@Saschka
Thank you.
The problem seems to be post F2.
F2 is brutal. DD is working with very sick patients. Her medium sized town hospital is full. 40 on trolleys even before the bad weather is hit so every ward is full. They suffer endemic staff shortages. Her Trust does not have a single consultant in a major speciality. The F2 shift pattern is tough and set in advance. In her case it has meant being full on, with lots of nights then her allocated 2 weeks vacation at the end of the four month placement - at a time when none of her friends are free to go on holiday. She came off nights on Monday and then had 13 hour longs on Wednesday and Thursday. This weekend she is doing little bar catch on sleep, training (required but no time allocated during working hours), admin and hopefully some leisure and social life, before starting again on Monday. Studying for the next set of exams is completely off the cards.
What next? The NHS does not have an obvious career path. As you say your Trust does not use the terms F3/F4 as these posts are also aimed at overseas trained experienced Doctors wanting NHS experience. More worryingly to get a training place place she needs to be able to compete with the very best in the world, and land a strong MSRA result. Her achievements to date, which include some impressive extra-curricular, good feedback on placements, and a strong intercalation (bio-medical engineering at Imperial) will count for nothing.
She is dyslexic, with slow processing speeds, albeit with compensating strengths. This has already meant that despite strong A level predictions her poor UCAT meant she was very limited in which medical schools she could apply to. She enjoys medicine and appears to be good at it, but the move away from merit towards "equality", as well as the opening up of opportunities to worldwide competition, and the likely need to move again both for an F3 post and then again for a training post makes the future seem bleak. She faces two years of work/study during F3/F4 and then a further 7 years of work/study on a training pathway. Even if she makes it, she would be mid 30s before being able to settle down.
My observation was that her batch of new F1s were hit like a train when they realised that getting into and through medical school was only the start. It was only going to get harder and more competitive, and that the fabled job security in medicine was a myth. In one of her placement groups, all but one were planning to leave for Australia. Australia wants them, the NHS, for all the talk of a doctor shortage, appears not to care. DD is relatively lucky as she spent her elective in a research lab, who have said they would welcome a PhD application from her. Better than driving an Uber, and for me better than her moving half way across the world.
The deep down problem is this move away from merit. Surely the NHS wants staff who will do that bit extra, who stay on an extra 15 minutes to both deal with a crisis or carry out a proper handover. Instead they seem to want those who treat them as they treat their staff, who understand that their priority is to jump the hurdles the NHS set and focus on exam prep over support for colleagues and patients.