To finally agree with a junior doctors strike

[Horsehow]

Junior doctors have decided to strike as they are being overlooked for jobs / training posts which are instead given to international applicants. I’ve always abhorred their money grabbing strikes in the past, but support this one 100%. UK doctors should be recruited where possible, and international graduates only turned to where we cannot find a suitable recruit in the UK.

A compelling one liner would probably be faster than the multitude of posts having a go at people over and over.

Up to you, you have an audience ready to hear it. Makes no odds to me.

If that’s it then I don’t see it standing up as the reason. It may as well be changed.

There were no accusations of deficient UKMGs or deficient UK medical training pre-2019. Of course no system is perfect but strange that these arguments have surfaced now from pro-IMG posters.

As you genuinely seem to want some answers, this is my perspective.

It goes without saying that medicine has a hierarchical structure. The government decides how many people are needed at the top, or rather how many they are prepared to pay for - with the infrastructure that each of them requires to function effectively, beds, operating theatres, hospitals, and junior staff. However, once appointed a consultant or GP stays in post for thirty years and juniors' training has been reduced to well under ten. So while it may seem to some people (including the BMA if you take what they say at face value) that NHS workforce planning is like planting turnips, and if you plant more seeds you get more turnips, this is not the way it works.

The NHS has always required an excess of doctors in the middle grades but their relative numbers increased when their working week fell to 48hrs after the EWTD kicked in fully in 2009, and consultants' working hours were unchanged. Historically this was alleviated by IMGs who came here for training (from their perspective but provided a service from everyone else's) and then most left, which meant that UK graduates - after a longer period of training - had a reliable progression to a consultant or GP post.

The response to mounting dissatisfaction among doctors and consequently poor retention has been to expand the number of medical schools, with plans to increase qualifying doctors by a further fifty-percent, essentially throwing more fuel onto the fire.

The short answer to your immediate question is that because retention is dreadful IMGs are filling the gaps and will be required to do so in increasing numbers according to the GMC until medical school expansion catches up.

www.gmc-uk.org/-/media/documents/somep-workforce-report-2024-full-report_pdf-109169408.pdf

Competition to maintain standards/ reduce complacency, especially with the new lower standards for entry to UK medical schools than has been the case.

The rudeness has originated entirely from the other direction, if you read the thread.

Why are IMGs filling "gaps" when we have unemployed UKMGs?

There are no gaps anymore ? There are unemployed doctors.

What lower standards ? Offer is AAA-AAA* as always (used to be BBC in the 80s). UCAT required has got higher every year. What has lowered ?

And please highlight where we have been rude ? I've been called many offensive names, told I have a reading age of 9 and been called a liar. Not once have I said one rude thing about you.

We don't need IMGs to to raise standards in UK medical schools or UK medical education leaving UK doctors unemployed.

Entry to UK medical schools, medical school education and specialty training are incredibly robust systems.

This is an example of the excuse that is always given by pro-IMG posters when trying to justify the UK doctor unemployment. Basically UKMGs and UK medical education is deficient in some way so thank goodness for the (20,802 in 2025) IMGs coming to the rescue.

That can't be right, can it - that UK medical degrees are less effective than overseas ones?

I read - following a link from a paper that Marchesman referred to yesterday - an interesting paper here, which said: "PLAB graduates’ knowledge and skills at MRCP(UK) and MRCGP are over one standard deviation below those of UK graduates, although differences in training quality cannot be taken into account. Equivalent performance in MRCGP(UK) and MRCGP would occur if the pass marks of PLAB1 and PLAB2 were raised considerably, but that would also reduce the pass rate, with implications for medical workforce planning."

PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study | The BMJ

I'm no scientist (humanities grad here!), but I read this as saying that overseas medical grads perform less well than UK grads in some important medical exam thing, but as the UK currently needs the staff, it doesn't matter?

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Thanks for that. Very interesting. UK medical education is excellent so no idea.

From Wes's letter to the BMA. Apparently some people are unhappy as it will cut their money tree from IMGs.

I don't see any other way of reading it, myself.

And it is probably worth noting that post-2000 medical school graduates (who do less well in MRCP and MRCGP than other UK graduates, inevitably contributing to the unemployment figures) only started to be included in the PLAB paper towards the end of the study period.

That won’t be a factor in the DoH thinking, so it’s an irrelevant point.

I don’t get a sense that anyone on this thread has any commercial interest in IMG recruitment, regardless of the very heavy handed hints on the part of yourself and PurpleFairyLights. The points which have been made are based entirely on the notions of merit and competition. I understand why you want to imply an ulterior motive, but it just isn’t sticking.

This letter, written yesterday, shows that Wes Streeting hasn’t in any way ‘lied’, as PurpleFairyLights posted. His integrity is entirely intact.

Peony - youa re adding another element into this thread. "to prioritise UK nationals that were trained here "

This is not what purple and mums want they want international ukmgs on non uk passports to be prioritised over uk citizens who may for wat ever reason have chosen to trin outside the UK. Simply because they went to a UKMG- many internationals in UK medical schools now as it is a money making business. Should they have priority over a UK citizen who went on a scholarship to the US for sport etc and studied medicine out there and passed PLAB now wants to live and work in their own country?

Do not lie. We have said all along that UKGs are anyone who has trained here. Do not try and make this racist. You demean only yourself. Apologise now or I'll report this post as it is blatantly untrue.

When I went to medical school the standard offer was CCC. At that time only 16% of pupils left school with more than 1 A-level.

Now 25% of pupils get grades that will get them into a medical school.

What do you think has lowered? This is like trying to explain calculus to a fish.

And yes, I do believe that people who have committed to this country should get preference. They paid a fortune to train here. They understand the NHS. They should get priority

Did you not read the comment from MN ? Or is abuse just standard for you ?

That's why UCAT was brought in. To sift out the quick thinkers and ones who won't kill the patients.

Please try not to resort to personal insults. I've never tried teaching calculus to a fish but I do teach it to 16 year olds every year. It's in GCSE now.

No, UCAT was brought in because of DEI, and it has been an unmitigated disaster because it is easier to game than academic attainment.

It bears no overall relationship to GMC sanctions - unlike academic attainment.

Some interesting reading from Sir Chris Witty. Not sure why it took an expensive review to conclude what me and @PurpleFairyLights (& many many others) have been saying 😊

https://www.england.nhs.uk/publication/the-medical-training-review-phase-1-diagnostic-report/

I think the stat purple used that UKMGs make an average of 1.3 applications and IMGS make 6.3 supports the theory you need to apply in the first instance.

The belief that 20000 IMGS have taken jobs from UKMGS is not true because on that basis there are not 20000 actual individual IMGS but 20000 IMG applications, 20000/6 individuals. That statistic fits better with the ratio of applicant to posts which range from 1:1.3 in some specialiites to 1:6 in other more popular areas when actually broken down.

So you know better than the GMC and every Uni in the country ? Even Oxbridge use it now. Not sure how it's a disaster. We seem to be producing pretty great doctors, which the rest of the world love to employ.