791 medical graduates could miss out on NHS junior doctor training

Almost 800 medical graduates could be denied the chance to train as doctors in the NHS this year, despite the health service’s crippling shortage of medics.

Denis Campbell www.theguardian.com 

A total of 791 medical undergraduates who have applied to start training as junior doctors at the start of August have been told there are no places for them – the highest number ever.

The risk that young would-be doctors may not be allocated to start their training at a hospital in the UK has sparked concern among the medical students affected, as well as medical organisations.

Pressure is growing for action to close the gap between the number of training places available across the NHS and the number of graduates seeking one, so medical talent is not wasted and hospitals hire as many fresh recruits as they can to help tackle the widespread lack of medics.

Doctors are worried that the mismatch between demand for and supply of training places will lead to the NHS missing out on medics it sorely needs and that some of those denied a place will either go to work abroad instead or give up medicine altogether. The most recent official figures showed that the NHS in England is short of almost 8,200 doctors.

Dr Dustyn Saint, a GP in Norfolk, tweeted the health secretary, Sajid Javid, about the situation, saying: “Sajid Javid sort this out! You know how much general practice needs these people in a few years, standing by and doing nothing is inexcusable.”

Another doctor said: “It’s bonkers that 800 would-be doctors could be denied training places at a time when the NHS in England is short of 8,200 doctors.”

Half (393) the 791 will soon graduate from UK medical schools while the other half (398) are “eligibility applicants” – those with a medical degree from an overseas medical school who are entitled to work in the UK or who graduated from a British medical school before August 2020.

The UK Foundation Programme (UKFPO) ensures that aspirant doctors who have just graduated from medical school are able to start foundation one training, the bottom rung of the ladder that leads to medics becoming fully qualified. Training usually starts in the August after graduation.

But the UKFPO has warned that the foundation programme is “over-subscribed” to a record level this year, raising the prospect that some of the 791 may not be allocated a training slot.

While it has already filled 8,209 foundation training places, the 791 who have missed out so far have been put on a reserve list.

The UKFPO, which is run by Health Education England (HEE), has told them that: “We would like to reassure the applicants on our reserve list, who may be feeling anxious, that we are currently working very hard to find additional places for everyone who needs one.”

It works with the health departments in the four home nations to ensure that the NHS has as many new trainee doctors as they need and works with them to increase numbers if necessary.

The 791 is the largest number of applicants on record that the UKFPO has not placed by this stage of the year. In 2017 only 25 graduates were in that position, though that number has risen sharply in recent years and by last year had risen to 494.

HEE has blamed the situation on a record number of applicants and promised “pastoral support” to medical graduates on the reserve list, many of whom are anxious about their futures.

“There have been record numbers of applicants for the 2022 foundation programme. Although the statutory medical education bodies have increased the number of foundation posts available, we recognise that 791 students have been placed on the reserve list,” said Prof Liz Hughes, HEE’s deputy medical director.

It has sought to reassure graduates without a training place that they will get one somewhere in the UK by August. Places will be freed because historically about 7% of applicants withdraw between applying and starting their F1 training, it said.

The British Medical Association has voiced concern about the large number of unallocated medics. “Now we have a situation where a record number are left with unnecessary uncertainty about where they are headed this August,” said Khadija Meghrawi, the co-chair of its medical students committee. “In a time where student mental health is declining, this additional source of uncertainty and stress is particularly unfair.”

Prof Martin Marshall, the chair of the Royal College of GPs, said: “It is important we get to the bottom of why this has happened and address it as soon as possible. It’s encouraging that we have so many people completing medical school and wanting to continue their training. This needs to be matched by capacity in foundation training schemes.”

Azeem Majeed, a professor of primary care and public health at Imperial College London, said: “It’s essential that workforce planning in the NHS is adequate, given that there are shortages of many health professionals, including doctors. This means having enough foundation posts for newly qualified doctors.

“It’s likely that most of the 791 people without foundation doctor posts will eventually be allocated one but it does create undue stress for them and they may be allocated a role in a part of England where it may be difficult for them to work due to family reasons.”