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?

mumsneedwine I don't think pay is adequate, as I've already said. The point is only that looking at F1 pay in the round, the figure of £15 wasn't accurate; it was exaggerated downwards. That was also widely recognised. It isn't a subjective thing.

Hopefully your DD may still get a training post in the UK - it's not over yet.

@mumsneedwine thank you so much that’s kind of you to share the info.
Best of luck to your daughter whether than be specialty training here or overseas. Great that she has something lined up - although sad that it’s necessary.

The fact that mumsneedswine's DD may or may not get a training post is irrelevant. Many good intelligent young people who have already dedicated 7/8 years of their lives to medicine won't, and as importantly wont get any job.

DDs take home pay isn't bad, but this represents a lot of hours and a lot of nights longs (13 hour shifts) and weekends. And the expectation that during her free time funeral directors (its certainly happened each time I have visited - paperwork signed by doctors was getting lost in the system) could call or she was expected to undertake mandatory training. The sort of conditions and overall pay that would be unacceptable in any other profession.

It is worth remembering that though new graduates can be allocated F1 posts anywhere in the UK, terms and conditions vary. Ironically England actually offers better conditions and pay for F1/F2s than elsewhere, not least because NHS funding is uneven. DD priorities were better conditions, and a career path. There is no point having better pay if you don't have a job. And there is no point having a great but demanding job if you are too tired to learn anything. I also suspect she and her peers would not have objected if they were told that any additional funding was going towards improving mental health and addiction treatment provision. A specialist care home able to accept the elderly man with severe psychiatric problems blocking a hospital bed, or a treatment centre where they could discharge the "b&bs", drug users overdosing on a regular basis, who were repeat overnight users of ICU beds. In the event the regional authority has announced that they can't afford to pay doctors the Streeting proposed increases, and there is little sign that there is money for anything else either.

There are lots of other issues. Medical school places have expanded so they are having to create F1 jobs and there will be other frustrations that are probably found in any career. (Actually doctors in those jobs should not complain too hard. Regular hours and not leaving work exhausted leaves them in a much better position to study for exams or apply for locum jobs.) But these should not confuse things. The big, big problem is that those completing F2 are facing unemployment. Not training places, but jobs, any jobs. Application numbers, both from home and overseas applicants, are soaring and those who have been at the coal face for the past couple of years may have bags of experience and some very good appraisals, but are at a genuine disadvantage when it comes to NHS selection criteria. (Strangely Australians seem to like practical, experienced grafters - curious that.) .

Totally agree. ALL F2s deserve a job. Or why did we train them. Scotland pays more than England who pay more than Wales/NI- and as they work v long hours they weirdly get paid for those v long hours. But used to be at £15.33 an hour (as per the actual payslip I posted 🤷‍♀️).

Not one of DDs friends has currently got into training. No paediatric places or IMT. Both used to be the easier ones as lower applicants. Does not bode well for the next few weeks.

What a waste of a generation of young talented humans who just want to work doing good in the UK.

As Needmoresleep says, the critical issue is the lack of training places after F2. But re. the money side of things I can only see the top two lines of a pay slip - possibly an error with my computer - no reference to additional pay for nights or weekends.

Out of interest mumsneedwine - as you say your DD already has a job lined up in Australia - is that what the current F2s are doing: teeing up a job abroad before they know the outcome of the UK selection? Do they then hang on to the offer and only sign a contract once the UK selection process is over? Or does Australia not penalise for no shows once a job is agreed?

@mumsneedwine knowing what you know now about medical training in the UK, how would you advise someone thinking of pursuing medicine as a career here? Given everything you know now, would you recommend it? My youngest is thinking of doing medicine but unaware of the difficulties with training that lie ahead. Like you, I don't want my DC to move abroad permanently if securing a post becomes difficult over here.

@AsTearsGoBy they don't all work night and weekends ?? Eg psych,GP some F1 placements that are super numery.

@AsTearsGoBy yes, they are securing jobs now as otherwise they'll be unemployed in August. What choice do they have ? Australia know the score - they know if they get into training they might not come ℹ️.

@OneMorePiece weirdly my job as a teacher involves supporting students into medicine. And they are more deprived than my own, so life is harder for them (Aussie visas cost money). It's why I'm so angry that it's come to this.

I pray things change and local graduates are given priority from next year, but I'm not hopeful. It's a mess. I find it hard to promote it as a career if you want to have a secure job, but I think if you know the risks and still want to do it then it's a good degree to have. A lot can happen in 10 years though - we went from the best health service to a 💩

No. Not training places, though these would obviously be nice. The lack of ANY job.

Even traditionally not all doctors went into specialist training, and even if you did, it was very normal to spend time working as a locum of a Clinical Teaching Fellow before gaining a training place.

The problem is that, with rapidly rising international competition and traditional new doctor jobs being filled by Physician Associates, there are not nearly enough medicine jobs for those emerging from F2.

Drive an Uber or go to Australia.

F1 was tough. Long long hours in a very stressful environment. To put our young people through this and then offer them nothing is exploitation. If you have ever been in hospital overnight and seen a young doctor race between wards, trying to ensure they were attending the sickest,and we owe those people something. Money is frustrating, but it is the lack of prospects that really matter.

And patients. In the coming decades when we really need care we will wonder why there is a shortage of doctors. The NHS and Streeting, in giving advantage to overseas trained doctors and PAs, are making decisions which almost certainly will adversely impact our future health service. The overseas consultants we trained will likely be working in private practice in Singapore. Who will oversee and train the doctors of the future?

Not every single placement out of the six will involve nights or weekends. One to two won't; four to five will. I'm aware I'm scratching at detail in rather a picky way but it's better not to exaggerate because that risks undermining an argument.

And obviously I'm not talking about yours but about the BMA's.

@AsTearsGoBy but they didn't exaggerate ? They did earn £15.33 an hour ?
Yes, if they worked unsocial hours they got an extra £4 an hour (like a lot of professions they got a bit extra for working at 2am), but for every hour between 7am-9pm, weekend or bank holiday, they earned £15.33 an hour.

How did they exaggerate ?

Exactly as needsmore says. Any job after F2 would be welcome.

Many F2s are way to busy to even attempt to sit the exams. DDs friend had a go but she is luck as she is currently in placement at a small and surprisingly quiet hospital. She does not except to pass. She is a nice, charming, working class grammar school girl, the first of her family to go to University, who wants to stay and work in the area she grew up in. She will not have the extensive support and contacts needed to beat a very competitive international field.

DD is just too busy. Her previous placement was in a notoriously frantic area, lots of nights, lots of very sick patients, and a fair commute from where she lives. Her idea was to do what many do, which is essentially take an F3. A regular hours locum job where she had time to learn more about her chosen specialisation and to study. My cousin's daughter became a Clinical Teaching Fellow, lived at home for a couple of years with her fiance. They both studied hard, and they both did well enough get on training, her as a GP and him in his chosen speciality. Living at home also meant they were able to save enough for a deposits.

In those days such CTF/locum posts were not open to international competition and attracting hundreds if not thousands of applicants, and PAs didn't really exist.

So yes you might sit the exams as an F2 but you probably won't pass them with sufficient marks. And if you don't, and don't fancy driving an Uber, then Australia is probably your only option.

DD has yet to apply, but applying against current competition in the UK will be too time consuming and the odds too long, so is only likely to try Australia. (There are two locum jobs coming up in her preferred speciality in her deanery, but neither are particular appealing and not only will she be competing against everyone else in her deanery in her year but those from previous years who have failed to get a training position, plus those in the rest of the uk who want to go into that speciality and who haven't yet landed training positions, plus all those from the rest of the world who want to have a crack at a UK training position so are keen to get some NHS experience.)

The simple solution is to allow young doctors to apply for PA posts. These are the ones that used to be filled by doctors but are now given to PAs. Or set up an agency designed to place UK trained doctors in the same way that overseas agencies work to place overseas doctors within the NHS. And change selection criteria so that it becomes merit based,giving weight to good NHS experience, rather than how many articles you have had published in the Phuket Journal of medicine.

I have no idea whether, when she is there, DD will be able to apply for Australian training places or whether she will have to complete a residence requirement. The current idea is for her to study for the UK exams and return once she has passed.

DD has five placements out of six that involve nights, longs and weekends. In a very deprived area, with huge drug, alcohol and mental health problems. Up to 10 days in a row. Because of that her take home pay is not bad, but it is exhausting. She is also finding that way more responsibility is being placed on her shoulders that she would have expected. She is learning a lot.

Some F1/F2s will have regular hours, and have time to apply for jobs and prepare for exams. For all the attempts at equality, it is a very unequal system, not least because F1s can no longer choose where they go.

What are you trying to work out.

I personally am deeply upset as is DD and her peers.

Money is not the problem. The lack of career progression, indeed jobs, is. If you think this is exaggeration do a deep dive into the stats.

I would add that it is not just salary. Cost of living comes into play. Where DD is working now you can still buy houses for £60,000. (New roof and kitchen too.) Very different from London.

My guess is that inter alia the need to make higher loans repayments has impacted on young doctor's disposable income. Remember they need to move every year or two and renting in a new area, where you don't already know people and where you need flatmates tolerant of shift workers, can be expensive.

@mumsneedwine thanks for your reply. Totally understand your frustration and upset with this mess and it must be hard to advise your students especially when they are keen on a medical career. I hope it gets sorted too. I feel IMGs should be sitting the same exams as UK graduates if they are competing for the same positions. For example, maintaining the PLAB exam for IMGs while stating it is MLA compliant is not acceptable. The PLAB takers' pass rates are determined by competition against other PLAB takers and not against UK graduates taking the MLA. PLAB is less stringent. I wonder why this is done when there is no separation of the two groups when it comes to other stages of recruitment? If the UK grads aren't being prioritised, there should have been at least a cap on recruitment of PLAB takers. Every other country prioritises their own graduates for training. Surely the NHS can't be certain of the quality of an IMG until they start working with NHS patients. Also there would be an adaptation period to the NHS way of doing things which would take a significant portion of NHS staff time. Surely it's a no brainer to just retain UK graduates in the NHS jobs by letting them do their training here. I agree with you that the current system is not fair on UK medical graduates and is not sustainable. This short sighted view that IMGs are cheaper is inaccurate since most come with families. I totally understand why your DD is considering Australia as an option.

OneMorePiece why would IMGs be cheaper? I assume they earn the rate for the job, not less. When UK grads are working in the UK they will have loan repayments deducted from their salaries, so they will actually be cheaper. And as well as NHS experience and language it appears that some IMGs struggle with cultural adaptation, with colleagues as well as patients. There is also a wealth of performance data on UK grads, which would make merit based recruitment easier. DD has now worked with a few IMGs who seem to have been let go from their original jobs and are now floating around the deanery/trust covering F1 sickness etc. Some are fine, but not all.

I find it odd that we also don't seem to believe that our medical schools can produce better doctors than some other places. Not everywhere, obviously. But some countries, dare I say it Bulgaria, seem to have picked up a reputation for low entry requirements and a variable quality in their graduates. The NHS has a lot of say about how UK medics are trained: communication skills, EDI etc. They don't have the same influence over overseas institutions.

@Needmoresleep I don't think IMGs are cheaper but they may be perceived to be cheaper by the NHS as many come with years of experience in their home countries so may not need as much training once here apart from a period of adjustment to the NHS way of doing things. They are often employed at much lower grades in the UK which is why they are being recruited in large numbers. I know IMGs personally with more than a decade of experience post graduation who earned £500 monthly basic salary in their home countries who are now here in the UK in the types of posts your DDs are seeking. Although the NHS conditions are hard, they have been offered speciality training here which they highly value as they know it will be well regarded globally. Also the ones I know really value the British education their children are having in school here compared to schools back in their home countries. Despite difficult NHS conditions, they are not going back to their home countries as the overall opportunities for their families are better here so they plan to settle here permanently when they have fulfilled the criteria for settlement.

My DD has often had to train the more senior IMGs as they are clueless about how the NHS works. One was a consultant who was doing an ST3 job. Had forgotten how to do simple skills.
Not cheaper or more efficient as he was intending to go home after 2 years here. Having UK on his CV increased his oat at home.

@OneMorePiece those doctors should get jobs after the UK graduates. In their home countries that's how it would work.

@Needmoresleep I agree with you that our medical schools here do provide high quality rigorous training. Why not recruit the many graduates coming through them like you say? How can the NHS be sure that the publications, quality of experience and education gained by IMGs in other countries is equivalent to that gained by a UK graduate if they don't use the MLA to test IMGs? The assessment using PLAB is certainly less stringent and not equal to the MLA. The interests of patients and patient safety should come first! I wonder if the PLAB is maintained separately to the MLA deliberately so that IMGs' pass rates are assessed only against other IMGs. How is that fair for UK medical graduates who sit the MLA? There seems to be very poor planning and organisation in the NHS recruitment system which should be changed asap to prioritise UK graduates ahead of IMGs. IMGs should only be considered if there aren't UK graduates to fill the position.