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?

Sorry to butt in with a question - but obviously this is concerning. DD is 4th year and I just wondered whether posters that are accepted at conferences while they are still students count towards these points for specialty training? Or would it only be once they are F1 an F2?
Thank you.

DS was able to count something similar which he did in his clinical years Pleasestopthebunfight but that was a couple of years ago now and things seem to keep changing so that could be out of date.

@ThatllBeTheDay they know because many have colleagues who are IMGs and it's their friends and family who have the interviews. I do wish it wasn't true. Last year cut off was 13/40 and this year 15/30.

Here are the scoring criteria - it says everything counts from when started your degree. But you need so much to hit 15 points.

www.imtrecruitment.org.uk/recruitment-process/applying/application-scoring

Sorry, not interviews yet. But shortlisted for interviews. While v many F2/3/4 have already been rejected.

Oh sorry I wasn't being silly about interview v shortlisted - that was shorthand on my part. I was just surprised that the students that you know personally were able to generalise at such an early stage if these IMGs aren't their colleagues and before any stats will be available, that was my question.

Thanks for that link.

I see it from a different angle. I have several friends in Malaysia whose DCs, the same age as mine, are training to be doctors. The private sector in Malaysia is very hierarchical and does not allow for many training opportunities. The public sector employs a lot of positive discrimination meaning is is difficult for people from some backgrounds to access local training.

One solution is to go to a private medical school, work very hard indeed, and then try to enter the UK system either at F1/F2 or at the specialist training stage, to return home at consultancy level, where a lucrative private practice in either Malaysia or Singapore can be guaranteed.

UK F1/F2s can find themselves having to work very hard indeed. DD was doing long shifts and nights with very sick patients (very deprived area - a shocking amount of illegal drug use). She spends much of the rest of the time catching up on some form of social life or trying to reset her sleep patterns. She would need to find an F3/F4 position in order to study, but a lot of these have been lost to PAs or are open to international competition. Her very NHS centred training may mean that she has good awareness and communication skills, but might not give her the edge of very focussed internationals when it comes to the next set of exams. Her (good and relevant) intercalation probably won't help either.

I know that my cousin's daughter went back home for a two or three years in her late 20s, working as a CTF and studying to get into GP training and for GP exams. Not everyone can do that, but that is probably what is needed. The NHS message seems pretty clear. Homegrown doctors are not wanted.

@ThatllBeTheDay I think they are so upset they may be exaggerating about the number of IMGs they actually know. Although one colleague seems to be involved in signing Crest forms (I don't know what these are).

What they do know is that they only know 2 people who they were at Uni with who were not rejected yesterday (apparently about 40 in their circle). Lots of v sad doctors. Lots v v worried if this is what it's like for IMT what on earth will it be like for the more competitive ones. My own DD (not an IMT applicant but can see where this is all heading - unemployment), has now started the recruitment process for down under 🙁.

Yes, totally understand all that mumsneedwine incl any very natural tendency to exaggerate as a consequence of feeling upset and unfairly treated. 2/40 is shocking.

Mine too. And almost all her peers.

It is very sad. Not what they would have chosen. Presumably the NHS feels overseas applicants are likely to be better If so they sold our DC down the river.

What should happen is the consultants should now be up in arms about this. They should be shouting loudly in the press, to the BMA, to the GMC, to the government, that the doctors they are training are going to be unemployed. That the opportunities they took for granted are no longer there. That training as a doctor in this country is now a complete waste of time and considerable money.

I am so angry. People on social media moaning - doctors should have to work for the NHS for 10 years because we paid to train them. Well honey, they'd love to, but they can't get a job.

And so it starts. I hope @Needmoresleep . 🤞🤞🤞🤞🤞

Wes Streeting today not answering the scandalous question of why doctors can’t specialise.. and why there aren’t enough jobs

https://x.com/DrHWazir/status/1876680462459879887

The system is completely mad.

DD suggests there is a further problem, at least in her Deanery. They are struggling so much with recruitment that they almost automatically use agencies to source medics from overseas.

When a vacancy emerges a local F2 who is working long hours will need to be pretty quick and organised to get their application in time to be considered. DD reckons she would be able to get a locum job somewhere she had already had a placement by getting the word out that she is interested and available. But anywhere new will be more difficult. And whatever Wes may think, overseas trained doctors are not necessarily better than those from the UK. One big issue is lack of NHS experience. Not knowing how things work wastes a lot of time. DD also suggests that consultants from overseas can lack confidence in their own decision making leading to a lot of over-referring.

DD is currently on the only placement of six that does not involve busy nights often with very sick patients. The difference is, well, night and day. She has evenings and weekends, food in the fridge and a regular sleep pattern. It is such a change not to speak to someone who is totally exhausted. Some of her peers are in deaneries where F1s & F2s don't do nights, or not as many. Some have distinctly better working conditions. It would be so much easier in those deaneries to study for the next set of exams.

There also seems to be a pattern that those whose parents are doctors have wider networks so are more likely to know of suitable vacancies coming up. So have a better chance of getting that F3 job that then leads onto a specialist training scheme. Good on them. This is what they all have the chance to do. The jobs are there. There should be some recognition that young doctors are facing unemployment and that they need to be prioritised over PAs or agency recruited overseas doctors. Perhaps a UK based "agency" that allows F2s to be automatically put forward for suitable vacancies nationally.

DD has learned a huge amount, has been given a lot of responsibility, and gets good feedback. The system is not interested in this, but prioritises those who pass the tests well, even if, say, they have been able to take a year off to study.

Sadly it is looking like Australia. I hope she comes back.Perhaps the NHS will wake up one day and wonder where those good doctors they trained went.

One odd footnote. A F2 she knows, and again someone who is resigned to leaving the UK, was asked to do some teaching. Not of medical students, but of student PAs. They were asking her to teach the very people who will be taking the jobs the post-F2s need. She refused and was backed up by her seniors. Others might not have felt able to do the same.

Are there the more senior/ training jobs though? I've assumed that the govt simply wants to keep more lower paid juniors doctors on the books. Probably this is too simplistic - I don't know the numbers.

One option for someone completing F2 is that they do something informally referred to as an F3. It might be a locum job or working as a Clinical Teaching fellow. Not highly paid but it does allow for more normal hours and a chance to study for the exams you need to to progress to the next stage.

However the Government have decided that these jobs are open, on an equal basis, to doctors from anywhere in the world. It is therefore not unusual for such jobs to have thousands of applicants and short application deadlines. The Government have also decided to expand the number of Physician Associates who are paid better and not expected to work anti-social hours, and who are starting to soak up these "locum" posts.

So it is not that the Government is trying to keep lowly paid junior doctors. Instead they are actively reducing their employment prospects, leaving them with little alternative but to leave the profession or leave the country.

PlopSofa's post has a useful link.

Yes the fault of the previous Government, but Wes Streeting will know about it and is choosing not to do anything.

It is unfair. F1/F2s have to work so hard. One night on her first rotation three F1/F2s were left on their own in a busy inner city hospital. Yes there was a consultant they could call, but still a huge responsibility. On that same rotation she had 10 consecutive days including longs (13 hours shifts). Yes all good in terms of learning and experience, but seemingly of less value to the NHS management when it comes to actually getting a job, than had she trained in Bulgaria or Tanzania.

What is the rationale? There must be one.

You will see in the tweet that this is what medics are asking Wes. He is not answering.

Well yes exactly. But what do you think they think the reason for the lack of training places is and the reason for the deliberate swerving of direct questioning? Or even, what do you think?!

Because I genuinely can't think of any reason other than wanting to train additional doctors who can form a deeper layer at the base of the triangle and be used as relatively cheap labour. I've certainly heard Wes Streeting talk about waiting lists and point to the additional medical school places in response (this was immediately prior to the election) but he avoids questions about career progression. Apart from wanting more very junior doctors who will never progress but are cheap to employ, what other rationale could there be?

Obviously not all those graduating from medical school can expect to go to the top of the pyramid but this imbalance suggests a big and deliberate re-drawing of the layers of the pyramid. As you yourself say, the F2s are carrying a lot of responsibility and doing a great deal of leg work. I can see that they're very useful at that level.

Those graduating currently just want a job. They won't have one. It's ridiculous. But hey, let's pay for some people to private (wonder who makes money out of that).

My F2 will also likely be heading abroad. It's that or unemployment in August. I'm angry.

I have no idea. I just witnessed a complete change in attitude from my DD when she started F1 and realised how tough it was going to be to achieve her ambitions, ambitions she had been working towards for a decade. Now she accepts that having a job, any job, in any part of the country will be the achievement.

What is completely bizarre the fact that competition for NMS medic jobs is completely international. What other industries/professions have this. If there were a surplus of a skill in the UK, visa's would normally not be issued to those from overseas. Except in medicine. Then the filling of positions by PAs, when you have unemployed doctors who are able to offer a lot more in terms of skills and flexibility and are cheaper. Even weirder doctors are expressly forbidden from applying to work as PAs, even though their training is much deeper.

What is also curious is the lack of interest in merit. It is as if senior administrators are chanting "A doctor is a doctor is a doctor". It used to be that if you did well at medical school you got more "points" so had more choice in where you trained. They did away with this a year ago so you could come top of your class at Oxford and rather than do your F1/F2 at a London teaching hospital you might find yourself in Enniskillen.

Appraisals too don't count when it comes to access to speciality training. Instead just a single exam. The incentive is to be selfish, look for placements that give you the most free time, never stay that extra 30 minutes at the end of a busy shift to ensure that you have handed over properly, as you are encouraged to put yourself first and ace that exam. Who cares what your peers, patients or seniors think of you.As long as you pass the rest counts for nothing. The exam was apparently formulated for would be GPs and has more limited relevance for would be hospital doctors.

Why they are doing this is impossible to answer. Some of it, taking out the merit element in F1 placements, is apparently aimed at improving equality. Perhaps the equal treatment of doctors from overseas is based on similar thinking, but it still seems weird to train young people for eight years, expect them to borrow large amounts of money, and then not give them at least a level playing field. (Given how demanding F1/F2 placements can be and so how limited the chances are for some to study.)

When do decisions come out for the next stage mumsneedwine?

@AsTearsGoBy depends on the speciality, but by spring they'll know if they've got an interview. Then it's 50:50 if they get a job. That's if nothing is late - last year was awful so expect this year will be worse.

Yes to all of that Needmoresleep. Allowing overseas doctors to compete on equal terms for jobs where their home countries don't allow that again suggests (to me, as a layman) that the government wants to suppress or at least slow progress for a good number of these F2s. They won't all go abroad where opportunities are by definition limited to an extent. And those who don't get a training place but stay won't all leave the profession. A lot will presumably just keep slogging away after all those years of training. And I completely don't understand the very impersonal approach to progression at all. It seems so strange not to include references from senior doctors who've observed the junior doctors doing their stuff, albeit for only four months on rotation. The system seems crazily mechanical.