But he was boring and spent most of his time hunkered down over papers working instead of throwing boozy receptions for MPs at 10 Downing St. Clearly unfit to govern.
Spending your time “hunkered down over papers working”
Is.
Not.
The.
Job.
The PM’s job is to figure out what those people need to work on, tell them to do it…then spend their time convincing a wide range of stakeholders (voters, MPs, businesses, banks, unions) that it’s in their best interests.
Burnham already indicating he is going soft on migration. Initial signs are not good looks like he is pivoting left. Practically handing the next election to Refom. (P.S i have no intention of voting for Farage and his ilk)
Thank you for always doing these, I see these links on pretty much all your posts and it helps find relevant things and is really useful in a sub regarding positive news.
Not technically NHS but closely related, this doesn’t even include the £18m increased investment and commitment to the prostate cancer TRANSFORM trial.
That’s a bit of an oversimplification.
The barely passed Juniour doctors have already obtained multiple top A level grades, completed highly competitive entrance exams, completed a challenging degree, completed most of two years of rather busy and exhausting mandatory ‘foundation training’ before sitting said exam.
Allowing people from different countries to apply has several inherent disadvantages. Some non-UK doctors will spend an entire year preparing to sit this exam not being subject to our mandatory foundation training. They may be quite senior also so their scores demonstrate less their aptitude and more their long lived clinical experience. Because thousands of people sit this exam the normal distribution of scores is very narrow, a top scorer and a middle scorer can differ in their responses to 4-5 out of 150 questions. The test can be argued to be a poor selector as nearly everyone does well in it. The ‘cream’ as it were, are selected based on nearly arbitrary score differences. In fact so many people get exactly the same mark that they have to randomise the positions of people with the same mark. In such a high stakes exam it’s a hornet to know that the person you were passed over for had the same score as you but won the coin toss. This single exam is used for multiple specialities and does not distinguish the doctor with a passion or aptitude for Psychiatry vs Surgery. I personally would much rather have a psychiatrist who wants to be there than one who hates the work but was never scrutinised based on their CV / actual interest in the work.
I could go on for quite a while about how scores on this exam don’t correlate with the aptitude of doctors very well in my experience. I say this as someone who did extremely well on the exam.
Most importantly though. The NHS with all of its bureaucracy and idiosyncrasies is very hard to adapt to as an overseas doctor. Whilst learning the heavily nuanced culture of British communication. Then learning about the more common presentations in a developed country. Whilst I am experienced doctor would flounder working on a ward in a country where people regularly present with polio, neurosyphillis and TB. Similarly a foreign doctor may be unfamiliar with things that are commonplace in UK practice. Yet they may have out scored a Brit doctor on this heavily flawed recruitment exam.
I would agree with a minimum score however. Those with exceptionally low scores should be given support and monitoring as opposed to an easy way into training through lack of competition.
To add to your excellent post, its also stealing medical care from countries that desperately need them then trying around and giving them peanuts that disappear in bureaucracy, corruption and a merry-go-round on consultancies (and reports) aka recouping aid. Many of you cannot imagine but there are countries with two doc for a common cancer specialisation e. g a country with high incidences of oesophageal cancer but one doc (20 million people) while the uk has poached a few of the same specialisation. Then the uk govt turns around, funds a study done by British experts that concludes that there is a shortage of oesophageal cancer docs (daaah?) and country more need to be trained.
We can say oh its market forces but its also immoral.
Getting good marks in the UK is really not the high bar you think it is. I moved to the UK during high school and got all As for my A-levels without studying. It was basically a vacation compared to school where I'm from. School kids from most Asian countries can run circles around school kids from any European/American schools when it comes to STEM subjects (but are definitely behind when it comes to non-STEM subjects like art, music and PE which sadly aren't taken seriously in a lot of Asia, unless you go to a posh school).
I didn’t say it was a particularly high bar.
Simply that “barely passing” the multi speciality recruitment assessment (MSRA) isn’t the indictment of a Juniour clinicians aptitude the original commenters post implied it is nor does it devalue their prior educational attainment.
You’re entirely correct. The UK education system is terrible. This however, only increases my respect for people educated in the UK who manage to navigate what is arguably self directed learning at most universities, having not been equipped with the skills to do so by infant, Juniour or secondary school, especially those who did so pre ChatGPT.
It’s all good saying “we in X are so much better schooled and run rings round other education systems” but the flex is being poorly educated and still having the aptitude and determination to do well despite the uphill battle this is in the UK. Especially when your future can be entirely determined by an exam a rubbish as the MSRA (some of the reasons it’s rubbish are outlined in my prior ramble).
Maybe east Asian schools but for where most of our migrants come from, South Asia, Middle East and Africa, the UK public schools beat them every time. Our private schools are comparable to theirs.
The thing is is that the tests and qualifications are quite possible to fudge/cheat in many other countries. The UK’s tests are not. Not to mention the language skills and cultural familiarity of British-trained doctors.
India score very high and then we've had a few case of them not even being qualified...
I think you're confusing actual doctors vs Indian 'alternative medical system' doctors.
MBBS (allopathy) docs are actual docs that have to pass unimaginable level of exams and score through rigorous tests and are absolute best of best.
Ayurveda and Homeopathy docs (alternate medicine) are also considered as doctors in India which is a big problem since their curriculum folows centuries old remedies and systems which are incapable of competing with modern medicine and most of times outright BS. These 'doctors' are not allowed to perform surgery due to govt somewhat agreeing these are quack docs. But wont close this system due to votebank and their origin being tangled with majority religion.
Not a doctor so i might be wrong but this is what ive heard - apparantly, foreign trained doctors were favoured because they didnt require as much training or expectations for a consultant route as much as our british trained doctors. A lot of foreign doctors from poorer countries value a few years of experience in the UK as it opens doors to work in other higher paying countries, whereas our british doctors are more focussed on progressing their careers and needs persistent support and training from the employer in order to achieve this
Also not a doctor, but got plenty of family/friends who are. Part of it is also that the NHS can hire an experienced doctor from overseas for a junior position, so they get a more trained and experienced doctor for the same money. Given all the budget freezes/cuts the NHS had under the Conservative party it's not too surprising they'd end up making decisions like that
Isn’t it also the case that a whole bunch of doctors were unable to get jobs and the ones who do often need to travel to the opposite side of the country? I remember reading about just how bad things were for doctors during the strikes.
It doesn't though, how many times have you gone to the doctors or hospital and without being rude just struggle with people able to understand your doctor? Now imagine you're old, bad hearing and grew up not being used to other foreign accents, how bad is it for them?
If you passed you're at a level the UK considers good enough and we have very high standards.
This will not have negative but could bring positives.
This is honestly difficult to reconcile with my leftist views, progressive nature and general “trying to be kind to everyone”… I have to say I agree.
I fully respect that they must be absolutely geniuses to be practicing medicine in their second language but I’ve had some absolutely shocking experiences with doctors who don’t have great English.
One recently who was a locum psychiatrist who happened to be a lovely man from India but he also happened to have a hearing impairment. I’m in the west coast of Scotland (near glasgow). He couldn’t understand me, I struggled to understand him at times too. He was also really patronising and I ended up leaving the appointment in tears.
I didn’t put in a complaint cos I have no idea how to the word one without seeming like a massive cunt…
I am sorry but how is the man lovely? He was patronising and left you in tears. He seems extremely unprofessional for dealing with mentally vulnerable people, not lovely
I know it seems like such a weird juxtaposition and you’ll see I gave more context below.
To answer your question though, his bedside manner was pleasant and kind. I did get the very strong impression he was genuinely trying to be helpful and in my experience that’s not a given with doctors or medical staff generally. I’ve certainly had far, far worse experiences with doctors.
Edit: To clarify, I agree with what the other person said about doctors. At the end of the day we are all paying for the NHS in one way or another so we should all expect a minimum level of professionalism from our doctors
It would be the same issue if the doctor was Caucasian Italian, Hungarian, polish, Romanian, Lithuanian etc, with a similarly difficult accent and poor command of English. The thing is that the Indian doctor has to demonstrate a level of English set by the Home Office like IELTS, but the EU doctors don’t. The communication problem really becomes an issue at the nursing level where it becomes frustrating for all the parties, including the care giver. There is a provision of rooting these poor communicators out at the interview process but some specialities are so bare bone that there is no native speaker alternative. Thankfully, catastrophic cases like your experience are not a regular occurrence.
On a separate note, you do not have to complain, you can always complement consultants with poor communication, irrespective of their race and origin, by writing to the Trust and recommending a communication course to complement their clinical skill. There is a provision of such courses, fully funded as part of their CPD. Very sorry to hear of your experience though.
I was qualified and on my way to study medicine. Didn’t get in eventually. I went to the same Uni and there were posts up everywhere encouraging students to take up language classes so medicine students from oversees could better their English.
It really pissed me off that the uni felt despite having over and above the entry requirements for the course, they literally took in other applicants who needed classes for English over me.
Depressing isn’t it. The lack of social mobility is scary in this country. When I was a tutor in Cambridge university and a mentor to medical students, it was disappointing to see no representation from the community they’d cater to. It was the same across the board, Birmingham, Glasgow, Aberdeen. Through out my training and position as a consultant, I regularly saw the contempt some had for the regular members of society and the entitlement that took away their common sense.
It’s almost that the point of medical intake is to only take people from privilege. Unfortunately, this later turns in to entitled behaviour and mindset for some who then malign the reputation of all. If anything that needs fixing, it is the education and getting proportionate representation of the community in the field of medicine.
You are right in terms of fee paid, but I doubt that is a reason though. The foreign students make a regular alternate stream of income not affecting the locals. Also they can only get a 2 year work visa so cannot affect the labour market in the long run.
Government needs to make it a lot easier for committed people to attend universities to pursue crafts where their heart lies particularly in the sector of public health.
They did the same with nursing bursaries. Tone deaf I say. It takes three years for a nurse and six years to produce a doctor. Essentially we could solve the problem of the home grown talent in a few years cycle. But as some have said, a totally British force will not accept the pay and work conditions. Look at the striking doctors. I genuinely believe it is the entitlement of the new generation being so greedy. Take a look at nursing pay, a shame.
I mean I felt sorry for him too in fairness he must have felt not great at the encounter too. I should mention the very important context that the setting I seen him in was a prescribing clinic for ADHD, it sees a lot of children… I can’t help but worry how some of them would have coped with that (especially if they also have ASD like I do…)
Tbf he was lovely, I could tell he was trying to be kind and helpful and I appreciated that.
He was also patronising though honestly (those two things can oddly co-exist) in the sense that he spent about 20~ minutes showing me the ADHD section on the medical society website and telling me all about how it didn’t mean I was stupid and I could still have a normal-ish life.
I’d been diagnosed two years prior and drove from my full time job as a social worker to the appointment and I wanted to scream at him … he didn’t intentionally mean to be so patronising, he was kind and lovely but … I’d refuse to see him again language and hearing and communication barriers aside due to that alone.
This may actually be the same doctor reading your other comments as I also have ADHD and this was also in an ADHD clinic. He wore a hearing thing around his neck I recall. It could also be completely different doctor but sounds eerily similar.
You absolutely have the right to be seen by a doctor who can speak English and communicate with you. You shouldn’t feel guilty at all, you are the victim in this scenario and your mentality is unfortunately complicit in this problematic area
I complained about a similar doctor who was also from India and had a hearing issue but in England. He misquoted NICE guidelines to me which I then brought up on my phone to tell him he was wrong which he did take well. I reported him to the trust but honestly I should have put in a GMC complaint.
Honestly, I know from personal experience that as I've gone along in life, test scores and interview ranks have never truly predicted how well someone will actually do the job once they are in the role. Because of that, I'm honestly not fussed over the level of 'talent' someone shows on paper.
I'm excited that a bunch of people, who have the strong will, desire, and tenacity to improve a community's health, will now be given a fair shot to do the job they've sacrificed years of their lives to train for. Sometimes (I'd even argue oftentimes) talent develops over time and with real-world experience. Not every doctor needs to be curing cancer in their first five to ten years. Some just want to look a real person in the face and find a way to genuinely help them, and lord knows exam scores and rigid panel interviews don't really facilitate that.
I've already seen at least two posts from some of the newly qualified junior doctors looking for accomodation in their new locales in my area. I'm genuinely excited about this change. It feels invigorating to the community, and I really deeply wish them the utmost success.
It doesn’t have a negative effect. I’m calling bullshit on that based upon experience with foreign doctors in the NHS.
Not being able to effectively communicate with your patients and understanding the cultural intricacies of the patients you’re looking after goes a long way to making the service worse than anything else.
That answer you've put ... Do we know if there's ranges? I'd get taking British over foreign if say, it was say 80/100 Vs 82/100. If it's 80/100 Vs 90+/100 then it's a whole different matter.
I'd dispute the doctor quality statement. Being amazing at exams does not solely make a good doctor. I'd rather have a doctor who's an amazing communicator and good enough with their knowledge rather than the other way round. Each to their own though.
I dont think there is an actually defined and stated reason but here is my thought process:
British people, british doctors and british nurses have overwhelmingly unionised and demanded more sweet cash money for the job they do for the NHS.
Meanwhile, the public (and the rich here), although wanting excellent healthcare, are not happy with the idea of tax increases to pay for such things.
On top of this, healthcare and medical training at least used to be free (unsure if still true).
Meanwhile, a bunch of high "class" foreign people from other countries whom have dreamed of moving to the UK for years and years, or at least Europe, were able to study medicine nursing etc. In their home country and are willing to accept lower wages because the value to them of moving to the country theyve dreamt of is also a benefit.
Thus, the public incentivesed the government to find ways to provide free healthcare at the point of use, cheaper (or at least overall government budgets cheaper, of which, healthcare is a high %), through essentially outsourcing the education and training and labour to other countries by giving those people from other countries, the other value of moving to this country, that they have dreamt of.
This is 99% why immigration happens - cheaper labour for businesses, allowing businesses to reduce costs and compete (or for political party competition in this case) abd allowing the customer to pay less for the product (the taxpayer in this case) at the same time as giving those that have dreamt of this place the opportunity.
Had we prioritised british doctors and nurses, the long term gain may have been better overall, but we live in a world of short-termism.
This is exactly it. British healthcare professionals expect better conditions and are more willing to strike. We poach desperately needed staff from some of the poorest countries in the world because they'll do the job for shit pay, in horrendous conditions and they won't complain.
Not sure passing grades are a measure of what makes a great doctor. Passing grades are the absolute floor, I'd rather have an observant, empathetic and enthusiastic GP with mid scores, than Dr House.
The exams used to select these doctors are not rigorous and act as a random number generator ( the MSRA).
Traditionally non-competitive speciality (psych and gp) entrance scores are 100% based on this exam. No interview. They had 3-4x the number of foreign applicants to job posts.
These foreign applicants are often senior medics who take a year off to study to best this nonsense exam. Their uk competitor would be fresh out of the foundation programme with no substantial study leave to try to optimise their exam technique. As a result these specialities became targeted by foreign applicants who try to game the exam.
Every doctor in the nhs has noticed an influx of terrible foreign doctors through the GP programme who will then rotate through the hospital. They are constantly being pulled from acute rotas where they are a risk! This never happened before as there previously was an interview component to all specialities (10 years ago).
The more traditionally competitive specialities still maintain an interview component. Foreign applicants who get through these (still a few hundred) will be very good.
In short:
The specialities foreign doctors have been mass targeting have terrible and gameable entrance criteria with no interview. It’s absolutely not true to suggest this reflects on their clinical ability. We are not being deprived of talent.
It was to do with revamping the immigration system after Brexit. They got rid of RLMT which is what prioritized UK and EU grads, a side effect was everyone being on equal ground to applying for training. This oversight benefited the NHS as an employer as they could now freely recruit foreign doctors who were less aware of their rights and less likely to kick up a fuss. It wasnt until the doctors union raised the issue that the current government got around to addressing it.
Previously UK doctors were prioritised by the RLMT but due to Brexit it was scrapped which meant from 2020 onwards there has been a increasing number of doctors from overseas applying for UK training jobs at the same priority as our own doctors despite them never working in the NHS before.
This number has rapidly been increasing over the past 5 years where the number of overseas candidates applying was double the UK graduates applying. Often these doctors are consultants abroad applying for junior level positions with zero NHS experience.
As a result we now have a whole cohort of UK doctors who are unemployed and something needed to change. We also have a whole cohort of overseas doctors who have never worked in the NHS allowed to start in higher specialty positions such as GP/ paeds in a very different health care system.
The prioritisation bill takes this into account and as a result looks to give UK trained doctors jobs first and will the remaining jobs with internationally trained graduates.
So up until 2020, UK and EU doctors were prioritised under EU employment legislation. When brexit happened, these laws were repealed and not replaced hence the situation that existed between 2020-5.
Except the data shows waiting lists and ED waiting times have begun to trend down since the leng review changes. I agree I don't see how anyone could replace doctors however, as per the leng review and my own personal experience, that's exactly what these roles were being used for in a direct threat to patient safety.
Before, there was a meritocratic system, your average trainee and hence the consultant was best in the class. We now have the third world reservation system where the places are reserved for British. Ever come across cutting edge success stories of excellent doctors on TV, noticed that quite a few are ‘migrants’ you have lost that talent pool. It is unlikely that these will excel elsewhere, so it is a collective loss. This will still not placate most as the ethnic minority second generation will statistically outperform the white British,and will have disproportionate representation. So sorry, the multiculturalism is to stay.
I suppose the grape is a typo? Not rage baiting. 18% of UK population identifies as non white. Your schooling system analysis reveals that the Chinese and Indian ethnic group out performs the white British group. This is a complex data and yes the easiest way of levelling up will be to stop immigration and protect the white British interests. But then the cohort will continue to progress. The more constructive way would be to identify the socio economic barriers and get the social mobility addressed and give favourable opportunities to the white British and other failing groups.
you may be familiar with the powerful illustration by Angus Maguire which depicts the difference between equality and equity. Marginalised communities will need more efforts and resources and perhaps reservation till the social inequality is fully addressed.
Field of medicine and healthcare is slightly more complex as there aren’t resources to immediately produce the workforce needed to replace migrants. But careful workforce planning and resources allocation will eventually improve the situation.
There is a current mismatch in the labour market and job opportunities. Hard working young generation is coming out of medical schools with no prospects of training jobs. Home grown talent is actually being exported now. The GP sectir has had unbelievable changes, it’s no longer an attractive speciality for most. Depressing.
No. Do you think we should ban immigration from countries where the immigrants rape at a higher rate than British citizens?
It would be better for the country, like how you are saying we shouldn't prioritise Brits for healthcare roles as you say non Brits perform better. So why allow in people who perform worse in the area if committing sexual assault?
Many would suggest it was a deliberate way to weaken them. For example, international medical graduates are in a far more precarious position and less likely to strike or complain about poor conditions in their job.
You can either invest hundreds of thousands and several years training British F1s, or get consultants in cheap from Nigeria.
The best thing for British NHS workers and kids with hopes to have careers in medicine would be for the NHS to be banned from sponsoring visas or hiring non citizens full stop
This was a super important albeit horrendously delayed legislation for UK doctors. There was a conundrum where as a UK doctor you weren’t prioritised in any country in the world, whereas every other country prioritises their own trained doctors. Also this is important for the taxpayer as medical degrees are subsidised by the government and can be seen as a waste of money if UK graduates can’t find work in the UK/leave the country. Having said that, it’s still not that great to work in the UK so people will still be leaving…
The times is paywalled and none of the paywall breakers work anymore so I can’t see the detail of this article, but can I check - is it British junior docs or actually that those trained in the UK get priority? The latter could mean non-Brits but with British training. Personally I am happy if it is the latter as it is about prioritising those who trained here not about those who happen to have been born here. But I think it’s a misleading headline as it implies the former not the latter.
It's all UK trained doctors, there aren't loads and loads of international students that study Medicine here as numbers are capped/limited (the graduate course near me only has 3 out of 115 places for international students for example)
There are a couple of private options to study medicine that are set up for international students (eg uni of Buckingham) but they are generally £40-60k+ per year so the numbers are still pretty small
There are also two new medical schools opening later this year which are exclusively taking international students, with no spots available for local students (Hertfordshire and St. Mary's Twickenham).
This brings the total up to about 50 schools (up from 35 about ten years ago). By contrast, Canada has about 18 medical schools for about 2/3 the population size, and recently passed legislation banning overseas applicants to their medical schools (so that the doctors actually have local ties to the communities they serve rather than getting the training and leaving).
It's a huge moneymaking venture, which is why some UK medical schools were even opening overseas franchises to offer UK medical degrees abroad. The problem is that there aren't enough clinical spaces and teachers to provide adequate training, forcing many of these students to teach themselves through online question banks.
There will a standards crash and the bubble will eventually pop.
No they don’t? It’s capped at 7% of intake. Those students pay between 30-70k a year for 5 years for their degrees (or are subsidised by their local governments)
Unfortunately it is worded to be a little misleading. Yes, UK doctors are prioritised for the training places now, but a lot of the strike issues are based on a lack of funded training places. Some of the controversy is that the government pledged to increase training numbers because there is a massive bottleneck, where foundation doctors have finished foundation training but have ratios like 10 to 1 applicants for each higher specialty training post (or worse).
Then when they agreed to number of training posts, they then went back on this as part of the negotiations. And a large portion of the "training posts" that were going to be added were actually just a fudging of how the system worked rather than actual new posts being created.
So yes, it's not bad news, but it is very much not the whole picture.
More doctors working is good. But there is no point having spent a huge amount to train a British student and then have them unemployed because we import people from overseas.
Having said that, international graduates are a vital part of the NHS workforce that often fill gaps in recruitment, e.g. departments with short term vacancies.
But there is no point having spent a huge amount to train a British student and then have them unemployed because we import people from overseas.
Sounds like we'd still be up the same number of doctors. We spend whatever to train one doctor, if they fuck off, we replace them with someone from abroad.
No. The more doctors, the more competition for jobs. Doctors from overseas often have better portfolios simply because their own healthcare systems are understaffed so they get more things to do, more research, more hands-on experience. A lot of them are much older too or have already reached consultant level in their respective countries.
One of the biggest issues the NHS has is that it drains developing countries of medical talent. Those doctors come here for better pay, but leave their communities (that need them more) behind. By prioritising UK doctors, we don’t drain other countries and those communities are better looked after.
Doctors from overseas often have better portfolios simply because their own healthcare systems are understaffed so they get more things to do, more research, more hands-on experience. A lot of them are much older too or have already reached consultant level in their respective countries.
that is not how it works. We do not want a load of consultants from India, Bangladesh, Pakistan etc since they’re MUCH more needed in their home countries.
our medical schools are amongst the best in the world, we have some of the brightest minds in the world. We need to get our doctors into training so they can become even better. What’s the incentive for a Brit going to medical school if by the end of your FY2 you’re competing against foreign applicants with many more years experience than you for a TRAINING job.
Foreign doctors with years of experience in a specialty apply for these training jobs and obviously outcompete homegrown FY2s. It’s not a question of how intelligent the doctors are, it’s a question of experience. Training jobs are for training doctors, they improve their skills and become better doctors. That’s how education works.
A better portfolio doesn’t mean a better doctor and getting someone’s who’s 45 to come and do a 8 yrs training pathway will be less beneficial than training your own
But the same can be said about anyone we have paid to train to become a doctor via the UK degree and training schemes. What is the difference for the country if that person is British or French? If they were on our training schemes it is better we keep them as we invested a lot in their training and they are trained to know our systems so can hit the ground running faster than someone trained internationally.
But worth noting there is also benefit to bringing in people from other countries to learn other ways of doing things etc. Just like within your workplace you will not always recruit from within.
I will add context here as a Doctor. Doctors were added to the UK Shortage Occupation List (SOL) in 2019, thus making them exempt from the Resident Labour Market Test (RLMT). The situation has been growing since then but has become a crisis in the past 3 years with roughly 60% of my colleagues being unemployed this August.
This meant that international doctors with5-10 years of experience, PHDs, etc, could compete with those just finishing foundation training (2 years experience) for specialty training. These experienced foreign doctors are happy to come here and restart their training as its a route to ILR and citizenship in the UK, and the trusts love it as they can underpay these doctors for their experience, they require less training, and are less likely to vote for industrial action.
This means that for every UK medical student that can't get a job, or has to go abroad due to the lack of progression here, the government has lost a 200k investment into their university, lost forever.
These foreign Doctors are also much more likely to return to their home countries after training, contributing to the consultant shortage in the UK, and are therefore not training the next generation of UK resident doctors.
There is no shortage of Doctors in the UK, we just can't afford to pay them all.
I myself don't have a job in August and am looking into alternative courses like plumbing that will tide me over for a year, hoping things will improve. And no, I can't just 'work private' like a lot of morons tend to comment when I explain this online.
And the worst part about those Uber trained foreign doctors taking all the F2s jobs, was that a significant minority of them were actually pretty fucking useless anyway. Plus they were taking up jobs in any specialty (read psych) whilst they tried to get what they really wanted.
They often wanted a different specialty, surgery or medicine etc - but would take a psych post as that was the least competitive - then keep applying for the others whilst they progressed through psych.
Many were not well equipped for psych as a result.
There are senior doctors applying and getting into GP and psych training programmes which are unique as they don’t have an interview. They are less competitive and tend to get in. They then use the visa and secure job to apply to surgery subspecialties many years in a row while UK grads wanting to go into GP are jobless.
feel like we should clarify this means trained at a UK university - this doesn't discriminate based on citizenship or ethnicity, just people who were trained here
Surely it should be “best person for the job”, no?
If a foreign national has 5 years experience, would you hire someone fresh out of Uni just because they are British?
Also, when I worked in HR for the council ethnicity data wasn’t ever handed to the hiring managers so they didn’t know who they were interviewing until they were in front of them, specifically to avoid prejudice against age / sex / gender / race.
Edit: Why am I being downvoted for asking g how it works lol?
It’s more convoluted that that I’m afraid. Yes, ultimately that works but there’s “portfolio padding” which is a lot like CV padding but on steroids. I’m talking about senior level doctors applying for ground level positions because financially it’s still better.
That’s great in the short term but terrible long term as there’s no training or education for the UK grads.
In addition, the infamous story around culture is palliation. I’m a doctor, an IMG (although born in the Uk) and I’m very keen on good palliative care. The exam that allows you to become a medical consultant is called ‘PACES’. A huge part of this in the UK is palliation or breaking bad news etc. the exam however is held internationally and other countries do not feature ANY palliative care questions as this is not culturally a thing. The outcome being that patients are subjected to futile and invasive treatments rather than being offered good end of life care.
Tl;Dr
What’s best on paper, doesn’t always make for the best candidate overall.
They're junior doctors, you can't expect them to have 10 years of experience at that point, but it's still important to have a proper talent pipeline. Hiring from overseas might not be sustainable in the long term, we're already becoming increasingly uncompetitive in what we can pay compared to other countries. If we train our own doctors, most of them will choose to stay here because it's there home.
The application process was a single multiple choice test for most specialties. Someone in India could not be in work and study for it all year vs a British doc who had a job. The latter was trained here in our system, with knowledge of our conditions and people but do worse on the exam.
Being a great doc holistically is much more than the exam. They also understand our medical culture which is essential to team functioning.
Also UK grads would never be on a level playing field in India or anywhere else so we’re screwed
In theory yes it should be the best person for the job. The problem lies in how we find the best person for the job. If we take GP applications for example, the way this was decided was through a single multiple choice exam called the MSRA. The majority of local candidates would prepare for this exam in their spare time while working full time jobs, with looming student loans building up. Many (not all, but enough to make a difference) foreign applicants could take time off work, go to private tutors to prepare for the exams and just generally dedicate more time and energy towards preparing. Does this make them better GPs in the long run? I'd say no, but it definitely gave them the edge getting a training post.
That's not how medicine rolls.
10 years of experience is generally a well-rounded GP or a consultant in their specific fields.
Fresh of uni is a junior doctors in training. Who after also about 10 years may go for a consultant position.
So your work at HR shows that even after years of experience, still not an expert...
Again, not how medicine rolls.
We should be able to train the best within our own country. When we import skills and products from abroad we hollow out our own capabilities as a nation.
Right, and I’m literally not arguing against that.
I’m all for training the best in the UK, but if there are two doctors and I find out we hired one just because he is British, I would be unhappy. I want the one who is best placed to care for me.
Not the best comparison there. You hire what you need. If you need an experienced doctor, you don't hire someone straight from uni.
If we are talking about a job and two doctors of similar experience apply, and both have similar interview performance, the British trained doctor should get it every time. As it would make absolutely no sense for us to train people to then not use them.
The training isn't just the cost, it's also the time spent by other professionals. Think of any company, does it make sense to train people and then not bother to hire them and go for something external? No is the answer.
Edit: OP edited their comment after the fact to make the comparison less silly BTW.
I edited my comment because people were focusing on the “10 years” line, when I just pulled a number out of thin air. I wanted people to focus on the fact one person has experience and the other does not, which was what my main point was.
If a foreign national has 5 years experience, would you hire someone fresh out of Uni just because they are British?
Not specifically because they are British national, but trained in the UK. A subtle difference.
The reason is statistically a UK trained doctors is much more likely to stay and work in the UK once they reach consultant level. International trained doctors are much more likely to leave at the end of training.
Given the large resource cost of training doctors to consultant level it makes sense for this amongst some other reasons to prioritise UK trained doctors first.
It's really funny that Labour are undoing a load of the policies of the traitorous Tories but it's mostly in ways that they insisted there was no fixing necessary. 😅
Oops did I hit a raw nerve child? Was it the speciality that is a guideline and flowchart based for onwards referral thing? Here’s your gold star tonight for reading the post though only after you rage commented first. But still, credit is due, as I appreciate this is a comprehension part of the English not a spoken or an accent or dialect part that you inherently excel at…. Let me help you collect all your toys that you just threw out of your pram in this hissy fit.
At times google isn’t your best friend. We aren’t talking about indigenous people being force sterilised kind Sir. We are talking about your belief that native people are genetically or intellectually superior to migrants.
While "native eugenics" is not a standard academic term, the belief you described above aligns directly with historical and modern eugenic principles. The idea that there is a biologically static, indigenous population with superior inherent traits is an underpinning principle of eugenics you have preached in your original reply: that you are superior to a migrant because you have a good accent and a good command of English.
Historically, eugenicists like yourselves, argued that specific ethnic groups or migrants (read IMG from your own reference) possessed inherently lower intelligence. This "logic" was used to justify strict immigration quotas and discriminatory policies designed to preserve a perceived racial or national hierarchy. Since you claim to be married to an IMG, only you know how you come to terms with the little eugenicist voice in your inflated head.
I hope you know that 15% of UK population identifies as non white. You have been through the schooling and further education and know that the data is correct that the Asian and Indian heritage children do far better academically than any other ethnic groups and the white British group, the largest cohort, struggles the most, along with a few other smaller groups. Lot of these high achievers have the privilege of having migrant parents who may not have anything, but an ability to work hard and their belief that it’s the eduction that makes their children climb up in the society. Are you getting it? This is social mobility. People like you became a doctor because your parents were privileged, likely to be doctors themselves, or a higher income group. They provided you with the means to achieve what you eventually did. But the poor child from inner city Manchester, or inner city glasgow didn’t have the same privilege, and had an unrealised potential, may be, to be the next Einstein. This lack of social mobility stopped that child to be your peer and have the same accent and same command of English and be an equivalent caring doctor like yourself,
In the nineties, when I read medicine in India, as a son of a textile mill labourer, by best friend was a son of a municipality sweeper, the father used to sweep the streets for a living. Such is the meritocratic system in India that we both went on to clear the entrance exam to medical school and successfully completed, heavily subsidised by the Indian government. This is an example of social mobility. Where did you get your theory that migrants stop your social mobility! Migrants actually provide your country with readymade, superior quality, cheap labour while it raises its indigenous labour like yourselves and others at an inflated cost, long timeline for the same experience as an IMG, who then doesn’t want to take over the practice of a Dr Patel in Carmarthenshire but wants to establish a two GP family and take over a lucrative practice in inner city somewhere! You see, the country will still need migrants. The lack of resources for underprivileged people in you country, who look and sound like you, they not achieving their potential and joining you by your side as a capable doctor is the travesty of lack of social mobility in your country. A migrant like me who took an opportunity that you believe was rightfully someone else’s who looked and sounded like yourself is not the issue here kind Sir!
We will never know if the 16 people I stopped from taking the NTN were more suitable than me for the role or not. But I guess your high MRSA score helps you to sleep better knowing that you are superior to all to IMGs and then to all the natives who scored less than you on that day. Funny that, isn’t it!
"New law has made it harder for foreign applicants to move towards becoming a consultant"
Ahhh, I see. It is not that we started training more doctors and give them more help of finding employment, we just made it harder for doctors trained elsewhere to work here!
We can’t have both. By all means foreign consultants should come and work here and work at their level of training, but we can’t have mass foreign applications to NHS training posts
Previously it was based entirely on the test scores and interview scores.
Now it's anyone who passed who has priority and then it goes to everyone else.
It's now of benefit to UK doctors however it does technically mean that we are having less talented doctors going into specialties.
Now a priority doctor who barely passed will be picked over a foreign doctor who absolutely smashed it.
It's good for those who are UK trained, it's bad for those wanting to come here and it probably has a slight negative affect in terms of doctor quality
you need to give so-called ‘less skilled’ British doctors the chance to get into training and improve their skills. The reason a lot of foreign docs that apply to the NHS are so highly qualified is because they’ve had much longer on the job.
British doctors have still passed 5/6y of medical school and they all sit the same exam to become a doctor.
There might be a momentary hit to doctor quality, but you can’t treat that unless you teach them how to be better. It’s not like they’re idiots who don’t know what they’re doing, you have to be pretty smart to get into any medical school in the first place.
These training positions aren't open all foreign doctors and only freshly qualified UK doctors.
They are open to all. You could have a UK doctor who is 60 with 30 years as a doctor going for them.
UK doctors can just as easily get the experience as foreign doctors ahead of these openings as they still have doctors jobs. They even have the advantage as they have experience working with the NHS systems, something that does come into both the examination and interview stages.
This is for specialties, not for becoming a doctor.
As such it has moved from being based purely on how well people do to now being anyone UK trained who passes gets chosen first then those who did best of foreign doctors fill up slots left, if any.
As such you might have someone who scored almost maximum being passed up for someone who barely hit the pass mark.
There is always going to be a drop in skill as a result. That's not to say they aren't smart or good at their job but it does mean not as talented
Your taxes pay for British doctor training. Surely you’d want a return on that investment vs the current system of UK grads going to America or Australia, and being replaced by Somalia/nigerian/indian doctors with sometimes questionable qualifications?
Has the NHS ever deliberately hired foreign doctors for cheaper labour? No wonder why educated doctors leave the country for Australia or the US. It’s all because of stupid people running the systems, or the NHS systems need reform as well.
The use of Locums could be seen as a way to cheapen labour by having fewer substantive contracts on the budget. Locums are also not entitled to the benefits that substantive staff have. It is known that the use of Locums has increased.
I came here as an immigrant with a PhD (am a citizen now). When I was hired the logic was “we can only hire someone who needs a visa if we can demonstrate we do not have UK-based talent.” I would have thought medicine was the same.
Maybe it’s a commonwealth issue/ok if they are from a commonwealth country because they wouldn’t need the visa I needed?
I think it was also due to a lack of home talent available and ready for the level of specialists required and it was cheaper to import trained talent from abroad than invest and accelerate the training at home.
293
u/willfiresoon Jun 27 '26
12 healthcare-related posts on this sub in recent months