Ideal university for Medicine

[Kayt79]

DS is in Y12, and set on Medicine. He's been to a few open days already, but until he's done his UCAT next summer it's impossible to know where will be realistic to apply.

So, just out of interest, and putting aside entry requirements and "prestige", which would be your ideal universities for Medicine, based on the overall student experience?

@PlopSofa it's unbelievable that the press are not more interested. Maybe in August when a chunk of doctors are signing on will anyone take notice.

Meanwhile Australia and New Zealand are recruiting the F2s by the lorry load. However they take the jobs their own graduates haven't filled. Like every other country in the world.

I am also really upset.

Five out of six of DDs placements involved busy wards, very sick patients and lots of nights. She is now working in a specialist out patient department. It really is like night an day. She has a regular sleep pattern and time to sleep, catch up on admin, have a regular social life and, if there were any point, time to study for exams.

But too late. Others who were at medical school with her had no nights at all or regular hour community placements. Others overseas will have add-ons like "gold medals" (very very rare in the UK and bringing with them lots of points - but more common overseas) or published articles and conferences (again really hard to get published in the UK, much easier in some other places.)

Last week at my local leisure centre in central London I heard two young women with talking, in the accent of DDs deanery, about wearing about whether they needed to wear scrubs or professional geat. It turned out that one actually worked in the same hospital as DD and they were over for an Osci. They agreed the situation was awful and that they had been locuming for a while. They said that a couple of locum jobs were coming up in a hospital elsewhere in the Trust, and suggested DD gave them a go. Dd actually knew about then jobs, but first they are not great jobs and second she could well be up against many of her current peers, people with more experience from previous years, and then potentially hundreds of overseas applicants, many of who will have had the publications, conferences and other add-ons that the NHS seem to want. Being good at your job is not enough, indeed performance reports count for nothing. Better to have been accepted by the Phuket Journal of Medicine, or to have spoken at a conference in Tegucigalpa.

So Australia it will have to be, with a fall back of taking a masters degree (she intercalated in medical engineering which is a high demand area and can move straight to a Masters, indeed was told that if she ever wanted she should go back to the lab in which she did her elective and see if they had a PhD opening).

This is someone who genuinely wants to be a doctor, has passed all her exams, works hard and gets on with colleagues and patients. But not good enough for the NHS who prefer to take someone from a less well known medical school and no background in the NHS, as long as they tick the bizarre boxes the NHS sets. If conferences and publications are needed, why are our medical schools, who after all are expecting their students to take loans which then need to be repaid out of salary, not making sure that their students have whatever is needed to get jobs.

(From what I have read about the BMA over recent years their focus seems to have been rainbow lanyards. The recent strikes were about pay, something that was an issue for those already on specialist training or had worked their way up the ladder, not about the near complete cutting off of opportunities for newly qualified doctors. DD and her peers were always more concerned about conditions and career progression, but until recently the BMA has been almost silent. Pay does not matter if there are no jobs. And anyway the devolved government have already turned round and said they can't afford Wes Streeting's pay increase, and it looks as if he can't impose it - so its all irrelevant.)

Thanks again @mumsneedwine.
So from below 3:1 in 2024 to -3.6:1 in 2025. Not a major shift as previously suggested but continuing gradual trend up. Would be interesting to know success rates for CT1/ST1 posts by medical school in 2024 Also whether applications by IMGs are clustered to certain ‘specialities.

Poor Wales, NHS colleagues there are having a torrid time at the moment.
I agree with @Needmoresleep that conditions rather than pay should have been negotiated in view of economic restraints. The BMA should have been able to do that without strike action. More training posts and GP / consultants are needed rather than the same number of higher paid ones.

I had a chat my DF retired general surgeon, this morning.

he said the problem is that training someone to do a job takes time. It’s quicker for trusts to take on a highly skilled person from outside who can do the job immediately without needing training up.

It’s probably why Streeting is so quiet. The waiting lists are longer than ever. He needs to get through them to make the claim there’s improvement.

Hes sacrificing the young graduates at the door of expediency.

DF also said you can train someone up to do just one thing, over and over again, so they become very good at it, and then they become a technician of sorts, not a doctor but able to carry out that one thing. He said lots is low level stuff is going there.

Also that AI and robotics making waves.

Medical engineering could be a smart move for now.

His overall view was that medicine was more like war time medicine in hospitals. Having to do less of a job than you’d like to because of budget constraints and waiting lists and endless box ticking. For those with a vocation that would be hard because as a doctor you want to do the best job possible but that was no longer possible in the U.K. today.

Other than the good pension he described the nhs as the worst employer in the U.K.

He thought that the value and status of doctors would decrease over time.

Thanks for the block graph mumsneedwine. Where is it from?

I have to say that I'm just asking questions to find out more about the situation, not because I disbelieve that something deeply concerning is happening for graduates of UK medical schools. That's simply my background; I see that it may be misconstrued.

Although I would also say that yes it was indeed junior doctors who said the BMA figure was nonsense. But those same doctors fully backed the strike, lost heaps of money on strike days and generally struggled to pay rent. On the whole it's better when making a case not to get into hyperbole or hyperbolic numbers, which is what a lot of people think the BMA did - but these same doctors still went and held up the placards, because their view was that the main aim of the strikes was legitimate and justified taking a hit for.

AsTearsGoBy I am no expert but

1. The strikes were mainly in England. New F1s can choose, or be sent to, and of the four regions. I think DD only managed one strike day and that was to remind people that they still had not had catch up with the old English pay and conditions.
2. Junior Doctor is a wide ranging term, and as far as I know includes Registrars and others who are safely within the training system. They wanted more money. From what DDs told me at the time, new doctors really wanted a good look at their working hours and conditions, as well as career opportunities, indeed any job within medicine would be a start. Conditions over pay.

F1 and F2 is brutal. Allocation is no longer merit based and can be random and a long way from friends and family. Hours are long and wards are busy. Even early in the autumn DDs small town hospital had 40 on trolleys. They go through this, and then nothing. The jobs they may have hoped for are now open to world wide competition or to Physician's Associates.

One quick fix might be to allow F3s (for want of a better term) immediate access to PA positions. Better pay and more regular hours, and with medical degrees and F1/F2 experience they would be more than capable. This then allows them regular hours, and time to study for the exams, gain experience and add the effectively-required papers and conferences, in their chosen speciality. Thus putting them in a better position to compete against the international competition.

As for international competition, some overseas doctors will be very good. I have a friend who used to be Dean of a medical school overseas, and who now has a very profitable private practice. The plan was always for her son to come to the UK, like she did, to get his specialist training. Then to return home to take over his mum's practice. He may or may not be as strong a candidate as, say, DD. However his mum has always known what was required and will have been in a position to provide mentoring and contacts. (Actually if and when DD decides to enter the fray, I might need to contact the mum for suggestions for competitions and conferences DD could aim for.) Is anyone in the NHS taking a step back and considering what is best for the tax payer/patient in the longer term. FWIW my friend is astonished that the UK does not look after it6s own. There is no way that DD would haver any chance of training in her country.

I was discussing this with my doctor friend, a boy she knows who is a Cambridge graduate was allocated to somewhere he had no intention of going and is not very good in training - think this happened in the second round as well. He is not going to do foundation program at all in this country, but preparing to go to US and is studying for USMLE and has cleared the first part. I was surprised to find that one can go to US before completing FP!

I am sure he won't come back, why would he ?

I see both sides but it's depressing frankly.

Why is the NHS recruitment a global stage for any doctor to come here? Why do we not prioritise UK graduates, like we used to, in 2019?

The whole channel is dedicated to helping doctors from abroad apply for UK NHS places.

https://www.youtube.com/c/RoadToUK

There's even personalised appointments to guide you through the process.

@ProfessorLayton1
The USMLE part 1 is actually best taken fresh out of medical school due to the broad base knowledge needed. Some do it as final year UK medical students.

I said this some time back in this thread but some states are not favoured by USA trained residency applicants due to their antiabortion laws (as doctors get board certified for a state it tends to be a long term commitment when applying for residency). The other states will be far more competitive.

Sorry to hijack. I'm really shocked and sorry to read about the statistics and odds being stacked against UK educated medical graduates getting speciality training places. The long term consequences of this are obvious to see. Why won't the government make these changes?

I wonder if the UK points system is having an impact on other graduate recruitment. Computer science? Pharmaceutical sciences? Why create graduate training schemes for UK residents when you can more easily get qualified and experienced employees from abroad?

Cost of taking round 1of USMLE is £1,073. Not in the reach of a lot of medical students.

And why should our doctors be forced to leave their friends and family just to work. Most do not want to. But it's that or unemployment in August.

"@AsTearsGoBy but you can see that it wasn't untrue that they earned £15.33 an hour ? It's on their payslip. It's now £17.03. Whoop.

And you can't strike over conditions, only pay. Last government made sure of that 🤷‍♀️

@bookmarket -over 50% of students in certain universities are international. Kings, UCL, Imperial and LSE. I am not able to say how many are undergraduates though.
Medicine has a cap on international students but no other degree course has this. I am not aware of any other country having more than 50% of their elite university with international students. No wonder you see so many deserving students not get their choice of universities.

Yes the points system is impacting UK graduate jobs in many sectors. UK students are not prioritised for jobs when companies can recruit from a global graduate pool. Getting into graduate schemes, internships, etc is more competitive than ever. Highly able foreign students have been known to take up 60-70% of undergraduate places in London universities such as Imperial. I think it's 70% at LSE. With these highly coveted degrees, many hope to secure graduate jobs in London say in finance, tech, etc. Many settle here if they secure their dream job especially if salaries in their home countries are poor by comparison. This has become much easier to do post Brexit due to the points based immigration system. There is not enough protection and consideration for young people who have grown up here and worked hard at school. How disappointing must it be to finish your education as a home student and find all the obstacles in the way to getting the job you worked so hard to get!

It conveniently ignores the additional earnings which are not for optional overtime but for hours that they're required to do according to their contract. It's therefore a false figure. It undermined the credibility of the BMA to use that figure.

People should write to their MPs about this system. It's ridiculous and needs to be changed.

@AsTearsGoBy you are wrong. This year (& last) many F1s got made up jobs that paid NO extra hours. They are earning base minimum and no option to earn more.

And if they worked more they earn more, at £15.33 an hour. It's still the same hourly wage. And not optional. Christmas Day ? £15.33 an hour. Lowest paid staff in the hospital.

Sorry to pop in with a question that’s not really in step with the current posts, but I wondered, if they go to Australia or NZ for example, is this to do specialty training, or simply to have a job?

If they do specialty training in Australia or NZ does this transfer back home if they wish to return?

Just wondering as DD is 4th year and I know she’s aware of the issues as she seems busy trying to collect points already, but I don’t know if she’s thinking of abroad or not!

mumsneedwine on this one single point about pay you have on this thread used the term 'many' for a relatively very small group of F1s who got a duff deal. This goes back to misrepresentation again because the BMA represented that this was the pay per hour across the board, which it wasn't. The BMA represents the broad spectrum, and it represented itself on these placards as doing just that. All the junior doctors knew that it was a wild claim, as did the government, as did the press and as - rather obviously - did the BMA itself. I don't really know where you get the idea that it wasn't an exaggerated claim. It's just not sustainable as an argument. But I do completely agree that pay for new medical graduates is relatively low given the length of training required to get to being even an F1.

@Pleasestopthebunfight they usually go after F2 to do a house officer type job (like an F3 in a speciality). But can apply for promotion to speciality training after 6 months. Some come back, to try again to get training (so do MSRA from abroad or try and get published in that year), but many don't. Pay and conditions (& ability to have a job) are so much better.

@AsTearsGoBy believe what you want, but young doctors are not earning massive amounts, whatever you like to think. And the BMA were v clear that the £15 an hour was for F1. But if you want to believe they are all driving Bentleys then you do that.

My own DD worked 82 hours last week. Every hour was paid at £20 because they were all before 9pm. Not optional. Because no one else was around to cover the shifts. She has her job in Australia and visa application in. I am v sad as I never thought she'd be forced to leave the UK just to be in work.

@Pleasestopthebunfight sorry, forgot to add that if they do 2 years abroad in a speciality they can apply for ST3 jobs back here. Different process (but even more competitive).