.

Why this sudden interest in Ireland

It's the easiest and most relevant comparison with the UK.

Why not? Surely the scheme is enabling wealthy applicants from overseas, who are new to the UK and prepared to pay up to £32000, to get an advantage over UK based applicants?

I think it's of interest to tax payers to know how much Trusts are being charged for recruitment through this scheme.

Can you explain how it works within the NHS?

And that a good F2 will almost certainly make a better NHS consultant than someone who comes in at that senior and important leadership level. - seriously what evidence do you have to make such a ridiculous statement.

she is in the middle of her only day clinic rotation so is making the most of having weekend- so not too busy or tired to apply for jobs, write papers, present work, do audits etc!

bapio - is offering non training posts, clinical fellow roles - not stealing training opportunities off anyone

NHS jobs are advertised and you upload your application via a portal - if they are sending CVs then they re doing it wrong.

Cheaper and less assertive? - who iMGs they get paid the same as any NHS employee on the appropriate scale, to anything but would be discrimination.

In contrast DD will probably be facing two essentially self-funded years. Yes some bank work in the first and a Clinical Fellow job in the second. Lots of her own time observing, researching, studying - on what planet did you figure this out. Clinical Fellow jobs are paid - if your daughter can not work and study for exams at the same time, on less hours than residents have ever done, witten papers and started research then you have no clue what you are talking about. She will not be self funding!

Many of those are also available for now for 6 months only. - that has always been the case in the NHS, often extended, what is the problem with that?

s it OK to restrict career paths to those who do have that white middle class privilege - where is there evidence that white middle class privilege gets you a training place and all the top jobs - so many medical schools now have "white" students as a minority- please show us the evidence for this.

There is so much unsubstatantiated rubbish in these comments - ladies you are not helping your arguments

OneMorePiece
Yes, but the removal of RLMT and the introduction of the current points based immigration system on 1 Jan 2021 exacerbated the situation and led to an explosion in IMG numbers

Most of the graphs in your link show a steady rise from 2019 with perhaps a small dip around Covid.

Those applying to read Medicine have a choice as to which degree they apply for. We're training masses of other young people and they don't all get employment the other side. I do think you're making too much of how hard it is to find a JCF post. You don't seem to know what a normal approach is at all and are very dismissive about anyone who says that. The rush of them isn't due yet anyhow - that will come when the interview round is over. Others have made the point too. But the F2s who are tactical don't wait around hoping something they might like will fall into their hands - they approach people, ask about likely posts. So much seems to be about what this group of F2s can't do, not what they can do. That's the take away from these threads.

Needmoresleep
Ireland will have to give equal treatment to EU citizens

I don't know why you keep telling me that - it was me who first pointed out the EEA requirement on the other thread - and this thread.

The UK has historical access to the Irish Labour Market

Yes, I know.

In theory, training post numbers should be determined by GP and Consultant numbers, but as long as I can remember it has never worked out that way.

Over the last 20 years (at least) in the UK, for complex but easily explained reasons, the profession deteriorated decrementally at all levels of seniority. I don't have data for the number of doctors leaving the NHS each year but for a long time this has translated into a worsening problem with retention. Rather than dealing with it directly the response has been to import more doctors.

UK graduates are being replaced rather than displaced. Quite frankly, if I were I young trainee in this country I would probably decide to leave too.

Junior hospital doctor numbers are determined in anticipation of the number of consultant posts that will need to be filled - that is so not true when you consider most medical graduates do not ned up working s consultants in hospitals

Again more non evidenced comments on this thread but you do not like being challenged on anything you have decided is fact.

I don't know anything about it, but it is possible that trusts that are dependent on agency staff to fill non-training posts might find this sort of arrangement less expensive and more reliable. I would be surprised if it impinges on training posts.

There is so much unsubstantiated bollocks being written on this thread it is farcical.

I made no comment about "most medical graduates". I referred to junior hospital doctor numbers, i.e. numbers of training and non training posts.

And what makes you think that I care about being challenged?

Unfortunately outnumbered by comprehension failures.

Given how much taxpayer money is allocated to the NHS, it would be helpful to know how much of the NHS budget is used overseas to support this scheme. I think it's important to get clarity on how exactly these schemes work within the NHS and how, if at all, it impacts on existing UK doctors whether IMG or UK graduates.

Fasttracking under these schemes, especially at a time like this, is a betrayal of our young medical students, medical graduates and IMGs who are already in the UK. These schemes and recruitment initiatives overseas should be paused until the powers that be get a handle on the unemployment issues faced by doctors already here.

The PLAB exams should be paused too since the numbers that have passed PLAB 2 in 2024 have more than doubled compared to 2021.

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

@Marchesman you suggest

"UK graduates are being replaced rather than displaced. Quite frankly, if I were I young trainee in this country I would probably decide to leave too."

This does not seem to be the way they see it. The competition for F3 jobs is huge. Those finishing F2 or already in the UK don't get any priority. They don't even get the support that overseas applicants will be getting in terms of job alerts, help ensuring their applications score well etc. It seems, as a recent poster is suggesting, they should somehow just know how the system works, when jobs are like to come out, how scoring and selection work, how to approach consultants for jobs, and presumably how to magic up the experience that the selected applicant might have.

In other areas University careers offices put in a lot of effort to ensure that their graduates are equipped for job search. Medical schools do nothing.

The NHS seems completely unbothered by the idea of retention. Just replacement. And the active replacement initiatives are having the effect of displacement.

I am still not sure how people see this and do not see the problem. I do not understand why people who don't know any resident doctors think they know better than people who do know resident doctors. We wish it was all 'bollocks'. But it's not.

Fortunately many people are now seeing this and realising things need to change.

@Auchencar how you take away from this that it's the F2s being too lazy is beyond me. Lots have asked about jobs and lots of consultants have tried to make them one, like in previous years. But this year the answer is no. Because the NHS would rather hire non doctors.

Oh for goodness sake @Needmoresleep no one is suggesting that these adults should 'just know how the system works ' or 'how scoring and selection work'. I for one would hope that someone proposing to be a doctor would have the gumption to find these things out. I also would expect an adult who wants a job to be applying for , you know, actual jobs rather than throwing their hands up and complaining that there isn't a pile of job offers for them with no effort on their part. Her social life needs to take a back seat while she finds herself a job, if indeed she is capable of actually progressing in her chosen profession.

Presumably all these dear children looking for work are in their mid twenties? They might have more initiative if their mothers stepped back and expected them to get on with their own lives, including doing what it takes to find employment for themselves or realising that they are not cut out for the amount of effort they have to put in themselves.

How easy it would be if only you could do their applications for them (In their home town of course!)

@oddandelsewhere and the rudeness becomes the argument when facts are too difficult to debate.

Explain this if you think nothing has changed.

@mumsneedwine the fact is some GB trained doctors are still finding employment, I expect they are the more pro active ones.
It isn't actually rude to point out facts, you just don't like them. (Or foreigners, it seems)

What a silly remark. We are , as a nation, subsidising the training of our own doctors. Let alone the cost to their parents. Why prioritise employment of doctors from other nations?

@marmaladeandpeanutbutter I'm not sure that doctors 'from other nations ' are being prioritised, it's doctors who have done research and gone above and beyond just turning up. It's also presumably doctors who actually applied for their jobs.

Maybe. When I was returning to work after a long spell in a previous job then a career break I found the recruitment culture had changed. Things like scoring against core competencies. I paid a consultant to help me with my CV to help ensure that it would have maximum effect and to suggest future career avenues. (My previous career had involved a lot of travelling, not something I wanted to do with young children.) It was money well spent.

They may be in their mid 20s but they have never applied for jobs. It is absolutely normal for University careers offices to support job search skills for their soon to be graduates. But medics don't get this help. They go off to guaranteed but allocated Foundations Years.

Then suddenly they are expected to apply for jobs against world wide competition. No priority or protection. Overseas applicants will often be motivated by the chance to bring their families to the UK and may well invest in the sort of application help whose advertisements are linked on the thread. Or have the support of recruitment agencies.

This is not a level playing field.

But yes, lets blame our young doctors for not having innate professional job search skills or for lacking in "gumption".

Ultimately the NHS needs to decide. Does it want to retain staff or not.

Aggressively recruiting overseas is exposing doctors (and nurses etc) already in the country to extraordinary levels of competition, at least when it comes to ordinary entry-level jobs. If they are content with this, so be it, but what an extraordinary waste of money.

If they are not, they need to talk to current staff including F2s, and find out why they feel they have to leave. The lack of a level playing field may be one. Current criteria where experience scores, yet it is known that newly qualified doctors, nurses, physios etc, need those jobs in order to gain experience might be another. Exemptions might be another.

https://www.ft.com/content/ddb51e41-8b24-4174-b58b-f57bce3ae8a3