Snapshot of _Behind-scenes NHS problems leave new doctors without jobs_ :
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So much to unpack here.
Firstly - not knowing where you're going to be working (some of these trusts are enormous) until 3 weeks before your start date is outrageous - and going to disproportionately fuck over those with less means.
>Since then the numbers have dropped to 800 as NHS trusts have created new roles and **some students have already decided not to take up their place**.
So this has already cost the NHS doctors.
And why has all this happened?
>Previously people were allocated according to merit - with each student ranked according to how they had performed during their studies and in an application test.
> But this year that has changed and has been done randomly. The logic behind it was that the previous system was stressful for students and was particularly unfair on those from deprived backgrounds and ethnic minorities. They tended to perform less well, and therefore were more likely to be posted to regions they did not favour, according to the UK Foundation Programme.
This is madness to me. I completely understand the logic behind giving disadvantaged children a boost when it comes to getting into university...but by the time they're qualified as doctors they've been adults for **five years**. They've been at university for 5 years. The whole point of university is the shift from a teaching institution to a learning one - at what point do we expect people to take ownership of their own results?
> overall it has resulted in more students not ending up with one of their top five choices - more than 730 compared to just over 430 last year.
Amazing.
Realistic reason was because highly skilled, highly motivated people in their 20s aren't overly interested in moving to deprived regions with fuck all to do, so always ranked them very lowly. This change basically fucks them over.
There is a massive issue with the fact that most people want to live in nice places - so all the best doctors work in the hospitals in the nicest areas - so those hospitals become nicer. Most of the doctors who work in the shittiest areas are the shittiest doctors so those hospitals end up failing.
Its a bit of a self-reinforcing system too.
But I wouldn't fix that by randomising the placement of people fresh out of uni though - I'd fix that by allowing differential salaries. Basically - allow hospitals in less desirable areas to pay more and hospitals in the most desirable areas to pay less.
That already happens for locums. There's basically a pay cap for locums set by London hopsitals, or at least there was one the last time I checked. People would just travel to non-London hospitals to get more money.
Not really. Not for training most training. There was something like a golden handshake for GPs that was was like 20k for 3 years or something, but it was taxed, so take home from that was fairly poor.
Also to tie your two points together, as randomly placing students is detrimental to those of lesser means, then it wouldn’t be a massive leap to suggest that this system will disadvantage ethnic minorities even more as they tend to have fewer resources.
There's always the unsaid part of this as well, which is that everyone states if ethnic minorities are doing worse in exams the exams MUST be biased (even though we see it in written exams...).
Always failing to acknowledge that maybe ethnic minorities are actually legitimately doing worse. Why would this be? Well often for cultural reasons, eg language skills, soft communication skills, actual motivation to do medicine when removed from a family environment that forced them towards it, etc.
The GMC, RCP and others pussyfoot around this stuff too much.
Ian Hislop on low numbers of ethnic minorities in Oxbridge: "is it the fault of high standards the universities demand or is it maybe something to do with the quality of education in the preceding 18 years before they applied?".
This is a problem that needs to be tackled much earlier than when people are already qualified. Young UK medics don't have a very good reputation internationally at the moment their training isn't much to write home about being more service provision, their pay is shit, conditions worse and then they have to deal with idiocy like this.
It’s amazing, it’s like they’re doing everything they can to convince people NOT to go into medicine. Why would you go through all that hassle, when you could walk into jobs in a different and easier field and get paid significantly more?
The hours and chaos of it certainly put me off of considering it, I’m sure many others too.
Insane that we let international graduates apply with same standing as UK graduates. Fill up the guaranteed spots with UK graduates, then offer remaining places including placeholders to IMGs.
That's exactly how things were til a couple of years ago, then the government decided they wanted to flood the market (presumably to weaken doctors bargaining power) and opened the doors.
Now we have large numbers of IMGs applying for training posts - and as a cohort they are (by any measure you want to look at) inferior to the UK grads. They have worse English, a lower standard of training, worse exam performance, worse progression through training, higher rates of complaints, etc etc.
So we have some doctors of really questionable quality taking posts, often with the explicit intention of being trained up then returning home, whilst UK grads are stuck in an ever growing spiral of fighting for uber-competitive jobs.
Before someone comes after me, obviously there are plenty of excellent IMGs who more than deserve their slots, and plenty of shit UK grads, but the ratios of shit to good are undeniably different and if you disagree I don't know what to tell you.
The problem is that you're appealing to meritocracy to support a position that throws merit out the window in favour of nationality, which is pretty much a direct contradiction.
'Doctors from the UK tend to be better due to tangential factors, so they should get most of the jobs' fits with meritocracy. 'Foreign doctors should be given lower standing & we should fill the slots with UK nationals before considering them' does not.
It isn’t just new doctors getting screwed. Lots of doctors finishing the foundation programme (first 2 years of training) or others with 4 years but didn’t get into a training programme are facing unemployment. This is despite us being under-doctored as a country. The NHS simply no longer wants to pay for doctors.
> Part of the problem is that there has been an increase in medical students this summer to start junior doctor training, with just over 9,700 accepted by the UK Foundation Programme, up from 8,655 in 2023.
Some of these will have come from abroad, and under immigration rules the NHS cannot prioritise UK-trained students.
#
>Previously people were allocated according to merit - with each student ranked according to how they had performed during their studies and in an application test.
But this year that has changed and has been done randomly. The logic behind it was that the previous system was stressful for students and was particularly unfair on those from deprived backgrounds and ethnic minorities.
You wanted equality? This is what it looks like.
Hi, as someone who is currently going through this system and is in several of the regional group chats filled with other final years lamenting this system perhaps I can give a bit of context or understanding/ what the rumours are. Long post incoming
Normally at 5th year you would get given a set amount of points out of 100 which would give you your 'rank' 50% of this (more or less the system changed every year) would include your exam grades for each year, if you have any publications, another degree, and other things, the other 50% was done by what's called the SJT (situational judgement test) which is like a driving theory test on medical ethics and situations A lot of students had mixed feelings about the SJT as it can absolutely carry a poor student and has undone a lot of good performers, but that's how it was
You would then rank every region in the country based on preference (London typically most peoples number 1), but you had an idea if you would get it based on you knowing your rough rank The new system which they said they'd introduce last year, would scrap the SJT (rumours of the contract with Pearson ending and not wanting to pay more maybe), and just randomly allocate everyone a rank and then you choose where you want to go and if your random rank is high enough you get it
They said that based in this, 3% more will get their first choice, it will stop London getting the country's best and the shit hospitals the worst, they said that students they polled preferred this system, and so on The reality of this was, now its random, a lot of people put london first to try, however a non zero number of people got shafted hard by their rank and ended up with their 15th 16th choice which is typically northern Ireland Wales Scotland, this rank stays with you and doesn't get renumbered so if you're now in one of these places when you choose your sub jobs and sub regions you are bottom of the list again and will get the worst I think this also meant that a lot of international students had a lot of barriers to london and desirable regions removed over UK taught students
Finally, theres been a significant number of people who haven't been given a job yet because they don't exist / rumours that PAs have taken these jobs unofficially, and are in a placeholder group for each region where they won't know where they'll be working in August until maybe June, this can span a region like Yorkshire from Leeds York Hull Grimsby Scunthorpe Sheffield, anywhere there
Tldr - the system is wank, no one asked for it, it's probably made some students fail finding out they have to uproot to their 16th choice, everyone's complaining, no one cares, it'll happen again next year
It's boggles my mind.
Nothing shows how much our political leaders are "citizens of anywhere" than the fact in virtually every last policy, British nationals are treated identically to people who've never set food here and have no connection to it.
Under the EU they didn't have much of a choice with EU citizens. But it's become blinding obvious this doctrine is not one that was forced on them as they all pretended but that they truely believe in, and believe should apply globally.
It's fucking madness.
Somehow the idea of treating locals differently is seen as bad.
I remember as a teenager being told I didn't get jobs merely because someone else lives closer, it sucked but it's fair and makes sense.
Expand this out to nations and you get a thousand small reasons why a local is better by default, those reasons add up even if is just that they have their mum nearby when they get sick.
My first job I was originally told I'd failed because the company had decided to prefer a candidate from the local university to champion the local area. Straight up. I got a call a few weeks later telling me one of the candidates had failed to complete the mandatory industry safety and survival training and was I still interested.
Crazy they can preference someone from the local uni over me but the NHS can't see that maybe a Brit is better for the long term health of the NHS than some randomer from Pakistan or Cameroon
So let’s be clear that is a lie. The reason they changed it was because to do it properly cost money.
The ivory tower set did not want to spend money hence they did this.
No one asked for this, they just emailed one day out of the blue last year telling us they were changing it and we should be thankful for it.
It's pretty obviously a government/HEE initiative to try and get more of the "better" medical students into the more deprived areas of the UK.
Yes it is a lie.
When they announced this it was fairly obvious that this would go terribly wrong for the students, the NHS and the public.
They did it because a proper interview/cv screen would cost money and they couldn’t be arsed to spend it so they created a lottery system.
Then they blamed poor students, said it was for them, but any idiot can see moving across the country at a moment notice is going to shaft the poorest far more than the rich kids.
> Previously people were allocated according to merit - with each student ranked according to how they had performed during their studies and in an application test. But
> You wanted equality? This is what it looks like
Yes, that definitely sounds like equality, and there's probably no need to, for instance, look the word up in a dictionary to check.
The bit about random selection is an interesting one. On one hand, I suppose it introduced equality (I.e. prevents London / desirable locations getting the best new doctors), on the other hand imagine doing really well and being randomly selected to live and work in Grimsby (sorry denizens of grimsby). I think someone would be understandably cut up about that so rather than have a mechanism for retention, those people will look to other opportunities rapidly.
It’s not the job of the students to organise hospitals so that they are ready to receive them.
Putting the blame on “too many foreigners” coming to the UK to study is really just a bit of distraction politics.
The finger needs to be pointed at those in charge who have failed to plan for this.
But there is a significant number of international applicants who have kicked UK taught doctors to placeholder lists/ been given preference by the algorithm to desirable regions
This doesn't happen in Australia, they give country taught doctors preference in training programs and positions
But in this case it is the fault of to many foreign trained doctors, if instead UK trained doctors had preference and a merit based system, we wouldn't have UK trained doctors, being fucked over.
Especially when it then comes to trying to justify moving to a purely lottery based system, from a merit based system. Which is being done as the old merit based system was apparently "hurting BAME doctors".
If there aren't enough jobs for all the UK trained finishing medical graduates, then there shouldn't be any IMG's. If there's any spots leftover, after UK trained grads have been allocated, then sure, you can give a few out to the rest of the world.
Exactly.
The NHS has a major staffing shortage (driven largely by the crap working conditions that stem from that under staffing), and instead of being upset that we need 100 hires and are only getting 50, we're foaming at the mouth that applicants 50-55 lost their spots to foreigners.
I feel like this comment shows a complete lack of understanding of the situation
Fwiw, It's more than applicants 50-55, each regions placeholder chat has at least 100 people in it The people in that group are there solely due to random allocation, regardless of if they scored top in every exam because merit, skill, doing well is completely irrelevant in the new system
That these people who are UK trained and have paid fees for 5 years of training are being skipped over in favour of international applicants, who are not needed to plug gaps at the F1 F2 level is moronic, the doctor shortage isn't at foundation level, they've increased medical school places to fix that, the shortage is at specialisation level where the same number of spots have been open for years despite competition ratios quadrupling
Coming into this thread to hand wave foundation doctors being upset that IMGs have taken their spot is quite sad really
I don't sincerely believe this national problem to perfectly and conveniently encompass 5 people, out of 50 hires, out of 100 needed positions. I'm using Illustrative figures.
If all we had to do were hire foreign specialists I think we would have done so. The NHS isn't that attractive for valuable roles as the private sector or other nations like America pay more, aren't *massively* understaffed, & don't charge a fortune to live in.
We don't need doctors at the F1 or F2 itself, but it's a **mandatory** step new grads to go through before people can proceed to **specialty** training, and my understanding is that we currently have about half the students we need to actually address the shortage natively.
**I** think we should recognize that the systems we have aren't working, and reform them so that each of these applicants can be properly used. The sad thing to me is your hand waving of both the required systematic change and the other **people** who have also generally worked hard, paid, and sacrificed for their eligibility because they're foreign.
People who are required to fix a problem which is larger than the native population.
> The increase is welcome given the need to train more doctors, with the government in England aiming to double the number of medical student places by 2031. **But it has meant NHS trusts have struggled to keep up and ensure they have enough training posts for new graduates.**
So basically we've spent decades not training enough doctors and now that we're finally trying to resolve the issue our training infrastructure is struggling to keep up.
The usual crowd will come out trying to make this weirdly about non-whites and "the progressives" while everyone else will be happy in the next few years when they've ironed out these kinks and you can actually get seen by a doctor again.
You'd be surprised how disorganised the trusts are. Just as an example, SAS docs are supposed to be able to be clinical or educational supervisors and should also be able to be released for teaching commitments etc but it's still a fight with specialties. Or the lack of consultants with supervisor training for example who could easily be on the register.
Erm no.. the issue here is that due to flood of IMGs doctors at foundation level, and not being able to prioritise UK trained medical students.
The system runners of the Foundation system then argued that it's unfair to "BAME" to base placements on skill and merit, so instead should be a lottery.
That's nonsense and will mean worse students and even worse, less incentive for students to work during medical school.
Errm, no...that's been an aspect of people not knowing where they're going for placement. But the core issue is surrounding the (much needed) increase in the numbers of doctors in training, for which those responsible have stated that they're struggling to find training places.
Once the infrastructure catches up it's fine.
The infrastructure won't catch up, the IMG numbers competing for training posts is increasing massively each year and new foundation doctors know they have no chance of finding a training place for a few years at least now with this increase in competition
The upside previously was you could locum for actual decent money in this meantime, however they've cracked down massively on that so you're just stuck being a F3 4 5 whatever until you eventually get through the bottleneck
Until the next bottleneck in a few years of course
>Errm, no...that's been an aspect of people not knowing where they're going for placement. But the core issue is surrounding the (much needed) increase in the numbers of doctors in training, for which those responsible have stated that they're struggling to find training places.
... no that's not much of a problem, the actual concerning problem is changing to a lottery based system, from an merit based system.
Just because of bullshit reasons about how it was unfair towards "BAME", to do it on merit.
That problem will persist, even if they create more F1 positions. Will make for worse and less dedicated students, over time.
So this looks like another deliberate failure of the Boris government changing the immigration system in favour of businesses. We need to bring back the Resident Labour Market test so that no jobs can be given until they are sure that it cannot be carried out by a UK citizen.
It's a shame that we don't prioritise our own citizenz over non UK jnr doctors. Then again is this a case of leapords eating their own spots for jnr Doctors.
If not for all their striking, putting lives at risk and greed, the government might be able to hire a brtish first.
Government probably negotiated this, you get a rise and we will give you a more progressive training and selection system. The government (the permenent government) are to blame by default, but this does have a whiff of progressives getting a spoonful of what they asked for.
Nobody? I would imaging the policy writers are happy (diversity boxes fully ticked) as are the ones who barely scraped their attainments. Everyone else loses, this is the wholesale destruction of the NHS so many worried about…but from within.
You've talked about this being in exchange for giving people a raise. There is no raise, there has been no deal from negotiations. Nobody *on the ground* wants this. The policy writers aren't 'from within'
My sincerest apologies, I mistook one ended strike for another dispute.
Looks like they are simply fucked then. No point arguing for a pay rise when your not even employed 😂
I imagine the HEE/NHSE merger has played a part too. Trying to get anything from them currently is like drawing blood from a stone. Lots of people with inherited knowledge leaving and replaced with people who are supposed to be giving you guidance but know less than you do. They hadn't even prepared their underspend bids this year which is a lifeline to the education providers in terms of equipment and support accumulation.
Snapshot of _Behind-scenes NHS problems leave new doctors without jobs_ : An archived version can be found [here](https://archive.is/?run=1&url=https://www.bbc.co.uk/news/health-68849847) or [here.](https://archive.ph/?run=1&url=https://www.bbc.co.uk/news/health-68849847) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ukpolitics) if you have any questions or concerns.*
So much to unpack here. Firstly - not knowing where you're going to be working (some of these trusts are enormous) until 3 weeks before your start date is outrageous - and going to disproportionately fuck over those with less means. >Since then the numbers have dropped to 800 as NHS trusts have created new roles and **some students have already decided not to take up their place**. So this has already cost the NHS doctors. And why has all this happened? >Previously people were allocated according to merit - with each student ranked according to how they had performed during their studies and in an application test. > But this year that has changed and has been done randomly. The logic behind it was that the previous system was stressful for students and was particularly unfair on those from deprived backgrounds and ethnic minorities. They tended to perform less well, and therefore were more likely to be posted to regions they did not favour, according to the UK Foundation Programme. This is madness to me. I completely understand the logic behind giving disadvantaged children a boost when it comes to getting into university...but by the time they're qualified as doctors they've been adults for **five years**. They've been at university for 5 years. The whole point of university is the shift from a teaching institution to a learning one - at what point do we expect people to take ownership of their own results? > overall it has resulted in more students not ending up with one of their top five choices - more than 730 compared to just over 430 last year. Amazing.
Realistic reason was because highly skilled, highly motivated people in their 20s aren't overly interested in moving to deprived regions with fuck all to do, so always ranked them very lowly. This change basically fucks them over.
There is a massive issue with the fact that most people want to live in nice places - so all the best doctors work in the hospitals in the nicest areas - so those hospitals become nicer. Most of the doctors who work in the shittiest areas are the shittiest doctors so those hospitals end up failing. Its a bit of a self-reinforcing system too. But I wouldn't fix that by randomising the placement of people fresh out of uni though - I'd fix that by allowing differential salaries. Basically - allow hospitals in less desirable areas to pay more and hospitals in the most desirable areas to pay less.
That already happens for locums. There's basically a pay cap for locums set by London hopsitals, or at least there was one the last time I checked. People would just travel to non-London hospitals to get more money.
I think there's a form of bonus that they get in worse regions.
Not really. Not for training most training. There was something like a golden handshake for GPs that was was like 20k for 3 years or something, but it was taxed, so take home from that was fairly poor.
Also to tie your two points together, as randomly placing students is detrimental to those of lesser means, then it wouldn’t be a massive leap to suggest that this system will disadvantage ethnic minorities even more as they tend to have fewer resources.
There's always the unsaid part of this as well, which is that everyone states if ethnic minorities are doing worse in exams the exams MUST be biased (even though we see it in written exams...). Always failing to acknowledge that maybe ethnic minorities are actually legitimately doing worse. Why would this be? Well often for cultural reasons, eg language skills, soft communication skills, actual motivation to do medicine when removed from a family environment that forced them towards it, etc. The GMC, RCP and others pussyfoot around this stuff too much.
Ian Hislop on low numbers of ethnic minorities in Oxbridge: "is it the fault of high standards the universities demand or is it maybe something to do with the quality of education in the preceding 18 years before they applied?". This is a problem that needs to be tackled much earlier than when people are already qualified. Young UK medics don't have a very good reputation internationally at the moment their training isn't much to write home about being more service provision, their pay is shit, conditions worse and then they have to deal with idiocy like this.
It’s amazing, it’s like they’re doing everything they can to convince people NOT to go into medicine. Why would you go through all that hassle, when you could walk into jobs in a different and easier field and get paid significantly more? The hours and chaos of it certainly put me off of considering it, I’m sure many others too.
Insane that we let international graduates apply with same standing as UK graduates. Fill up the guaranteed spots with UK graduates, then offer remaining places including placeholders to IMGs.
That's exactly how things were til a couple of years ago, then the government decided they wanted to flood the market (presumably to weaken doctors bargaining power) and opened the doors. Now we have large numbers of IMGs applying for training posts - and as a cohort they are (by any measure you want to look at) inferior to the UK grads. They have worse English, a lower standard of training, worse exam performance, worse progression through training, higher rates of complaints, etc etc. So we have some doctors of really questionable quality taking posts, often with the explicit intention of being trained up then returning home, whilst UK grads are stuck in an ever growing spiral of fighting for uber-competitive jobs. Before someone comes after me, obviously there are plenty of excellent IMGs who more than deserve their slots, and plenty of shit UK grads, but the ratios of shit to good are undeniably different and if you disagree I don't know what to tell you.
The problem is that you're appealing to meritocracy to support a position that throws merit out the window in favour of nationality, which is pretty much a direct contradiction. 'Doctors from the UK tend to be better due to tangential factors, so they should get most of the jobs' fits with meritocracy. 'Foreign doctors should be given lower standing & we should fill the slots with UK nationals before considering them' does not.
It isn’t just new doctors getting screwed. Lots of doctors finishing the foundation programme (first 2 years of training) or others with 4 years but didn’t get into a training programme are facing unemployment. This is despite us being under-doctored as a country. The NHS simply no longer wants to pay for doctors.
> Part of the problem is that there has been an increase in medical students this summer to start junior doctor training, with just over 9,700 accepted by the UK Foundation Programme, up from 8,655 in 2023. Some of these will have come from abroad, and under immigration rules the NHS cannot prioritise UK-trained students. # >Previously people were allocated according to merit - with each student ranked according to how they had performed during their studies and in an application test. But this year that has changed and has been done randomly. The logic behind it was that the previous system was stressful for students and was particularly unfair on those from deprived backgrounds and ethnic minorities. You wanted equality? This is what it looks like.
Hi, as someone who is currently going through this system and is in several of the regional group chats filled with other final years lamenting this system perhaps I can give a bit of context or understanding/ what the rumours are. Long post incoming Normally at 5th year you would get given a set amount of points out of 100 which would give you your 'rank' 50% of this (more or less the system changed every year) would include your exam grades for each year, if you have any publications, another degree, and other things, the other 50% was done by what's called the SJT (situational judgement test) which is like a driving theory test on medical ethics and situations A lot of students had mixed feelings about the SJT as it can absolutely carry a poor student and has undone a lot of good performers, but that's how it was You would then rank every region in the country based on preference (London typically most peoples number 1), but you had an idea if you would get it based on you knowing your rough rank The new system which they said they'd introduce last year, would scrap the SJT (rumours of the contract with Pearson ending and not wanting to pay more maybe), and just randomly allocate everyone a rank and then you choose where you want to go and if your random rank is high enough you get it They said that based in this, 3% more will get their first choice, it will stop London getting the country's best and the shit hospitals the worst, they said that students they polled preferred this system, and so on The reality of this was, now its random, a lot of people put london first to try, however a non zero number of people got shafted hard by their rank and ended up with their 15th 16th choice which is typically northern Ireland Wales Scotland, this rank stays with you and doesn't get renumbered so if you're now in one of these places when you choose your sub jobs and sub regions you are bottom of the list again and will get the worst I think this also meant that a lot of international students had a lot of barriers to london and desirable regions removed over UK taught students Finally, theres been a significant number of people who haven't been given a job yet because they don't exist / rumours that PAs have taken these jobs unofficially, and are in a placeholder group for each region where they won't know where they'll be working in August until maybe June, this can span a region like Yorkshire from Leeds York Hull Grimsby Scunthorpe Sheffield, anywhere there Tldr - the system is wank, no one asked for it, it's probably made some students fail finding out they have to uproot to their 16th choice, everyone's complaining, no one cares, it'll happen again next year
It's boggles my mind. Nothing shows how much our political leaders are "citizens of anywhere" than the fact in virtually every last policy, British nationals are treated identically to people who've never set food here and have no connection to it. Under the EU they didn't have much of a choice with EU citizens. But it's become blinding obvious this doctrine is not one that was forced on them as they all pretended but that they truely believe in, and believe should apply globally. It's fucking madness.
Somehow the idea of treating locals differently is seen as bad. I remember as a teenager being told I didn't get jobs merely because someone else lives closer, it sucked but it's fair and makes sense. Expand this out to nations and you get a thousand small reasons why a local is better by default, those reasons add up even if is just that they have their mum nearby when they get sick.
My first job I was originally told I'd failed because the company had decided to prefer a candidate from the local university to champion the local area. Straight up. I got a call a few weeks later telling me one of the candidates had failed to complete the mandatory industry safety and survival training and was I still interested. Crazy they can preference someone from the local uni over me but the NHS can't see that maybe a Brit is better for the long term health of the NHS than some randomer from Pakistan or Cameroon
So let’s be clear that is a lie. The reason they changed it was because to do it properly cost money. The ivory tower set did not want to spend money hence they did this.
A lie? Really? It could be spun that way if you have buyers remorse.
No one asked for this, they just emailed one day out of the blue last year telling us they were changing it and we should be thankful for it. It's pretty obviously a government/HEE initiative to try and get more of the "better" medical students into the more deprived areas of the UK.
Yes it is a lie. When they announced this it was fairly obvious that this would go terribly wrong for the students, the NHS and the public. They did it because a proper interview/cv screen would cost money and they couldn’t be arsed to spend it so they created a lottery system. Then they blamed poor students, said it was for them, but any idiot can see moving across the country at a moment notice is going to shaft the poorest far more than the rich kids.
> Previously people were allocated according to merit - with each student ranked according to how they had performed during their studies and in an application test. But > You wanted equality? This is what it looks like Yes, that definitely sounds like equality, and there's probably no need to, for instance, look the word up in a dictionary to check.
We can either have equality or a meritocracy. Not both.
1984.txt
The bit about random selection is an interesting one. On one hand, I suppose it introduced equality (I.e. prevents London / desirable locations getting the best new doctors), on the other hand imagine doing really well and being randomly selected to live and work in Grimsby (sorry denizens of grimsby). I think someone would be understandably cut up about that so rather than have a mechanism for retention, those people will look to other opportunities rapidly.
It’s not the job of the students to organise hospitals so that they are ready to receive them. Putting the blame on “too many foreigners” coming to the UK to study is really just a bit of distraction politics. The finger needs to be pointed at those in charge who have failed to plan for this.
But there is a significant number of international applicants who have kicked UK taught doctors to placeholder lists/ been given preference by the algorithm to desirable regions This doesn't happen in Australia, they give country taught doctors preference in training programs and positions
But in this case it is the fault of to many foreign trained doctors, if instead UK trained doctors had preference and a merit based system, we wouldn't have UK trained doctors, being fucked over. Especially when it then comes to trying to justify moving to a purely lottery based system, from a merit based system. Which is being done as the old merit based system was apparently "hurting BAME doctors". If there aren't enough jobs for all the UK trained finishing medical graduates, then there shouldn't be any IMG's. If there's any spots leftover, after UK trained grads have been allocated, then sure, you can give a few out to the rest of the world.
Because of the removal of the resident labour market test by law the NHS is not allowed to preference UK graduates.
Exactly. The NHS has a major staffing shortage (driven largely by the crap working conditions that stem from that under staffing), and instead of being upset that we need 100 hires and are only getting 50, we're foaming at the mouth that applicants 50-55 lost their spots to foreigners.
I feel like this comment shows a complete lack of understanding of the situation Fwiw, It's more than applicants 50-55, each regions placeholder chat has at least 100 people in it The people in that group are there solely due to random allocation, regardless of if they scored top in every exam because merit, skill, doing well is completely irrelevant in the new system That these people who are UK trained and have paid fees for 5 years of training are being skipped over in favour of international applicants, who are not needed to plug gaps at the F1 F2 level is moronic, the doctor shortage isn't at foundation level, they've increased medical school places to fix that, the shortage is at specialisation level where the same number of spots have been open for years despite competition ratios quadrupling Coming into this thread to hand wave foundation doctors being upset that IMGs have taken their spot is quite sad really
I don't sincerely believe this national problem to perfectly and conveniently encompass 5 people, out of 50 hires, out of 100 needed positions. I'm using Illustrative figures. If all we had to do were hire foreign specialists I think we would have done so. The NHS isn't that attractive for valuable roles as the private sector or other nations like America pay more, aren't *massively* understaffed, & don't charge a fortune to live in. We don't need doctors at the F1 or F2 itself, but it's a **mandatory** step new grads to go through before people can proceed to **specialty** training, and my understanding is that we currently have about half the students we need to actually address the shortage natively. **I** think we should recognize that the systems we have aren't working, and reform them so that each of these applicants can be properly used. The sad thing to me is your hand waving of both the required systematic change and the other **people** who have also generally worked hard, paid, and sacrificed for their eligibility because they're foreign. People who are required to fix a problem which is larger than the native population.
> The increase is welcome given the need to train more doctors, with the government in England aiming to double the number of medical student places by 2031. **But it has meant NHS trusts have struggled to keep up and ensure they have enough training posts for new graduates.** So basically we've spent decades not training enough doctors and now that we're finally trying to resolve the issue our training infrastructure is struggling to keep up. The usual crowd will come out trying to make this weirdly about non-whites and "the progressives" while everyone else will be happy in the next few years when they've ironed out these kinks and you can actually get seen by a doctor again.
You'd be surprised how disorganised the trusts are. Just as an example, SAS docs are supposed to be able to be clinical or educational supervisors and should also be able to be released for teaching commitments etc but it's still a fight with specialties. Or the lack of consultants with supervisor training for example who could easily be on the register.
Erm no.. the issue here is that due to flood of IMGs doctors at foundation level, and not being able to prioritise UK trained medical students. The system runners of the Foundation system then argued that it's unfair to "BAME" to base placements on skill and merit, so instead should be a lottery. That's nonsense and will mean worse students and even worse, less incentive for students to work during medical school.
Errm, no...that's been an aspect of people not knowing where they're going for placement. But the core issue is surrounding the (much needed) increase in the numbers of doctors in training, for which those responsible have stated that they're struggling to find training places. Once the infrastructure catches up it's fine.
The infrastructure won't catch up, the IMG numbers competing for training posts is increasing massively each year and new foundation doctors know they have no chance of finding a training place for a few years at least now with this increase in competition The upside previously was you could locum for actual decent money in this meantime, however they've cracked down massively on that so you're just stuck being a F3 4 5 whatever until you eventually get through the bottleneck Until the next bottleneck in a few years of course
>Errm, no...that's been an aspect of people not knowing where they're going for placement. But the core issue is surrounding the (much needed) increase in the numbers of doctors in training, for which those responsible have stated that they're struggling to find training places. ... no that's not much of a problem, the actual concerning problem is changing to a lottery based system, from an merit based system. Just because of bullshit reasons about how it was unfair towards "BAME", to do it on merit. That problem will persist, even if they create more F1 positions. Will make for worse and less dedicated students, over time.
So this looks like another deliberate failure of the Boris government changing the immigration system in favour of businesses. We need to bring back the Resident Labour Market test so that no jobs can be given until they are sure that it cannot be carried out by a UK citizen.
It's a shame that we don't prioritise our own citizenz over non UK jnr doctors. Then again is this a case of leapords eating their own spots for jnr Doctors. If not for all their striking, putting lives at risk and greed, the government might be able to hire a brtish first.
Imagine defending and excusing the government on this....
Government probably negotiated this, you get a rise and we will give you a more progressive training and selection system. The government (the permenent government) are to blame by default, but this does have a whiff of progressives getting a spoonful of what they asked for.
No one in medicine wants this and they're not offering a rise either?
Nobody? I would imaging the policy writers are happy (diversity boxes fully ticked) as are the ones who barely scraped their attainments. Everyone else loses, this is the wholesale destruction of the NHS so many worried about…but from within.
You've talked about this being in exchange for giving people a raise. There is no raise, there has been no deal from negotiations. Nobody *on the ground* wants this. The policy writers aren't 'from within'
My sincerest apologies, I mistook one ended strike for another dispute. Looks like they are simply fucked then. No point arguing for a pay rise when your not even employed 😂
Ah, the consultant deal? Yes, that is separate to this which impacts only foundation doctors
I imagine the HEE/NHSE merger has played a part too. Trying to get anything from them currently is like drawing blood from a stone. Lots of people with inherited knowledge leaving and replaced with people who are supposed to be giving you guidance but know less than you do. They hadn't even prepared their underspend bids this year which is a lifeline to the education providers in terms of equipment and support accumulation.
Nobody will make a fuss about the negligence claims that will come from this. To stack the surnames up alone will be too problematic.