Newly trained doctors-you need to know this

[2020Raquet]

DSS3 is about to be a newly qualified FY2 doctor along without about 8,000 from his cohort (number who qualified this year). There are about 1000 jobs for them to apply for in the NHS this year. So we, the tax payer have paid an average of £250,000 to £327,009 to train these doctors over the past 7-9 years and 87% will not have a job.

A simple google search (appreciate that not be the most accurate, so happy to be corrected if based on facts) show that 20,060 doctors immigrated to the U.K. in 2024.

DSS3 is emigrating because he has little other choice.

The doctors strikes are not based on money, but the fact that they come out of uni with £100’s of £1,000’s of debt in a job apparently vital in the U.K., but with no job prospects!!

AIBU to believe the system has failed.

I had 2 years of chronic pelvic pain due to having a 10lb cyst removed, I could barely walk. GP's and consultants keep giving me pain killers. Then finally was sent to a pain clinic, where fluke would have it, an amazing man who knew his stuff looked after me. 1st treatment took away 50% of my pain, then two more treatments took away another 40%. He gave me back my life and never met a kinder, or more 'human' doc in my life, he even had a great sense of humour and am getting on a bit!

He was also training other pain management teams, up and down the country, challenging the out of date method of NHS treatment, specialising in ladies pain and pain in the elderly. He was also training some 'back home', in Iran where he was from. I am grateful for him more an any other UK born doctor who just wanted to give me codeine or tramadol - which has been proven not to work anyway! There was no cultural differences coming into play with my treatment, what an odd thing to say.

The NHS would be lost without foreign workers, it would collapse overnight.

Why do we have such a high proportion of immigrants as doctors if we have so many being trained here? I’ve had more interaction with the NHS than I’d have liked and from nurses up to the consultants through the process they were more often than not immigrants (all lovely by the way, not complaining about that directly but in the context of this thread).

Would you not think it odd if, on a visit to, say, Poland, you needed healthcare and discovered that most or all of the medics were from overseas, maybe from Bolivia or Vietnam? No questions, concerns, curiosity as to how this situation had come about and whether the Polish people were ok with it?

I am also a frequent user of NHS due to my own ill health and my mothers. The last year I have had 4 stays in hospital and my mum has had 2.
i am not racist and I only speak as I find. My Indian consultant and surgeon was amazing and spoke English very clearly and was most articulate. I also had several Indian nurses care for me - again they were of a very high standard as were the Phillipinos . However, some of the Nigerian male nurses were imho quite misogynistic and I felt very vulnerable around them and they were not keen to answer the buzzer.
its very easy to accuse anyone who criticises the training and language skills of foreign medics of being racist but it’s far more nuanced than that in reality and cannot be remedied until people feel able to voice these concerns without being labelled as bigoted/ racist.

Indian medical and nursing schools traditionally followed a “British” style approach to education so yes, are generally better “prepared”. European nurses tend to hold similar cultural values.

There are problems with those coming from sub-Saharan Africa. They have huge corruption there whereby “agencies” can recruit basically anyone to get a visa to come and work in the UK caring sector.

These are places where for example, HIV rates are amongst the highest because women have no right to say no to sex with an infected partner. They practise FGM on young girls. They have some of the highest typhoid and other communicable diseases levels globally because they believe that demons are responsible for disease, not a lack of good hygiene.

Ask yourself this - would you want to be a patient in a hospital over there?

But yeah, let’s employ them in there 1000s to “care” for our vulnerable people.

Not necessarily that academic with doctors though. I was quite shocked to see how low A level results can be to get into medical schools in countries like Bulgaria. Or that you can be trained to be a doctor without speaking the local language - so never properly engaging with patients.

The training more I think is fairly new. I can remember the tories cutting doc training places, against the medical council's advice' because it saved money. They knew it was cheaper to have overseas staff in and they were advised that in about 10 years there would be a shortage of docs as they retired or moved away - we're at that stage now. I think now the NHS just can't afford to hire docs, despite being so badly needed. Thanks our governments!

The same tories cut bursaries for nurses, midwives, radiographers etc and the numbers applying dropped but they again, relied on foreign staff. I believe a bursary of some sort for nurses is back but not 100%.

The whole lot has been royally mucked up and they knew what they were doing and simply didn't care.

One key point youre missing.

You’re comparing training posts with all qualified doctors from an immigration perspective.

Your many of those will be going into roles your relative isn’t qualified for.

Although I do agree, I can’t understand why visas are issues for training program places.

Thanks for explaining, what a cock up indeed!

Agree. When there was the case of a British based Palestinian doctor suspended earlier this year for anti semetic posts on SM, it made me wonder about how potentially dangerous a situation could become, whereby she was treating someone Jewish. Would her beliefs affect what treatment she provided that person with? It’s really a myth perpetuated by those on the left that without immigration we would be screwed because we need doctors and care workers. We have enough trained doctors coming through, and we have enough people to fill health care posts if we reform the Welfare system to get people back to work. I hope your DSS gets a post OP without the need for him to go abroad. We need good quality doctors not someone coming in with a Mickey Mouse certificate from a country with low standards of training.

My late husband who had Parkinson’s - quadruple heart bypass - I simply couldn’t understand a word the doctor said he wasn’t English and gabbled away at a speed it was impossible to understand my husband was hospitalised many times I couldn’t understand a word and said I needed to speak to a person who could actually speak English I feel if people are in the NHS should at least speak English

Stop with the racism accusations. My Father was an immigrant and spoke a decent level of English but his accent was very heavy, DH really struggled to understand him sometimes and did others. In times of stress people need clear communication.

And yet they managed to employ 20,000 overseas doctors last year whilst simultaneously leaving 48% of British trained FY2s unemployed - despite in theory there being enough training places for nearly all of them.

https://www.nursinginpractice.com/latest-news/applications-to-uk-nursing-programmes-hit-record-low/ The government needs to do more to make nursing careers attractive, pay being a major factor. Furthermore stop putting junior staff at the forefront of care and put qualified registered nurses there. Studies have been done to say if the registered nurse to patient is more than 1 to 6, the death rate rises on the ward. qualitysafety.bmj.com/content/32/5/254 Is the latest in a long line of studies. And in my opinion get rid of titles such as Matron, to grades of nurse manager, so men can be attracted to the profession, to make a more equal workplace . all staff who come to the ward have to undertake the care certificate to instill values of person centred care, dignity choice. To enroll on the TNA program learners have to complete a level 3 diploma in healthcare which again cover the values expected in nursing.
i see first hand these attitudes of distrust of overseas nurses, affecting frontline care from dedicated healthcare assistants and nurses. I believe that anyone who has the guts to step up to attempt to help another human needs to be supported, no matter where they are from.

Well good luck to her an awful lot of money wasted on becoming a doctor hope she pays it back

No this is factually incorrect

There was no money due to the debts that arose via PFI so the Blair Government could imply there was lots of money by making everything look shiny and new. It's a much older problem than post 2010 and has its roots as far back as 1947 when the UK implemented the wrong system. A system the GPs were diametrically opposed tonfor all the right reasons but came on board because their mouths were stuffed with gold not because they had the best interests of the people at heart.

Once again, Shipman isn’t relevant. No-one is saying that all doctors who speak perfect idiomatic British English are good. That is trivially obviously untrue.

I am specifically talking about risks to patient safety where doctors and patients can’t understand each other.

Have you looked to see what IELTS level is considered adequate for doctors who do not speak English as their first language? Do you think that is a safe level?

”I believe that anyone who has the guts to step up to attempt to help another human needs to be supported, no matter where they are from”

I dont!

Are you really that naive to think all of those coming from abroad to work in MH and the care sector are doing it for altruistic reasons? Those of us with vulnerable family members using the sectors can see this is very much not the case.

Also there are many young UK people
wanting to train to be nurses but they actually want a job at the end of it. The lack of jobs is the issue.

In what way? There are more training places than UK medical graduates.

The problem is the number of overseas candidates.

https://www.independent.co.uk/news/uk/home-news/wes-streeting-government-bma-general-medical-council-whitehall-b2774826.html

I think people forget that English as spoken in many ‘English speaking’ countries has diverged quite a bit from English spoken here. It isn’t just an accent, it is a different way of pronounciation, sometimes a creole or pidgin (a mix of languages). So when they say they speak English they don’t actually speak the same language as us.

And yes I do worry about the impact this has on the Reform vote.

The Tories caused this. Labour are doing SFA and would rather throw vulnerable patients and med/ nursing students under the bus than prioritise UK trained staff. So that leaves reform looking increasingly attractive for many( not me) which is kind of ironic considering they want to privatise the NHS. .

It's across the entirety of the NHS

There are no jobs for GPs either - ridiculous amounts of GP unemployment and underempolyment.
Consultants that have just cct'd are also struggling to find work
When people leave or retire they are not replaced as there is a hiring freeze in some trusts.

In my experience:
This means that 2 week waits are being seen in 4 weeks
Urgent appointments are seen at 8 months - year later. When I first qualified max was 2 months.
Routine hospital appointments take up to 18 months
Skin cancer surgery 9 month wait.
Hernia repairs patients are waiting 2 years. Longer in most cases
Joint replacements 2-3 years.
ADHD assessments for adults 3-5 years

What a great system to work in and what care we are delivering.....not

Some misconceptions here so a brief summary
of the way it works in the UK:

1. You study 5 years at med school to qualify as doctor (or 6 years if you do an extra degree intercalation). The govt has been gradually increasing numbers of places at med schools.
2. After graduating you work 2 years as foundation doctor in which you rotate around various hospital jobs. You are a fully qualified doctor but still learning as you are for the rest of your career. Foundation places are allocated by lottery (literally). For the past couple of years the number of foundation places has not correlated to the number of foundation doctors causing some immense stress but this isn't the main problem referred to here.
3. After working 2 foundation years doctors then have to apply for their next job. A job is not an automatic given at this stage (fair enough). It could be a core training job if you want to be a medicine type doctor, surgical training, or GP training. Qualified doctors from other countries are also eligible to apply for these jobs.

THIS IS WHERE THE BOTTLENECK IS. There are not enough training jobs for the number of doctors coming through from Foundation years. There has been a decrease in the number of training posts, and a large increase in the number of applications for the posts in part caused by a large increase in the numbers of overseas qualified doctors applying. To get an interview for any of these posts a doctor has to first have a certain number of points gathered from their previous experience (for things like teaching and publishing research). Anecdotally it is easier to get experience in some of these areas of work if you have qualified and worked overseas than if you are an NHS Foundation doctor who is very unlikely to be given a look in on a research paper at this stage. The alternatives to a training jobfor a recent F2 are shorter term fill in non training jobs and locum jobs. These jobs are also now really difficult to get as a knock on effect. The result is that large numbers of UK trained doctors are becoming unemployed after their foundation training years. Many are going to Australia, some are giving up altogether.

Not only is it a crazy waste of UK tax payers money to train doctors that we then don't employ. It is massively demoralising for UK trained doctors to feel that they are being put on the scrap heap and undervalued after working incredibly hard in pretty difficult NHS conditions.
THIS is why doctors are striking..

I know, our government(s) are rubbish.