I started a similar thread a couple of months ago.
This is a huge issue. The scrapping of the Resident Market Labour Test means that the UK is the only comparable country that does not give preference to those already in the country. Throw in some exemptions from exams and some immigration incentives and the outlook for many of those finishing F2 this year is looking like a disaster.
Three main issues.
- entry level jobs (F3/locum contracts/house jobs) are often inundated with hundreds of applicants from overseas, some of whom will have the experience that newly qualified doctors in the UK need. Doctors recruited from overseas but who are now resident in the UK, and whose contracts have now come to an end, are also affected. Without resident priority, the job goes to the most experienced. Many overseas applicants will have support and mentoring from overseas recruitment agencies in terms of CV writing, alerts etc, something that those in the UK don't have access to.
- Training. There is a huge shortage of places, and over half go to those from overseas medical schools. There is now an arms race in terms of CV enhancements. Fine if (whether in the UK or overseas) you can take a year out to study for exams and take additional qualifications (some overseas training institutes actually provide two year training courses with that end). Or you are lucky enough to work in a London teaching hospital with lots of research going on or did a six year degree with something publishable in your intercalation year. Or if you are super focussed and determined and willing to give up any sembalnce of a work life balance. (Then you go on to be a GP who is advocating work-life balance to stressed out patients!)
- Young doctors who took jobs in Australia to avoid unemployment and who would to come home. This is becoming a serious problem and getting worse.
I was at an event where I got the chance to bend the ear of an MP. She was surprisingly receptive. A constituent had come into her surgery that morning with a daughter stuck in Australia, and she had been perplexed. Surely we had a doctor shortage. She was therefore interested to hear that it was a real problem with a specific cause.
Since then the MP (Aphra Brandeth) has tabled the following question
Question:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help junior doctors find employment in the NHS after they have completed training. (46472)
Tabled on: 17 April 2025
Answer:
Karin Smyth:
Decisions about recruitment are matters for individual National Health Service employers. NHS trusts manage their recruitment at a local level, ensuring they have the right number of staff in place, with the right skill mix, to deliver safe and effective care.
We will ensure that the number of medical specialty training places meets the demands of the NHS in the future. NHS England will work with stakeholders to ensure that any growth is sustainable and focused in the service areas where need is greatest.
To reform the NHS and make it fit for the future, we have launched a 10-Year Health Plan as part of Government’s five long-term missions. Ensuring we have the right people, in the right places, with the right skills will be central to this vision. We will publish a refreshed workforce plan to deliver the transformed health service we will build over the next decade, and treat patients on time again.
The Government committed to recruiting over 1,000 recently qualified general practitioners (GPs) through an £82 million boost to the Additional Roles Reimbursement Scheme (ARRS) over 2024/25, as part of an initiative to secure the future pipeline of GPs, with over 1,000 doctors otherwise likely to graduate into unemployment in 2024/25. Data on the number of recently qualified GPs for which primary care networks are claiming reimbursement via the ARRS was published by NHS England on 7 April, and showed that since 1 October 2024, 1,503 GPs were recruited through the scheme.
Newly qualified GPs employed under the ARRS will continue to receive support under the scheme in the coming year as part of the 2025/26 contract. A number of changes have been confirmed to increase the flexibility of the ARRS. This includes GPs and practice nurses being included in the main ARRS funding pot, an uplift to the maximum reimbursable rate for GPs in the scheme, and no caps on the number of GPs that can be employed through the scheme.
My understanding is that MPs will often ask an initial question to get a Government response on record (in Hansard) and then follow up with more specific questions, and this is what the MP plans to do. I also understand that another MP is active on aspects of the problem, but have yet to look at his twitter.
Then yesterday I was introduced to someone who is involved in developing the NHS ten year plan, who confirmed that the issues I raised were correct, and indeed went on to effectively agree that there were some very powerful lobbies in both the BMA and GMC who were preventing these genuine concerns from being properly heard. (And to head off the inevitable MN cries of racism, this person was not British born. One irony of the argument that we should prioritise overseas doctors because of the debt we owe their predecessors is that many of the earlier generation now have DC who have gone through British medical schools and who are struggling to find work.)
I think this piece from a medical journal where members of a BMA panel complaining about "protectionism" from British resident junior doctors is interesting. Though about GPs specifically it rehearses the arguments, and perhaps suggests why decision making and representative bodies seem so paralysed. https://www.pulsetoday.co.uk/news/education-and-training/gps-criticise-juniors-for-protectionist-policy-against-international-graduates/
My own DD is finishing F2 and has not got a job. Her Deanery is still on the old 2005 contract, so less good terms and money and no personal development time. All but one of her rotations has involved nights and she has been working very hard. She knew this. She chose the Deanery because she knew she would get a lot of good hands-on experience and responsibility, and then intending to spend an F3 gaining experience and applying for training. In some ways this has worked. The sort of medicine she had always thought she wanted to do is now close to the bottom of the list, replaced by something that I think suits her far better. The lack of accessible jobs has knocked her sideways, but eventually she decided that she would stick it out and rely on zero hours NHS bank work. Work is drying up rates are low and apparently you have to pay for your own insurance. Unfortunately there is now a particular problem as the regular locum she met whilst on placement has failed to get onto training, so it might be two of them competing for the same small amount of irregular work.
In her Deanery, ie several NHS trusts, DD is only aware of two F2s who have got training. For the rest nothing. This is starting to show through in terms of demoralisation so in her final placement there are only 3 F2s when there should be six.
A particular problem then is one of filling training places. The high flying Oxbridge type and overseas graduates who have invested large amounts of time and money into getting their training number don't want to work in the boondocks. Instead they will wait till something better turns up, or equally damaging, move to England half way through their six (or whatever) years. In one major speciality DD's Deanery eight out of the 16 training places are vacant. This means that Consultants are on call one night in four and that urgent referrals (for serious, life affecting conditions one of which can be slowed if treated early enough) are taking two years, with an eight year wait for non-urgent referrals. Two of the consultants wrote my daughter lovely notes saying she was a very good clinician with strong diagnostic skills. They are so short of staff, and though they have been given a Physicians Associate it is an area where you really need doctors. I am sure they would love to hire her or one of her equally able peers, but they can't. If they can create a short term contract to cover for one of the unfilled training positions, it will have to be open to worldwide applicants and probably go to someone without NHS experience, who will then probably move to somewhere more popular as soon as they can.
This policy is not just affecting young doctors and their families, it is impacting on the loads of other doctors and their ability to provide meaningful care. DD chose medicine because she wanted to treat people. So what do you say to the man who has been waiting eight years with a massive life affecting hernia - and no prospect of surgery anytime soon. It is getting to the point where she is wondering whether, though she loves the rural area she is in, she might be better off working in a functioning health service, albeing on the other side of the world. The evidence is that many of her more senior colleagues are thinking the same thing.
This is a real issue. A stupid, stupid waste of lives and taxpayer money. With more awareness, perhaps the Government will be forced to take action. Please write to your MP, the chair of your NHS trust, the Dean of your Medical School, etc. If we all chip away we will get somewhere.