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?

A new thread in AIBU might be a good idea

I'm a UK Doctor.... Please... No... Don't Get Me Out Of Here!!!!!

Can you believe it? They don't want to go to Australia and NZ!
Increasing numbers of UK trained doctors wanting to stay and serve in the NHS are having no option but to take jobs overseas. Yes, you read it right! UK trained doctors are not prioritised for UK medical jobs!!!

@PlopSofa please would you give the premise for your figures from the FOI request data. I’m not a data buff so I would appreciate the insight of someone who is better at this than me.

It was not a FOI request. Looks like Mumsneedwine took a photo from a Reddit post which derived the percentages from the accessible nhs link I have previously posted and provide here again. This time with the image.
https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/equality-and-diversity/equality-and-diversity-2023-recruitment-data/country-of-qualification-2023-recruitment-data

The percentages that were given in her photo were for training posts at all levels. As we are discussing FY2s, only entry level (year 1) training posts are relevant. For these.
2021 64% of accepted offers were UK graduates. (9761 posts)
2023 59.5% of accepted offers were UK graduates (10037 posts)
These numbers show increments of <5% between 2021 and 2023 for IMGs (including EU trained).
Importantly the profile is dependent on how popular the speciality is for UK graduates.
The highest proportion of IMGs were for GP, psychiatry and histopathology.
with 48% UK graduates for GP training in 2021 and 50% in 2023. Only 55% of UK graduates with offers for GP training accepted that offer. Similar for those with psychiatry offers. So the appointable IMGs were filling a gap here.

Radiology, Emergency medicine, Anaesthetics are at least 85% UK graduates in 2023. Paediatrics 67%.

As GP training posts are over 45% of total entry level training posts, this proportion skews the proportions obtained for all accepted offers.

We will see what happens in 2024 and this year. Possibly the number of appointable IMGs will have sharply increased but it is more likely to be a gradual increment since 2021. As @Needmoresleep has pointed out, FY3 type posts are possibly more relevant and that data is not held centrally.

OK then:

I have a policy not a political background, and this is bad policy. When I worked in Whitehall we used to con sider whether any policy passed "The Sun headline test". In short was any policy so weak that it could be questioned by Tabloids and their readers.

This one fails.

The BMA/NHS may be riddled with all sorts of clashing priorities and under pressure from all sorts of lobby groups. Culturally they may have got into a habit of firefighting rather than planning long term. I don't know. I am pretty certain that tabloids (and other media) and their readers will understand. I am also certain that that NHS bosses won't like adverse publicity. We are not fighting them. Monolithic organisations can submerge into weird, illogical, policy bubbles. They can also need a fair weight of pressure to sit up a review current thinking/policy and to make appropriate changes.

My best guess is that some of this has arisen though post Brexit trade trips to India, and pressure from the Indian Government. Someone has decide that because India wants up to employ and train some of their doctors and we are short of Doctors and can no longer access EU trained Doctors, opening our doors was an all-win. Not quite. They forgot to protect the Doctors who studied her and want to stay.

I think the trick is to find people with voices, either public ones (ie media) or with influence behind the scenes and who will run with it. A clear message, spread widely. I am finding that people usually fail to believe that it is as bad as our young people are telling us. Once they look into it they are shocked. It is crazy that as a country we might lose a substantial proportion of our current generation of young doctors. Hopefully we can get some of the influential people we contact to run with it. Media, MPs, members of the House of Lords with a health interest, people with influence within the BMA and NHS and so on. Regional parliaments should be good as they can often have more problems recruiting than England and they, particularly, will not want to lose local people who want to go on to serve their local community.

Actions:

1. Would someone start an AIBU thread. OneMorePiece?
2. PlopSofa has suggested she might be willing to to do a first draft standard letter, which we can discuss here. We do not need too many facts. Our experience is observational. If the NHS workforce planners don't know what is going on, they need to find out. I think that quoting the recent BMA statement, which confirms they are concerned, and a couple of indicative stats, like the slightly shocking one that almost 50% of training places go to overseas doctors, the competition ratios for, say, GP training, the help and incentives that the UK government are offering overseas doctors, and the parallel problem of hundreds of applicants for even just basic entry level jobs. A standard draft should be personalised slightly depending on who you are writing to.
3. We then need to think through who we know that might have influence. I realise that I have access to three political lobbyists: a friends husband, a neighbour and a friends son. None are likely to have time to do any heavy lifting, but might well make suggestions of who to approach.
4. Then write, write, write. MPs vary. Some are very good and employ energetic researchers. Others less so. If an MP writes to Wes Streeting they have to be given a proper reply. If enough write, someone in that part of DoH will notice and perhaps ask what is going on. I am happy to share contacts for health journalists. (The Telegraph, Mail, BBC and probably more have written on issues facing young doctors, more often the PA issue. They will be obvious starting points.) If we get tractions from an MP they could ask a Parliamentary Question or propose an Early Day Motion.
5. Would any of our DC be willing to be interviewed? (If so PM me.) DD finally decided a week or so back that after a few months of saying "perhaps Australia" this is what she will do, so she won't be that good. Her aim now is to study for her exams whilst over there (what she would have done during an F3). If the situation is not sorted there will not be any way back for her or her peers.

I once fought both the Church Commissioners and the NHS to protect my local park. It took eight years including Parliamentary questions, a proposed Early Day Motion and a three week planning inquiry, but we won. Years later I bumped into a senior NHS manager who had been involved on the other side. He was very amiable. He said that in retrospect it was really useful that someone had prevented them from going ahead with a poorly thought out scheme. I would anticipate similar conversations in the future if we manage to help the NHS retain our bright young people.

I would write to my MP if there was a draft letter I could amend.

Also I think whilst you can argue about just how big the issue is, it still makes complete sense to prioritise uk trained doctors (like every other country does)

Thanks. Hopefully we can get some sort of draft up within a week. Which could also be used on an AIBU thread.

The scale is less important than the fact that there does seem to be a problem (F3 jobs - the fairly random sample of F2 mums suggest our DC all perceive the same problem and it is influencing their behaviours. As well as anecdotal evidence that even though the NHS is not keeping stats, application numbers are rocketing. There is better evidence for the training bottleneck and the increasing proportion of scarce places going to overseas applicants.)

Whatever the scale we need policy makers to review issues before they get worse.

I've run needmore's suggested approach by a friend who works a lot with Westminster. Their comments are below and apologies if they have already been covered.

They agreed with her suggested approach. They are not involved in this sector but thought that the BMA should be taking the issue up on behalf of its members. There are student reps for the BMA in all med schools so could this be another way to raise the profile of the policy by current med school students putting the pressure on the BMA to do something. The BMA should be able to harness the support of established NHS doctors. The issue of use of public funds in training doctors that are not deployed is a very good hook, particularly if the tabloids pick up on it. If the NHS is seen to be wasting public money in that way, it does not reflect well. Letters to everyone's constituency MPs would be a good idea as they will hopefully raise the matter directly with ministers. Another idea might be to write to the select committee for health and social care. Evidence (stats) is really important. Is there any data available showing how many doctors are being forced to leave NHS/UK because they can't get jobs.

They also said that it needs to be framed carefully that it is all about UK doctors not getting jobs after years of expensive study and placements rather than being anti-immigration in general. The danger of a tabloid like the Mail picking it up is that is is very likely to be morphed into the latter.

@Needmoresleep ok to the AIBU. I am not aware of the minute details but how's this for an AIBU discussion? To everyone, is this draft ok or does it need amendment?

Increasing numbers of UK trained doctors wanting to stay and serve in the NHS are having no option but to take jobs overseas. Yes, you read it right! The people I am talking about don't want to go to Australia or NZ but do so just to be employed and pursue the medical career they studied so hard for.

Their experiences reveal that they have not been prioritised for training and jobs within the current NHS recruitment system. Unfortunately, our UK medical graduates have found themselves disadvantaged since the introduction of the points-based immigration system which was introduced after Brexit. Many find that vacancies advertised by the NHS online, open and close so quickly due to a deluge of applicants. It appears that places have been snapped up by global applicants while our UK medical graduates were working long shifts in NHS hospitals. Our young people should not have to suffer due to poor planning. No one is opposed to recruiting from overseas if that's what the NHS needs but the numbers from overseas in the last couple of years appear to be disproportionate and at the expense of medical graduates that the UK has trained. Overseas doctors have made valuable contributions to the NHS and will always remain an important part of it. This issue is raised here in the hope that problems are addressed quickly. This is especially important before the matter becomes divisive in our multicultural society.

Kier Starmer is quoted in the Guardian as having said "The government would publish a white paper with a plan to reduce immigration, Starmer said, adding that he would target sectors seeking labour from abroad. We will reform the points-based system and make sure that applications for the relevant visa routes, whether it’s the skilled worker route or the shortage occupation list, will now come with new expectations on training people here in our country,” he said.

Would you agree that it's a matter of urgency to fix these issues? Any delays or a 'let's wait and see what happens this year' attitude is not only a betrayal of our young people, but will undermine the proper functioning of the NHS and in turn affect patients. It is also a real waste of NHS time and resources and if we want the NHS to continue to function, let's do everything possible to ensure that all our UK trained medical graduates are prioritised for training in our NHS.

High stars Please thank your friend.

Writing to members of the select committee is a good idea. And yes, it is important to keep the focus on our young people and the poor value for money. There is enough of argument there.

I plan to write to named health correspondents, who hopefully will understand our argument and not politicise. Our DC have been exploited enough.

I was sort of leaving the BMA to one side. Apart from their recent statement they seem to have done very little, though stuff may be happening behind the scenes. If we can get others to speak up this might spur them on. A few months back I was depressed by their initial response to the Cass report on gender. My fear is that, like other unions representing professionals (authors, academics etc) their priorities can be influenced by activists rather than the needs of their members. But that is possibly down to personal cynicism. I understand there is unhappiness around PA registration. The focus on pay during the recent strikes benefitted those already on career paths. F1/F2s had a whole raft of issues around allocations, conditions (they seem to vary massively) and, obviously, employment/career prospects which were not really prioritised. The BMA will also represent IMGs so it might be a difficult issue for them.

In terms of stats, I hoped to avoid going beyond a few headline NHS stats and the BMA statement. (Too many stats on this thread, and too much debate over them.) We should be clear who we are and why we are concerned. We are alerting policy makers to a possible problem that we are observing. Namely in the rush to encourage overseas recruitment the need, in parallel, to retain existing staff also attempting together NHS careers underway, seems to have been forgotten. They need to look at data, ie application numbers for F3 jobs per trust.

OneMorePiece, many thanks. I will look later. Also thoughts from others. How best do we get the AIBU mob agitated?

Re AIBU mob agitation, possibly the fact that IMGs are much more likely to take their NHS training and either go back to their country of origin or move on internationally and where does that leave us as future patients. Our homegrown doctors are not much use to us if they have permanently emigrated to the countries that were able to offer them what the UK chose not to. The NHS has enough challenges to fix without having that potentially huge resource problem to deal with down the line.

Agree that I don't want this misconstrued as being anti-immigration and potentially making overseas NHS staff already in the UK feel unappreciated or unwanted. It's bad enough when Europeans living here felt unwelcome and felt they had to leave after the Brexit decision. This is solely about ensuring UK trained medical graduates are prioritised or given first refusal for UK medical jobs like elsewhere in the world. Maybe overseas applicants who haven't entered the UK workforce can be on a waiting list until UK grads are allocated according to their preferences. What we want is an adjustment to the recruitment system and a closing of any loopholes (that disadvantage UK applicants) in the current immigration system that are resulting in unintended consequences. Given what is happening in the world, it's really important that we maintain social cohesion.

The basic principle regardless of profession should be that if there is a suitably qualified British candidate they should get priority. If not you are opening the door to exploitation.

I think there have also been issues with newly qualified nurses and midwives (or perhaps just midwives) being unable to find work due to recruitment from abroad.

I would not be surprised. It would be the same failure to join up the dots.

And yes, if our DC are applying for some of the F3 jobs that are attracting hundreds of applicants, they will almost certainly be up against someone from overseas with bags more experience and qualifications. Somewhere upthread a poste talked about a colleague from overseas taking an entry level who had ten years experience but only earned about £500 per month in their own country.

UK doctors further up the career path should be concerned that the NHS might see overseas recruitment and increased international competition for jobs as a way of keeping salaries low. Say a consultant job in the Highlands and Islands where recruitment has always been tough. Rather than increase pay or improve conditions (say allow a job share or for a senior registrar to act up), you appoint someone from overseas who will take whatever salary is offered. And if you do this to doctors, why not teachers, and, and, and.

Yes, £500 a month. More than 10 years of experience. @Needmoresleep that was a DF of mine who arrived in the UK with her young family 6 months after passing PLAB 2. NHS gave them free accommodation for a couple of months and helped her secure school places for her DC.

She showed me her application that's how I know.

She said that someone she met on her PLAB course who didn't have much experience but had recently graduated from an overseas medical school was hoping to get an FY position. I think her friend got one a few months later. She also told me that IMGs who were successful in getting UK jobs were mentoring and coaching new cohorts from their own home countries in how to navigate the system.

She said that for her family the overall package (not just the NHS job) on offer in this country is better. Also, it's easier to get into the UK medical workforce than Canada, Australia, etc.

Was talked about on LBC today. Nearly crashed the car ! Host was flabbergasted that doctors will be unemployed. Maybe it's a start...

Exactly. We will be recruiting some very good and experienced doctors. Far more experienced than UK doctors going for the same jobs. (And obviously some less good ones, then then there are also some relatively weak UK educated doctors.)

Given the need to give equal
consideration, how on earth could my DD with only 2 years experience compete. And how will she get the eight extra years experience she is going to need to land an entry level job.

So depressing.

Part of the reason I have spent so much time on this thread is that I have hoped someone with influence is reading. You never know.

I will have a look at the AIBU text first thing tomorrow. It was too lovely a day today.

First they came for the unskilled jobs
And I did not speak out
Because I was not an unskilled worker
Then they came for the tradesmen jobs
And I did not speak out
Because I was not a tradesman...

isn't it how the chattering classes didn't seem to mind when immigrants were out undercutting and putting blue collar workers out of a job.
Don't like it when it's a bit closer to home do they?

Perhaps for another thread, and clearly one of the reasons behind Brexit and the popularity of Reform.

Importing labour in preference to employing an available local workforce has all sorts of implications. That labour may not want to stay long term, and though it might be seen as a cheaper short term solution, there is a cost in terms of loss of taxation and loan repayments from UK graduates who either move overseas or earn less. I do think senior doctors and the BMA should do more. They must be aware of the unfairness of using F1s and F2s to work long hours, cover nights etc, and then leave them with nothing. More pertinently, they may like it less when they are applying for a consultant post and find it goes to a better qualified candidate from outside the UK.