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?

From those articles, it appears that the Indian Medical Association is pushing back the NHS taking consultants and skilled doctors out of India by offering the NHS their MBBS graduates for training instead. Such a proposal should be rejected when there is a surplus of UK medical graduates who should be given preference for these positions.

What arrangements are there to train the thousands of extra UK medical students who are going to graduate from the many new UK medical schools which are opening? How do they balance this with all the postgraduate training schemes the NHS appears to have with foreign countries such as India or Malaysia as mentioned by @Needmoresleep
There is also a duty to train the existing medical graduates.

Not only is the current recruitment system badly planned and short-sighted, it's a contributing factor to the increasing migration figures. Perhaps if they look at redressing the balance, the government will also be able to reduce the net migration figures.

Doctors are expected to be resilient but the current system is breaking them and as a parent I am so, so worried about this. The point is that those that want to serve as doctors within the NHS without leaving the UK but can't find positions are being driven out of the country just to hold on to a medical career! I think that's outrageous and a betrayal of our young people.

AsTearsGoBy there seem to be on-going communication issues. I don't think it is me.

However by thriving I mean that your DS has a job and career prospects. This is a far better position to be in than having to move overseas. He should be as proud of himself as you are of him.

And yes I have said that DD could have written a paper or something. But honestly why should she. I also suspect that there is less of a culture of writing papers where she is compared to London deaneries. Just too many patients and too much work. She works bloody hard and is very good at her job. If it were a sensible comparison there is every chance, papers or not that she could make as good as specialist as your DS. The big advantage she has is that she actually wants to build a career in an unpopular deanery, to the extent that she bought a house there. The NHS should care about retention of good practical doctors in hard-to-recruit areas, but instead is prioritising academic doctors whether home grown or from overseas.

@AsTearsGoBy never said you didn't. Just keep going then.

Thing is that unless we reform the NHS, many of these doctors won't stay.

They may have a generation ago, but not now. I remember when I was a lot younger and had just returned from working in Malaysia. A doctor friend who had returned to the UK at the same time, invited me over for Chinese New Year. The discussion was about whether to return home, take a well paid job in the regional medical hub that is Singapore or stick it out with the NHS. Opinions were varied. (What was particularly nice was that people forgot I was English and asked if I intended to balik kampong.)

Employment opportunities for experienced specialist doctors in Malaysia/Singapore are even better now. I assume the same is true for India. However, like our own young doctors, they need to get both the training and experience. English doctors who rise through the ranks are likely to stay in the system through to the end of their careers. Malaysians or Indians are increasingly unlikely to. Even on straight investment grounds (noting those earlier accusations of xenophobia) training UK based medics makes more sense.

Needmoresleep again, this isn't either/ or. It's not either academic or a good doctor. Why should the two be mutually exclusive?

I haven't mentioned pride at all. I'm no prouder of DS than I am of any of my DC who work in other fields. In mentioning DS's experience, I'm just trying to create a foil to this idea that all of a sudden the current cohort has it uniquely bad. I think it's far more likely that you and mumsneedwine just haven't experienced this particular work environment vicariously until now. All you say is very familiar to parents of slightly older DC; it really is the same world, not a new one.

I've been sending students to medical school for over 15 years.

I don't think that's relevant mumsneedwine. My own DC had some completely fantastic teachers who championed them/ should take a lot of the credit for any success - but they'd find it super weird/ odd to communicate too frequently with them, describing the minutiae of working conditions. A normal teacher-pupil relationship doesn't (and shouldn't) compare to a parent-child one.

@Needmoresleep yes, it's highly likely that many that come from Singapore and Malaysia won't stay. Very familiar with those countries. I agree that we should invest in our UK medical graduates and make conditions better for them so that they don't have to go to Australia to feel valued or have a medical career. I am aware of what it's like to be from that end of the world your DCs are having to go to. It's so very far away and at first really exciting and new. It's fantastic to have such an opportunity. There's however so many things you miss like parents, siblings and friends. You can't just drop everything and leave to visit them if you hear parents are unwell or the pandemic means that you can't attend their funeral due to a shut down. The geographical distance makes it impossible for grandparents to spend time with their grandchildren and often grandparents miss all the milestones. Just have to make do with short visits to visit parents during school holidays. Airfares during these periods for an entire family are extortionate. After a few decades away, if you have been very close to your parents, it's hard to not feel guilty or helpless when parents are ill or at the end of their life. They can't travel due to illness. You just can't be there to help or see them one last time due to the geographical distance of being on the other side of world because of responsibilities to your young DCs who you can't just take out of school just because your parent on the other side of the world is unwell. Missing large chunks of their lives and missing seeing them at the end is the hardest and of the greatest regret.

Just thought I would add that the content of my posts and concerns follow on from what I have encountered or experienced. I never envisaged that DC may be forced to possibly emigrate to pursue their medical career. Having given my perspective, I hope others understand why I along with some others on this thread with DCs in the early stages of their medical careers have legitimate concerns for our DCs. I appreciate that others with DCs in later stages may not have encountered the same difficulties. We just want the issues in the current recruitment system to be addressed so that it is fair to home medical graduates who (like in other countries) should be prioritised ahead of IMGs.

The experiences of the three poster's DCs give an insight into a much bigger problem which if isn't addressed now will only become worse.
Would those experiences add sufficient weight though?
One appears to be applying for their preferred speciality training number straight from FY2 and will go to Australia (or the USA) if she does not get it. Another may go to Australia without applying for FY3 posts. The third is waiting for a specific local teaching post and does not appear to have applied for other posts.

More compelling would be specifics rather than hearsay concerning these applicants with excellent portfolios and high point scores who failed to get shortlisted for paediatric core training despite being well above the threshold for other years.
Further information from the deaneries concerned would be good evidence that 2025 is the equivalent of a market crash for FY employment.

Sendsummer, not meaning to be argumentative but if you were facing the levels of competition that, say HaffDonga's DC is facing for the local F3 position, and knowing that competition levels are similar elsewhere, what would you do?

Especially if you know that plenty of those candidates will have those extra points (research etc) that you don't have.

Underlying any stats are behaviours.

DD's original plan was to do things one at a time. Select (she got her first choice) a demanding set of rotations and gain good experience. Then take an F3 and focus on her training application. The F3 is not happening. There are two posts in her preferred speciality where she is, and an expectation that as well as local applicants from her year and previous years and applicants from elsewhere in the UK, there will be applicants from overseas with very polished applications. The only realistic options seem to be to apply overseas or to join Lovecats DC as a bank locum working zero hours covering for staff absences.

I assume Mumsneed's DD has similar thinking. It is an approach being used by DDs close friend who is finding her F2 placements surprisingly quiet. She has had a crack at her speciality training exams, as much for the experience as any hope of success. She too will then apply to Australia.

You talk about applicants with excellent portfolios and high point scores. By and large those with high points scores will do fine. Their applications will score highly, so it will be worth their time applying for F3 positions. When they get to interview they will have a real advantage over overseas applicants. In fairness some are impressively dedicated, managing demanding jobs with lots of super-curricular, effectively from the start of medical school (often with doctor parents who knew what was required or on one of the six year courses where research is more naturally encouraged and supported.) Others in their experience will have been quite focussed, and prioritising their own CV building over supporting group needs.

But we are not talking about the superstars. Our DC are good doctors who passed their exams first time, are well regarded by their colleagues and get strong appraisals. They don't want to run hospitals or become professors. They are happy to work in less popular Trusts.

The immediate problem is that, with worldwide access, the competition for F3 posts has gone through the roof and so the option of spending a year or two preparing and application for training whilst gaining useful experience is no longer there. At least for good but ordinary applicants.

What would you suggest those without high levels of points do when they finish F2?

A local shopkeeper has four children of whom he, as a refugee himself, he is extremely proud. One is a doctor and doing very well. I enjoy him telling me about the son's progress, though it scares me slightly. This son is now in a good training position, after winning completions all over the world and all sorts of other achievements. The son decided at the start of medical school that he would not take any holiday until he had got his career established, ie until he was in a Registrar position. Culturally he is expected to live at home, and will do so until he marries. DD could doubtless achieve the same if she had dedicated herself in a similar fashion. Given how pressured the NHS is, there also needs to be space for those who want a reasonable (still long hours and plenty of studying) work life balance.

What surprises me is that rather than the NHS workforce planning people ask why UK trained doctors are moving abroad, they simply increase incentives for overseas doctors to come to the UK to take up junior jobs. Thereby exacerbating the problem, given the lack of junior jobs is why they are having to leave.

Out of my DS peer group, only him and two others are applying to be GP's, the rest are looking into going to Australia, or Canada or taking a year out for F3 before deciding what to do. This is also from a non competitive Trust which was his first choice as he studied in area.

In DDs placement group it was all but two who planned to apply to Australia.

I am sure that like DD, F3 would have been a preferred option if it had been realistic. My fear is that Australia won't be able to take them all, and they will be left competing for the odd day of bank work, presumably picking up shifts from Deliveroo the rest of the time.

Lovecatsanddogs it would be interesting to know what the picture looks like at other Trusts. Although Needmoresleep has drawn a distinction between 'superstars' and others, mumsneedwine's post a short while back suggested that even so called 'superstars' weren't getting even to interview:

Doctors can't get jobs. They dream of a training number but can't get one despite publishing papers and having amazing portfolios and feedback.

Obviously things will change down the line with random allocation but it's possible that in the 'competitive' deaneries (apologies for using that term - I'm picking up my cue entirely from your reference to 'non-competitive') F2s are seeing more success in the current round. One thing which seems to be a common factor is that your DS is apparently not in one of the 'competitive' deaneries and Needmoresleep and mumsneedwine have both said the same about their own DC. I do wonder if the perception of the current situation is skewed by environment. Because it does seem to be the case looking as figures posted that this is a gradual thing. sendsummer has already suggested that data from individual deaneries would be instructive. I wouldn't be in the least surprised to find a different peer picture elsewhere - particularly since all three of your DC made a deliberate choice - for clearly very valid reasons in each case - to avoid the more applied to deaneries.

If you consider somewhere to be your home and have personal ties, its not so easy to make the decison to move to London or Australia. He is an excellent doctor and wants to remain in the area and also have a work life balance. This is why he has decided that becoming a GP, if he is fortunate enough to get a place training, is now the best option going forward. We shall see what happens in the coming weeks.

Completely understood. It would nevertheless be interesting to see what the picture looks like nationwide and see if there's any correlation between success and geographical area.

Most of DDs colleagues are local. The local medical school is very good and her peers are equally capable.

Traditionally those wanting high flying careers have aimed for London. DD ruled it out, first because this is where she is from and where she spent 18 months during lockdown. But also because she was getting feedback that many London hospitals are either too specialist or so busy that senior doctors don't have much time to support newly qualified doctors. She may be right or wrong in this, but does not regret her decision. She has some very interesting, demanding placements and senior staff have quite an old fashioned approach to supporting junior doctors. She was told before she went that once they worked out you were trustworthy, you would get more responsibility than you would in London, and that seems to be the case.

Interestingly many in her capable and outdoorsy friendship group opted for the Celtic fringe for F1. I think lockdown played a part.

The NHS wants to relieve recruitment pressure in places outside London and the home counties. If there is a problem accessing a career path if you are not in certain places, the NHS workforce planning people should be looking at remedying this. Supporting applicants from Africa and Asia cannot be the optimum long-term solution.

There is no need for a deep dive into stats. There has been a lot of anecdotal evidence on this and other threads about application numbers for F3 posts. Once you get beyond ratios of 100:1 for a job good applicants will be deterred especially if they don't fit with selection criteria giving weighting to super curricular activity. Given the efforts the NHS is making elsewhere it should not be too much trouble to consult F2s directly and ask what they are planning and why.

AsTearsGoBy as you are a data expert, could you do a deep dive into deanery stats?

I'm not clear that I've ever made such a claim or even anything approximating to it Needmoresleep. I've read sendsummer's posts that's all, which certainly show a less alarming picture than that suggested by the limited anecdotes here. Data won't be available for this round yet anyhow, obviously. But I'd certainly put a bit of money on the probability that the traditionally more applied to deaneries are seeing a generally more positive outcome and that therefore the concern felt by F2s in those deaneries isn't as great, because there isn't currently a sea of rejections among their peers.

Sendsummer does not have a DC about to complete F2.

You dug deep into previous Mumsneed's stats so I assumed it was your area of expertise.

It is not surprising that London F1/F2s do better. Historically it was the most competitive deanery and the one that high-flyers aimed for. Which does not mean that young doctors are not equally as good. Depending partly on whether you feel that solid experience in regional hospitals is as valuable as working in specialist clinics and publishing papers.

It does not matter. We have a shortage of doctors which is why the NHS are recruiting internationally. I doubt your son would be keen to work where DD, or indeed Haff's, Lovecats or Mumsneed's daughters are working. They equally don't want to move to London. It might be that Haff's son would have a more competitive CV had he studied on a six year course and applied to a London Deanery, and so be confident of achieving interview despite possibly a thousand other applicants. But going to a good medical school, working hard at F1/F2 regardless of deanery, should be enough to get an entry level job.

I am not sure what you are arguing. Are you saying it is our DCs fault because they did not apply to London?

For non-believers: last year more IMGs than ever applied and the UK immigration system as it stands doesn't allow UK grads to be prioritised over international applicants.

https://www.bbc.co.uk/news/health-68849847.amp

Of course I'm not suggesting fault! I'm suggesting that the more applied to deaneries are likely to be seeing F2s have more success and therefore the mood may well be less gloomy there. It's a suggestion which might not be correct but it would make sense. The anecdotes here don't correlate with the numbers and so there must a reason. Wide geographical variation is at least plausible.

Why are relative success rates between Deaneries important.

Shouldn't around 95% of those completing F2 be able to find work.

The issue, again, is that good, competent, UK trained doctors are not able to compete when there are hundreds of applicants, many of whom will have more polished CVs and where, under immigration rules, hospitals cannot give priority to UK applicants.

A year or so ago I met someone who had run a private medical school in Penang. He said it was relatively easy to place F1 students anywhere in the UK as long as they did not want to go to London. He may be right, and those students will go absolutely determined to achieve F3/training places. Good for them, but tough for our Covid generation DC who are willing to work the long hours for long pay but still want some work life balance. Medical schools should be warning that unless you are prepared to dedicate the next ten years of your life to the ticking the required boxes, there will not be a job at the end. Indeed out of kindness they should radically reduce places and up requirements to ensure their students are able to compete against the applicants that the NHS seems to be prioritising.

@Needmoresleep I am noting what you and others say but strong objective data will be most compelling to swing the oil tanker of national workforce planning.
At the moment we have data for an incremental increase in IMG applications for entry training posts but up to 2023, very few getting numbers for more competitive specialities. We don’t know yet for 2024 or for this year obviously.
Then, from posters on this thread all I can gauge is anxiety or restrictive criteria blocking action to make UK applications.

You say that the USA system is not a good example but it produces the right number of excellent doctors that include about 25% ambitious IMGs. Australia and NZ will do similarly and have the advantage of being international outliers with regards high pay during the training years.