We may be describing the same issue from different angles.
As I said in my post, DD's deanery has been hit by a number of F1s not turning up. You have the same problem with F3s.
Could it be the lack of career path that is causing young doctors to drop out, either to a different career or to another country? Reddit, when I last looked, was full of discussion by young Indian doctors about why taking up alternative offers in the US, Canada, Australia or NZ were preferable to a move to the UK. There is the risk that young UK doctors are also reaching the same conclusions.
DD may have many faults, amongst them indecision. She had always been interested in a particular, competitive, speciality but F1/F2 rotations caused her to change her mind. She is now torn between two other specialities and ideally would spend F3 time in one or the other before deciding. Her generation will probably be working to they are in their 70s so she wants to get it right. (Covid struck during her first clinical year so she missed out on ward experience in some key specialities.)
F3 has always been an option so I am surprised that this approach attracts so much criticism.
The issue now is not the six month jobs but the having to compete with several hundred for that six month job. And then doing the same for the next and the one after. Unless you are very lucky, this is hours and hours and hours spent writing applications alongside work and the rest. With the very real possibility that some of the overseas applicants will be offering better experience and additional qualifications. Very different from Australia where you seem to be able to make one application to an agency, or complete a state wide application followed by applications for specific jobs or rotations within a speciality, ie that you move round as in the UK but over a two year programme and with the chance to gain a breath of experience within that speciality. No need to reapply for jobs every six months. The role she is hoping to get will also allow her to be involved in research, so she should end up in a better position to then apply for a UK training place than she would if she found something in the UK.
Her friend did it all right as far as previous posters are arguing. Came from a w/c background, applied for training during F2 but did not get a number. Eventually found a scarce F3 short term position, in geriatrics. She too is looking at Australia. Her current role is not giving her the experience she wants and is, well, boring. (Most work is carried out by HCPs but they need a doctor around.) It is not just this year that is affected. Previous years have suffered from the increase in worldwide competition and there is a backlog. In six months time she might have nothing. The career path in the UK is broken and a good proportion of competent doctors will need to go overseas to get the experience required to progress.
I was genuinely surprised a few weeks ago to hear that a local family were heading to Dubai. Couple in the 40s with children. She is a consultant and has landed a good job there.
It used to be that a proportion of IMGs would leave after completing their training in the UK, whilst others would stay. I suspect that the proportion leaving is now higher. With the grown of the private sector overseas, I had also heard the it is increasingly common for consultants who were originally from overseas not to wait till retirement but to now head home once the children are grown. Indeed some will start a pattern of retaining residency in the UK to ensure DC have access to higher education, but in parallel start to spend periods working in well paid medical centres overseas. If UK educated and trained consultants are also heading overseas half way through their careers, the NHS really does have a retention problem.
Rather than blame young, or middle-aged, doctors for abandoning the NHS, it might be more constructive to ask why.
- conditions. DD says it is why Consultants she has worked with talk about leaving. You can only hold the fort for so long.
- competition for jobs. Too much competition, as we have following the lifting of the RMLT, makes job search a lengthy, difficult and often unrewarding process. Opening up entry level jobs to full international competition may allow a Trust to recruit someone very experienced at the bottom of the pay scale, but it takes work away from unemployed doctors here who need both the work and the experience.
- the lack of reward for merit. DD and her friends work for a Deanery which still uses the old 2005 F1/F2 contract. They have been in demanding jobs with irregular shift patterns and have delivered. Yet strong appraisals and references and good experience give them no advantage. Indeed they are disadvantaged when it comes to applying for F3 or training. .
- the relatively low number of training places and the high competition. (And the continuing high levels of competition further along the training pathway.)
- the opening up of job opportunities around the world including the US for newly qualified Doctors and the growth of private health centres in the Middle East, Asian and elsewhere keen top recruit experience UK trained consultants.
In short is it sensible to be unconcerned that 50% of this years F2 leavers will be unable to stay in the NHS? Are we sure that we are retaining the right 50%? And are we bringing in the right doctors from overseas to take their place?
Then how do we keep the ones we train. How is the NHS placed in the market for sought after consultants? Are the careers offered competitive with the UK private medicine sector or private medicine elsewhere?