I understand that even Consultants are now recruited from overseas. This apparently leads to problems in that they are used to different ways of working, and can then, presumably through lack of confidence, struggle with decision making. Whereas at a more junior level, if there are problems, it is possible for other team members such as nurses/junior doctors to have a discrete word with the registrar or consultant. Much more difficult if the person is a consultant.
(And worth noting that the problems might not be medical, but the way a doctor interacts with fellow staff or patients.)
@ProfessorLayton1 your post was interesting. A couple of years back I was trying to help an older Ukrainian doctor find work. He had a pretty starry CV, including radiology, but little English so was looking for work, perhaps with ultra sound. He was 60 so did not have time to jump through the doctor hoops. I asked a friend who had just made consultant at a very young age to look through the CV that I had helped rewrite, and he showed me his. It was weird, pages upon pages of competitions won in Thailand and publications in Peru. I did not understand it as it was so completely unlike the CV you would see for any other profession. I now realise he understood the game around collecting points. I just wish there was more interest in actual experience and how you perform on the job. It is fine and dandy to have all sorts of publications or to have stuck to a narrow Oxbridge/London path but what happens to the smaller regional hospitals. I have heard older doctors complain that the system is producing plenty of specialists, but out in the sticks they need general pediatricians, geriatricians, even general surgeons. DD is currently in one of those hospitals, somewhere I had never heard of until she went there. 40 on trolleys overnight, massive bed blocking in intensive care, a really deprived area with inadequate mental health provision and a huge drug problem. She is really enjoying it, likes being busy, and would be happy to stay. I am confident that her colleagues would love her to stay. But...she is busy and does not have the time to faff round looking for obscure competitions to enter. Her deanery is less popular so it used to be that if you could probably stay if you wanted. Now with the massive increase in overseas applicants it will be very tough. With the real likelihood that DD and her peers will have to be content with zero hours jobs covering for staff absences, and having to hand hold new arrivals whether locums/F3s/specialist trainees or consultants. What is this about?
I have said that doctor's children tend to do better because they can access parental networks as well as their own. DD is lucky as she, in part because she saw the writing on the wall, bought a house and so could take in a lodger to pay the mortgage whilst essentially working as a temp doctor on insecure short notice, short-term contracts. She comes from central London so could also do what a neighbours child did, which is to come home, take on similar temp work which those paying rent can't afford to do, and then slip into a more structured locum/F3 job in a London teaching hospital which hopefully will lead to a training position. A different approach was taken by my cousin's daughter in the days when it was easier to get F3/CTF jobs. She went to live at home with her medic fiance in an expensive part of the home counties for a couple of years, so had time to study for exams (whilst mum cooked meals etc) and do well enough to get on GP training. It also meant that they had money saved for a deposit.
In short for all the talk of diversity and encouraging non traditional applicants, the system is set up to advantage those whose parents can step in and help.