Meet the Other Phone. Protection built in.

Meet the Other Phone.
Protection built in.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Junior Doctors Unemployment in August

1000 replies

PurpleFairyLights · 17/05/2025 22:13

Name changed but long term poster. Have a child that is in this situation with 100k of student debt.

https://www.itv.com/news/granada/2025-05-07/bma-we-could-potentially-see-thousands-of-unemployed-doctors

Unbelievable this was allowed. Most countries protect their medical graduates.

OP posts:
Thread gallery
46
footpath · 18/05/2025 08:30

Why do the jobs go to those from overseas? Are they cheaper?

Howisitonlymonday · 18/05/2025 08:32

I'm a clinically practising GP and also work in a UK medical school.
The training jobs situation is complex and multifactorial (apologies for the long post!):

Previously we did prioritise UK doctors for training posts. The current situation has arisen because, for many years, UK NHS Trusts were unable to fill many of their training posts. This was because UK graduates wanted to go off to Australia/ NZ/Canada for a few years, or wanted to train part-time, or wanted to do trust grade/locum posts until a very specific post became available. Trusts had to jump through a lot of hoops to employ an IMG, so it was disincentivised. Training posts have a significant service delivery element, so it had become very difficult to run safe rotas, especially in areas of most need (outside of the SE and major cities). The Conservative government had threatened for some time to open up these posts so that IMGs (international medical graduates who have passed stringent UK medical exams and language tests) would have equal standing, and eventually they did it.

I don't think the DoH had any grasp of just how many experienced, well educated IMGs would apply for training posts - they are outcompeting our UK grads because they have years more experience, so on a points-based application/interview they can easily get the job, and there is also the phenomenon of the application portal getting saturated before UK grads have had chance to apply. This policy needs reversing and quickly, but there is a little bit of me that thinks that UK doctors have been very happy to take advantage of the international jobs market when it suits them, and were very happy to go off to Australia rather than take a job elsewhere in the UK, but don't like it when the privilege is reversed.

There have also always been bottle necks in training in different specialities from time to time, partly because workforce planning in the NHS has been non-existent forever, and partly because many surgical and some medical specialties are very competitive, not everyone who wants to have that career will be able to, or they may need to move around the country to train, and that has always been the case and was accepted by doctors. If you were offered a post in a competitive specialty that was at the other end of the country, you would always have had to take it and be thankful. This is especially true of many surgical specialities. Many of us, myself included, have had to make the choice between moving away to pursue a more competitive/smaller speciality (most surgical specialities, O&G, cardiology, some smaller specialities), or staying local and going into something (usually GP or Psychiatry, or A&E) that is easier to get into.

NHS jobs are made where there is a population need, not where doctors necessarily want to live and work. There would be an outcry if we were using taxpayer's money to make more jobs in the SE/ major cities than are needed, and fewer in the provinces, to accommodate the preferences of doctors. New UK graduates are guaranteed a foundation training place but, again, it may not be where they want to be geographically. This is the case in other countries also. Yes this is harsh when people have to move away from their support network, but being a doctor in training has always been very hard.

There is also the situation that a PP refers to of doctors who have completed training being unable to get consultant posts. Again, for surgical specialities this has been the case for as long as I can remember - there would be an expectation of a post-CCT fellowship, often abroad, or a higher degree, before you'd be competitive for consultant posts.
For GPs and generalist hospital posts, availability of jobs comes and goes in waves and is due to the funding landscape at the time. When I got my CCT in 2007, only two doctors in my training cohort of 60 were able to find substantive jobs straight from training! We then had years and years of there being loads of jobs because people preferred the flexibility and higher pay of locum work. The jobs market has tightened up considerably in the past 2 years, not because the work isn't there, but because there's no money/space to employ people.

The GP locum market dried up completely within months when the ARRS funding (specifically for nurse practitioners/ physician associates etc) became available and practices had an incentive to fill their empty rooms with essentially free HCPs rather than expensive locum doctors. The empty substantive posts then all filled within a few months, as long-term locums couldn't find work and scrabbled to get into substantive posts. This has been great for practice - GP numbers have stabilised for the first time in many years - but we have the ridiculous situation of GPs who are unable to find work on one hand, and the GPs who are in jobs being overworked to the point of burnout on the other, because there are still not enough GPs for the complexity of the workload and there is now a huge supervision burden in practice, because NPs and PAs are (in some practices) being asked to see patients that are too complex for their training.

The labour government is hearing all this, the BMA and the Royal Colleges are lobbying hard, but it takes time and attention to sort all of this. So far we have had sticking plasters (such as ARRS funding being allowed to employ newly qualified GPs), but they are busy writing their 10-year NHS plan, and re-working the long term workforce plan, both due later this summer, and we won't get much else out of them until that point. History suggests that this situation will get resolved, but it is hard on the people who are caught up in the mess at the time. I narrowly escaped the MTAS debacle of 2007/8, which affected many of my peers, but we are all now working as GPs and Consultants. I would advise anyone in this situation to take whatever job they can, even if that means moving elsewhere in the UK for a couple of years, or doing a fellowship post, or going abroad, and bide their time.

RosesAndHellebores · 18/05/2025 08:32

Surely this level if mismanagement speaks volumes about the extent to which the NHS is not fit for purpose.

NCJD · 18/05/2025 08:35

I’m a higher specialty trainee with a good few years left until CCT (finishing training and becoming eligible to be a consultant).

Im heartbroken for some of the excellent and dedicated F2s I have worked with this year, who are really struggling for work come August. I’m also scared for myself. I’m ahead of the current wave, but being 80% (which in any standard job is still more hours than full time) and not having the ability to move due to DHs job, I worry I will get swallowed up and get stuck eventually.

I despair at the amount of new medical schools pumping medical students through my current large teaching hospital. Where are all these doctors going to go?

385nfw · 18/05/2025 08:37

@Spiderwomann they recruit from abroad because they would say ots a higher caliber of candidate same as in medicine. But then why waste money to train these people.

However, medicine is a very clear test case where it's obvious the effect that recruitment from abroad has on local skills. But that's true for most industries. People who say that medicine is special simply want to benefit from the effects of such recruitment without interrogating the underlying issues with it.

IdiottoGoa · 18/05/2025 08:40

@mumsnet why is this showing up in shopping rather than trending

RosesAndHellebores · 18/05/2025 08:45

IdiottoGoa · 18/05/2025 08:40

@mumsnet why is this showing up in shopping rather than trending

Because members of the public are consumers of the NHS and it isn't free at the point of delivery.

Presumably, the op opened the thread in shopping.

DeathNote11 · 18/05/2025 08:47

PurpleFairyLights · 17/05/2025 23:46

I was talking to someone whose DC in same situation and they have gone from loyal Labour supporter to saying they were going to vote Reform in next election. I waa shocked.

It's not just medicine being affected. 18 year olds leaving our local colleges with L3s in vocational subjects (culinary, construction, hairdressing etc) can't get entry level positions. There are no bottom rung of the ladder jobs anymore because they're filled by older Eastern Europeans who were recruited for the local warehouses, but have since left & entered the local workforce in their thousands. These disillusioned young people are very much attracted to Reform & to be honest, I can see why.

MrsBennetsPoorNerves · 18/05/2025 08:48

385nfw · 18/05/2025 07:46

I think that's why the assumptions that we should also prefer high skilled migration over low one is so erroneous. In practice it de-skills the local population.

However, that's true for all jobs and not just medicine. Medicine isn't special in that way - but would people be happy to put in similar restrictions for other professions?

The government paying for them is not an argument as the government invests in all graduates as most student debt is written off at government expense.

We used to have the Resident Labour Market Test, which required employers to demonstrate that they had tried to recruit from within the UK first, but the last Tory government chose to scrap that.

IdiottoGoa · 18/05/2025 08:53

RosesAndHellebores · 18/05/2025 08:45

Because members of the public are consumers of the NHS and it isn't free at the point of delivery.

Presumably, the op opened the thread in shopping.

It’s in AIBU, I think they’ve ’labelled’ it wrong. I supposed it’s still being seen but it feels like it’s minimising it

footpath · 18/05/2025 08:54

@Howisitonlymonday thank you

Shedqueen · 18/05/2025 08:57

This is not going to go down well BUT this is the situation in lots of professions. Solicitors, barristers, accountants, many teachers don’t have jobs at the end of training or have to move because more are trained than there are jobs. DD did a five year degree in engineering and has a bigger student loan debt as didn’t get the NHS support that medical students do.

i totally agree the F1 arrangements are harsh. Pay is low compared some other professions training but against that is pay is the same for everyone working in England or whichever part of the UK they work. And improves quite quickly. People have always moved for consultant/ GP partner jobs but not all do.

i think young graduates are having a tough time generally, medical graduates included. Doctors do themselves no favours by thinking they are exceptional.

SaySomethingMan · 18/05/2025 08:57

Howisitonlymonday · 18/05/2025 08:32

I'm a clinically practising GP and also work in a UK medical school.
The training jobs situation is complex and multifactorial (apologies for the long post!):

Previously we did prioritise UK doctors for training posts. The current situation has arisen because, for many years, UK NHS Trusts were unable to fill many of their training posts. This was because UK graduates wanted to go off to Australia/ NZ/Canada for a few years, or wanted to train part-time, or wanted to do trust grade/locum posts until a very specific post became available. Trusts had to jump through a lot of hoops to employ an IMG, so it was disincentivised. Training posts have a significant service delivery element, so it had become very difficult to run safe rotas, especially in areas of most need (outside of the SE and major cities). The Conservative government had threatened for some time to open up these posts so that IMGs (international medical graduates who have passed stringent UK medical exams and language tests) would have equal standing, and eventually they did it.

I don't think the DoH had any grasp of just how many experienced, well educated IMGs would apply for training posts - they are outcompeting our UK grads because they have years more experience, so on a points-based application/interview they can easily get the job, and there is also the phenomenon of the application portal getting saturated before UK grads have had chance to apply. This policy needs reversing and quickly, but there is a little bit of me that thinks that UK doctors have been very happy to take advantage of the international jobs market when it suits them, and were very happy to go off to Australia rather than take a job elsewhere in the UK, but don't like it when the privilege is reversed.

There have also always been bottle necks in training in different specialities from time to time, partly because workforce planning in the NHS has been non-existent forever, and partly because many surgical and some medical specialties are very competitive, not everyone who wants to have that career will be able to, or they may need to move around the country to train, and that has always been the case and was accepted by doctors. If you were offered a post in a competitive specialty that was at the other end of the country, you would always have had to take it and be thankful. This is especially true of many surgical specialities. Many of us, myself included, have had to make the choice between moving away to pursue a more competitive/smaller speciality (most surgical specialities, O&G, cardiology, some smaller specialities), or staying local and going into something (usually GP or Psychiatry, or A&E) that is easier to get into.

NHS jobs are made where there is a population need, not where doctors necessarily want to live and work. There would be an outcry if we were using taxpayer's money to make more jobs in the SE/ major cities than are needed, and fewer in the provinces, to accommodate the preferences of doctors. New UK graduates are guaranteed a foundation training place but, again, it may not be where they want to be geographically. This is the case in other countries also. Yes this is harsh when people have to move away from their support network, but being a doctor in training has always been very hard.

There is also the situation that a PP refers to of doctors who have completed training being unable to get consultant posts. Again, for surgical specialities this has been the case for as long as I can remember - there would be an expectation of a post-CCT fellowship, often abroad, or a higher degree, before you'd be competitive for consultant posts.
For GPs and generalist hospital posts, availability of jobs comes and goes in waves and is due to the funding landscape at the time. When I got my CCT in 2007, only two doctors in my training cohort of 60 were able to find substantive jobs straight from training! We then had years and years of there being loads of jobs because people preferred the flexibility and higher pay of locum work. The jobs market has tightened up considerably in the past 2 years, not because the work isn't there, but because there's no money/space to employ people.

The GP locum market dried up completely within months when the ARRS funding (specifically for nurse practitioners/ physician associates etc) became available and practices had an incentive to fill their empty rooms with essentially free HCPs rather than expensive locum doctors. The empty substantive posts then all filled within a few months, as long-term locums couldn't find work and scrabbled to get into substantive posts. This has been great for practice - GP numbers have stabilised for the first time in many years - but we have the ridiculous situation of GPs who are unable to find work on one hand, and the GPs who are in jobs being overworked to the point of burnout on the other, because there are still not enough GPs for the complexity of the workload and there is now a huge supervision burden in practice, because NPs and PAs are (in some practices) being asked to see patients that are too complex for their training.

The labour government is hearing all this, the BMA and the Royal Colleges are lobbying hard, but it takes time and attention to sort all of this. So far we have had sticking plasters (such as ARRS funding being allowed to employ newly qualified GPs), but they are busy writing their 10-year NHS plan, and re-working the long term workforce plan, both due later this summer, and we won't get much else out of them until that point. History suggests that this situation will get resolved, but it is hard on the people who are caught up in the mess at the time. I narrowly escaped the MTAS debacle of 2007/8, which affected many of my peers, but we are all now working as GPs and Consultants. I would advise anyone in this situation to take whatever job they can, even if that means moving elsewhere in the UK for a couple of years, or doing a fellowship post, or going abroad, and bide their time.

Thank you for explaining things so clearly.
It reads to me like the UK looks abroad to subsidise HCPs availability easily.

RosesAndHellebores · 18/05/2025 09:02

MrsBennetsPoorNerves · 18/05/2025 08:48

We used to have the Resident Labour Market Test, which required employers to demonstrate that they had tried to recruit from within the UK first, but the last Tory government chose to scrap that.

That went hand in hand with Brexit and losing workers from the EU. They had to make it easier.

Academics are recruited from abroad because of REF scores and research funding.

I can't help but wonder if all those overseas doctors have to pay the NHS surcharge or are they exempt from that?

mumsneedwine · 18/05/2025 09:06

Predicted to be 20,000 UK trained doctors unemployed in August. Not sure that’s ever happened before.

Its v v hard to get a fellowship post as 1,000+ applicants in 24 hours and the job closes. Abroad not possible for everyone as have families. All young doctors I’ve met are willing to move anywhere in the country to just have a job this year. V few locums so can’t pay your bills. It’s a disgrace.

I say this as the mum of a young doctor who has got into training. But so v many of her friends have not. They want to work in the NHS anyhow and anywhere, but there are no jobs. One is intending to go back to being an HCA (ironically will earn more doing that on a bank holiday than she currently does as a doctor).

footpath · 18/05/2025 09:09

This is not going to go down well BUT this is the situation in lots of professions.

I do agree with the this, it's one reason why we have seen wage stagnation for the last 20 yrs. Austerity & QE really did a number on young people & governments & companies haven't invested in them.

GreenFressia · 18/05/2025 09:13

So universities made money from training doctors from overseas and the NHS doesn't have jobs for them.

Sounds like standard conservative party policy to me. Make a quick buck at any consequence.

mumsneedwine · 18/05/2025 09:13

I think a difference with doctors is the NHS waiting lists are huge. We need more doctors as they could sort this out. But we have less. Doctors pay has not stagnated, it’s been cut by 22% (was 35%). And all
this has happened since these young people started medical school, so they didn’t ’know what they were getting into’. They have £100,000+ debt and have studied 5+ years at Uni, done 2 years service provision, often working 72 hour weeks, to be told oh sorry, there are no jobs.
Meanwhile Australia and New Zealand are actively recruiting them. They get the jobs their own graduates don’t want. No one thinks that’s unfair if a bad idea.

footpath · 18/05/2025 09:16

Sounds like standard conservative party policy to me. Make a quick buck at any consequence.

Indeed!

mumsneedwine · 18/05/2025 09:16

@GreenFressiaLabour are not currently proposing any changes. And UK students are also unemployed. But you can apply from another country and get a job so all the taxpayers money training our staff is wasted. And many of this non UK staff don’t intend to stay long term.

PurpleFairyLights · 18/05/2025 09:20

Destiny123 · 18/05/2025 07:18

An f2/3 isn't a surgeon by definition

DC is not an F2/3 but an ST2 in surgery so is due to go into 3rd year of surgical training (higher surgical training). .Passed both membership exams and invited to join Royal College of Surgeons. F2/3 is very different to someone that has finished ST2.

OP posts:
TizerorFizz · 18/05/2025 09:20

In very few areas do degree holders match jobs available! It’s been like this for everyone else for many many years. We’ve increased numbers training so of course it’s not a perfect science when looking at the jobs market. I agree that it’s about biding your time. As others have to. Not earning - not paying loan back. The size of the loan is immaterial,

GreenFressia · 18/05/2025 09:20

mumsneedwine · 18/05/2025 09:16

@GreenFressiaLabour are not currently proposing any changes. And UK students are also unemployed. But you can apply from another country and get a job so all the taxpayers money training our staff is wasted. And many of this non UK staff don’t intend to stay long term.

Agree with PPs that this needs to be taken to local MPs / and the media. It doesn't matter who started it- what I'm saying is that it shouldn't become a dig at Labour or blamed on the last party i.e. Labour saying 'nothing we can do' - but it needs sorting out.

oddandelsewhere · 18/05/2025 09:22

@Howisitonlymonday thank you for setting out the situation so clearly. I think that part of the problem is that many newly graduated doctors don't realise that getting jobs and therefore experience has always entailed moving, and that continues to be true. Also the massive increase in undergraduate places is only that, it isn't and never was a job guarantee. The career structure is pyramidal and only the base has been broadened, there are still roughly the same number of senior roles. Inevitably this means employers can be picky.
The problem is compounded by the fact that some of the new medical schools have lower entrance requirements and many of their graduates would never have become doctors in the past.

GreenFressia · 18/05/2025 09:24

TizerorFizz · 18/05/2025 09:20

In very few areas do degree holders match jobs available! It’s been like this for everyone else for many many years. We’ve increased numbers training so of course it’s not a perfect science when looking at the jobs market. I agree that it’s about biding your time. As others have to. Not earning - not paying loan back. The size of the loan is immaterial,

I disagree - wheres the attractiveness in doing a degree you can't use. It's also proven that just six months of unemployment can have a long term lasting effect on how effective someone perceives themselves to be at work.

Please create an account

To comment on this thread you need to create a Mumsnet account.

This thread is not accepting new messages.