I hope it is good news. DD is currently applying for jobs in both the UK and Australia. The Australian application is very focussed on work experience, and indeed there was no space for her to include time spent working in a bio-medical research lab. They really wanted to know what she has actually done on the wards. Good in that she has two years of working 60 hour weeks in very busy hospitals with a fair amount of responsibility.
Locally is more difficult. Unfortunately, at least in the speciality she would like to go into, good applicants from the previous year did not get onto training so have landed the couple of Fellow roles that were available. This means that she is having to look for temporary appointments which, given the budget crisis, are limited. That said one consultant seems determined she should stay. Several of his consultant peers are locum recruits from overseas, and until they get used to the ropes (if they stay that long) the department needs a core group of staff familiar with the NHS. They are so busy that burn out is a real issue, and those on specialist training programmes often leave as soon as they can find work somewhere more popular/prestigious.
DD, who picked a busy F1/F2 rotations with the aim of following with an F3, waiting till then to apply for specialist training, has been knocked back by a system which apparently does not want her. I recognise that Auchencar believes that the current system promotes excellence, and that if doctors trained overseas perform better on the current speciality training selection process that the UK trained doctors my daughter works alongside, this is a good thing and will mean we are getting the best.
At the coal face it looks different. First, though she had always intended to build her career in the UK and believes strong in a public health system, she has lost faith in the NHS as an employer. Australia will be a chance to experience a different system. She now also says that if she then decides to look for training in the UK, she will accept parental help. Perhaps follow the trend of taking a paid for "panic Masters" in lieu of an F3 to buy the time to prepare for the ever more competitive application process. (@mumsneedwine will have the figures) Or help with building her CV. One of the resident doctors she works with is open. He bought the lot: international competition prizes, name on research papers published in obscure journals, coaching for the exams etc. No surprise. Exactly what an Asia-based Doctor friend of mine has done, though in her case she is involved in research so easy to involve her son.
DD is too honest to fake it but recognises that if the system remains unchanged she is lucky that she would be able to take time out, and would have the contacts to allow her to get involved in research etc. (On the whole, senior doctors where she is are too busy firefighting to focus on research.) Many of her peers, despite being dedicated and competent doctors, are less fortunate. Yes a number of very focussed, very academic young people will get through, as they should. They would get through whatever the selection process was, though then unlikely to work in smaller hospitals in more remote areas. For the rest, the current system has a heavy bias towards those with affluent parents either in the UK or overseas. And despite repeated calls for UK medical schools to put more emphasis on communication and other soft skills, the system rewards those whose education has focussed on academics. (Overseas private medical schools, whilst providing a good academic education, often find it difficult to offer much patient contact, particular those where the local population does not speak English. It can show, especially in the early months.)
I know Auchencar disagrees, but it seems mad to have a system where we export our young doctors in order to import others. A system that rewards "academic" achievements like prizes won in obscure competitions over solid NHS work experience and good appraisals. A system that does not give training priority to those already in the UK and likely to stay, over those who see UK training as a route to well paid jobs in Singapore or Dubai.
Australia does it differently, actively seeks our graduates, and appears to have a well regarded health service. There are large parts of the NHS that are effectively failing, whether hospital or community care. And the vicious cycle. Losing staff at Resident and Consultant level means more vacancies and more pressure on those that remain. I find it bizarre that the idea that we try first to retain those who have done well at F1 and F2 rather than recruit from overseas, is seen as controversial, even racist. I am pleased that Wes seems to have recognised this. I am also pleased that Wes is recognising that staff and patients have been poorly served by current NHS management. (Even if it means that Auchencar loses his/her job.)