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?

No it's not just about IMGs, it's a discussion about how the current recruitment system is inadequate. You mentioned previous posts on this thread as being xenophobic and I directed you there as, with IMGs raising the same issues, you would see that xenophobia doesn't come into it.

If you had read it, you will see that IMGs (that came years ago) are also raising the same issues in great detail. There is mention too of the current PLAB exam standard letting in poor quality IMGs into the UK. There's mention of applicants making fraudulent applications working in hospitals being a threat to patient safety. Other new recruits needing a lot of supervision which is a waste of NHS time and resources. Also IMGs that were being relied on to show junior colleagues the ropes but in fact needing handholding themselves by juniors. Shocking!

As a taxpayer and patient, I am furious this is happening! As a parent, I feel that our UK medical students being forced out of their own country is unacceptable not only because of the expense of training them but also because it splits families up. It's also not fair on young UK doctors who are having to handhold incompetent seniors when they're supposed to be trained themselves. Your DS graduated in 2018 and benefitted from employment opportunities at a time when the recruitment system wasn't as competitive. It's much more competitive now especially with the new immigration system in place post 2018.

It was still pretty competitive to get a training post OneMorePiece. I think the figures show that, the ones posted above. But the fact that it was less competitive and is getting more so is accepted on this thread so there's no quarrel. What is more doubtful it the claim the current cohort have fallen off a cliff edge, which they clearly have not. I can't see why it matters whether the 2018 had it slightly easier, so I'm a bit confused.

@AsTearsGoBy

Your DS graduated before a major relaxation in the laws regarding recruitment in the NHS. All the anecdotal evidence- and there’s quite a lot of it now on Reddit and personal experience on here on MN suggests things are far more competitive than 6 years ago when your DS graduated. Does it matter if it’s a cliff edge or not? The very fact that even one person who has spent thousands of pounds, years and years of their lives, have a vocation to try and help others, that they they can’t find work on the NHS, because someone from abroad has been prioritised, due to poor government planning is plain as day wrong. Isn’t that something we can agree on?

The idea that this figure might be in the hundreds, possibly thousands because again, international doctors are taking precedence is morally wrong.

These students put their faith in the system and expected to find some form of employment in a country that’s supposedly crying out for doctors. There are other dare I say it better paid jobs these bright motivated people could have done.

Please also make no judgement on someone’s ability to buy their first house. A 2 bed in Newcastle may cost £150k. A similar sized property on London would be £700/800k plus. It’s a spurious point.

Anyway, here is a summary of the changes to date:

“The application system for international doctors wishing to apply to the NHS has undergone several changes over the years, particularly in terms of recruitment policies and how medical graduates are prioritised.
A significant change occurred with the introduction of the Medical Training Initiative (MTI)and the shift towards the NHS International Recruitment Programme, which have evolved as part of broader workforce planning strategies. However, the most notable shift regarding the prioritisation of UK graduates versus international applicants began around 2016-2017.
Before this, UK hospital trusts were under a strong incentive to prioritise UK medical graduates (UKMGs) for training posts, particularly due to the immigration control measures and the immigration skills charge that made it harder to recruit doctors from abroad. Additionally, there was a quota system in place limiting the number of overseas doctors who could be recruited.
In 2016, the Tier 2 visa restrictions were tightened, which impacted the recruitment of overseas doctors. However, by 2017-2018, NHS trusts began to face significant shortages of doctors, particularly in certain specialities, which led to a shift in policy. This culminated in the government lifting certain restrictions on international doctors and allowing NHS employers to recruit overseas candidates without needing to prioritise UKMGs in specific areas.
The policy around international recruitment was formally relaxed in 2019, with the government allowing more overseas doctors to apply to NHS posts without being subject to the previous UKMG prioritisation rules. This policy continued to evolve through the NHS People Plan in 2020, which called for an increase in international recruitment to help address workforce shortages, particularly in high-demand specialities.
In summary, while the system started to change in 2016-2017, the most significant changes around the de-prioritisation of UK medical graduates in favour of international doctors came about in 2019 with the wider shift to increase the NHS's ability to recruit from abroad to fill staffing gaps.”

No doubt, it was always competitive but now it's worse than ever. Maybe this might help you and anyone else interested understand how the IMG explosion has come about:

https://thesavvyimg.co.uk/8-ways-the-uk-has-made-it-easier-for-imgs-in-the-past-2-years/

The current NHS recruitment system and the post Brexit immigration points system need to be reassessed asap as therein lies the problem. We shouldn't be waiting to see whether the next UK cohort falls of a cliff edge or not! We need to draw attention to this issue now without debating every small detail. There needs to be action now to prevent more heartache for these young people!

It seems like this was the moment everything changed:

”4. Understand RLMT exemption
RLMT stands for the Resident Labour Market Test. It was a rule that prioritised certain groups of doctors (eg. British citizens) when it came to training jobs. Because of this, RLMT used to be the primary barrier for IMGs to enter competitive specialties such as Surgery, Radiology and Ophthalmology.
However, as of October 6, 2019, all medical jobs have been included on the UK Shortage Occupation List. This means that IMGs are now exempt from RLMT and are now eligible to apply for UK specialty training in any specialty! (Except Public Health)
”

It’s taken a while for word to get round but now we are seeing thousands of applications per post, due to global accessibility of NHS jobs.

It also seems to be that Brexit had an impact on labour shortages that led to this relaxation in the rules. Up until this point British graduates were prioritised but there were so many gaps in the workforce, this prioritisation was dropped. However it now looks like the pendulum has swung well and truly in the opposite direction.

The article states:

"Compared to other English-speaking countries, the UK offers flexible pathways for IMGs of all backgrounds, and the possibility of British citizenship within 6 years.
But don’t just take our word for it! In this article, we list 8 ways that the UK has made it easier for IMGs to work here in the past 2 years alone. Then you can make up your own mind!"

If all else fails to make a case for UK graduates, maybe phrase the urgency of sorting this problem out as a means of reducing net migration especially as there are unemployed UK based medics! Isn't that a hot topic? Put the IMG applicants still outside the UK on a waitlist or something and allocate after UK trained grads and UK based IMG applicants. Prioritising UK applicants first is the only sensible thing to do.

There has been mention of IMGs just 'floating about' the NHS hospitals after not having contracts renewed, etc. Some do this because of the better salaries compared to their home countries and because they have made a massive upheaval to come to the UK. For the sake of their families and children who are in schools here, it's difficult to leave even if they feel exploited by the NHS. Some go home but many do hold on until they fulfil the criteria for permanent settlement.

Competition has doubled in 2 years, Find me a time before even these figures were the same. Number of training places is the same.

PlopSofa I slightly take exception to the idea that I made any judgment other than a positive one about Needmoresleep's DD showing the initiative to buy a house. Needmoresleep has already said that property is relatively very cheap in her area. mumsneedwine had said that it was impossible to buy a house because of the possible need to move, so I replied to that and that only.

Does anyone think reform might be interested in this?

I am not a fan of reform or in particular Nigel Farage but perhaps if the government felt under political pressure they might act.

No idea why we had to have Brexit (which I hate btw) and still aren't able to prioritise our own young people for jobs whilst closing off the opportunities they would previously have had in Europe.

No please don't get Reform involved! There has to be other ways...

I feel that I need to reply to this post even though I will be repeating what I have said before.

It is not incredibly unusual for young professionals to buy properties in their mid twenties, especially in areas where you can still find basic two up two downs for £100,000. I don't know when AsTearsGoBy first bought, but London is an exception rather than a rule.

DD fully intended to work hard on demanding F1/F2 rotations and then take an F3 in order to prepare for exams and training applications. She likes where she is and wanted to stay so it made sense to buy.

It started to become apparent last year that things were getting tighter for those finishing F2. All the data upthread confirms that IMG application numbers are rising. Indeed rising so fast that posts may only be advertised for a few hours. Throw in tight budgets, posts being taken by PAs and the NHS' selection priorities, and DD and her friends have little chance.

This is what the discussion is about. The fact that our DC do not expect to get jobs in the UK.

No she did not buy to rent out. She bought because she planned to spend six or more years in that deanery.

To be honest she really does not know what she will do. She has been super busy and her next placement will also be demanding and rewarding. She has not applied for F2s because she won't get them. The competition is too intense and she will need to strengthen her CV. She has talked about doing what LoveCats DS is planning, ie bank jobs covering sickness etc, but these are, as the Reddit thread suggests, getting increasingly tight. Her aim now is to apply to Australia, but my fear is that lots of others will be in the same position and it won't be as easy as it was in previous years.

As for the house. Who knows. She is saying that when she gets back (and the plan now is to study for the key exams when she is in Australia) if she can't get a medic job she might apply for medical engineering jobs. Since it will then be a while since she did her intercalation (a first from Imperial) though she ought to get a job she might need to follow up with a Masters. She would prefer to be a doctor than an engineer, but the NHS have let her down badly.

The irony is that she might well end up renting out her house to a newly arrived IMG. Someone with the right research and conferences so selected for an F3 ahead of our home trained doctors.

(On other medic threads I have argued with Mumsneedwine. I have always claimed that it is worth prioritising medical schools the allow external intercalations. My argument then was that it allows an escape route from medicine it you come to realise you don't want to be a doctor. It turns out I was probably right, but because the NHS might not want you as a doctor )

I find it so sad. Everything she has worked for over the past eight years is being lost.

Renting out to pay rent elsewhere is clearly an option, even if not the original intention. mumsneedwine used the word 'impossible' in relation to buying a house because of the possible need to move to another deanery. Mine was a very straightforward response to the idea of of property ownership being 'impossible' on that basis. It said nothing whatever about your DD's original plans for the house. I also said that it was unusual for a medic of your DD's age to buy a house, which indeed it is. I didn't say it was unusual for the entire population in that age group (although it apparently has been increasingly so).

I think @Needmoresleep DD has very sensibly bought somewhere in an affordable area. Mine not able to do that just yet. But one day. When she knows where she'll be for more than 12 months and has a deposit saved (from the humongous salary some people say she earns).

Both our DDs deserve a job in August. Be nice if it was somewhere of their choosing, but any job would be nice.

@AsTearsGoBy can you just stop being unpleasant. Really not a good look.

mumsneedwine your DD may well still get the training post she wants. She just doesn't know either way yet.

I've literally no idea what you mean mumsneedwine. My posts are incredibly measured. There isn't a single unpleasant thing about them.

@Needmoresleep we have had our different opinions over the years. We come from v different backgrounds and views. But both of us have always agreed that our DDs have worked so hard to get where they are. And deserve a job in the NHS.

Doubt mine will come back if no training job. Which makes me v sad. She wants to be a doctor so will go where she can do that 🙁

@AsTearsGoBy some of your comments can be quite cutting. Glad to know they are not mean that way. I hope you understand how personal this is to some of us.

DD might get training. But it's a long shot as she has to be in top 5% of the 30,000+ people who sat it this year. In a stood exam that had 1 question on her speciality. And an equally stupid SJT test that is known to be a random

Competition has doubled in 2 years
Firstly the total number of applicants is not 200% of 2023 from those graphs. Secondly you have to differentiate between the total number of applicants and the actual competition which is from appointable applicants. For example in 2023, 3355 applications were made for CT1 anaesthetics but only 1176 were appointable. Of IMGs, only 47 were appointable from 1063 applicants.
Similarly for internal medicine 4406 applicants but only 2865 were appointable. Half of IMGs were not appointable compared to 76% of UK applicants.

Possibly more IMGs are better qualified this year but it seems unlikely. As the increased number of applicants is mainly from IMGs then competition from appointable applicants won’t be that much higher.

@sendsummer really ? You think it's that simple. Our stupid, lazy UK trained doctors should just suck it up and be unemployed because the consultants from India want an ST1 job.

Again. Appointee applicants

And those of you with kids in training I hope you're aware of this. Consultants now unemployed too

I disagree. I rent property, originally as a side hustle to support a London lifestyle on fairly low public sector incomes.

The days of the amateur BTL landlord is dead. Way too many rules and regulations and a decreasing profit margin. It made sense for DD to get a foot on the property ladder. She reasonably assumed that because her deanery is relatively unpopular, not least because the wages are lower, if she were to get a training slot her chances there were higher than elsewhere.

An F1 with a reasonable amount of overtime should be able to get a mortgage of £150,000-£200,000. So with some form of deposit and hopefully with a lodger waiting in the wings, it is doable. Once you have your mortgage you can over pay and build up equity just in case your next job is in a higher priced area.

DD was busy so let me do the search. It would be better for her career if one of us was a doctor, and knew the ropes. Her situation where I, my husband and my son are all economists is probably the next best thing.

PM me if you want the name of a good mortgage broker.

But a house is no good if you are many thousands of miles away. Her deanery has always had problems recruiting. Now they risk losing not just my daughter but her peers from the local area who understand their patients, are good at communicating with them and would expect to stay until retirement. It is mad.

Obviously aware. Have been for ages since DS explained to me in very clear terms that nothing could be taken for granted. I'm sure that other parents will have been told the same by their own DC.

But I thought we had agreed that UK trained doctors were ducking out because they are too busy to apply for jobs where they think their chances are low.

The overseas applicant may well have an agency helping them. Ours have nothing.

You are also talking about training positions. Before that they need F3 posts. These are attracting hundreds if not thousands of applicants. Our DC are not allowed to redo F2 so they face a cliff edge when it comes to employment.

Do you think this is worrying for the future of the NHS? ?