UKC

http://www.bbc.co.uk/news/education-39577507

Interest rate was 4.6% but now set to rise to 6.1%.
As it's chargeable whilst you are on the course, the rough maths is:

For a 3 year course:
Year 1: £9250 tuition plus, £3500 living costs loan (plus top up to afford accommodation and eat, but not from the government) = £12750 plus 6.1% of half that (mid year point) = £390 Total £13140
Year 2: £13140 + £12750 + £800 + £390 = £27080
Year 3: £27080 + £12750 + £1650 + £390 = £41870
Interest at that point is £2550
Average graduate salary £23000 so interest is 11% of gross salary

For a medical degree:
As above, then
Year 4: £41870 + £12750 + £2550 + £390 = £57560
Year 5: £57560 + £3500 (fees paid by NHS) + £3510 + £110 = £64680
Year 6: £64680 + £3500 + £3950 + £110 = £72240
Interest at that point is £4410
Foundation Year 1 salary £22862 (yes, lower than graduate average), so interest is over 19% of gross income.

No wonder my son and his mates are all leaving the NHS after FY1

In reply to Deadeye:

The interest rate after leaving university is lower if you are on a low salary.

I'm not sure why leaving the NHS before the sharp salary increases as you progress in seniority helps the financial situation?

In reply to climbwhenready:

I would imagine because they realise public sector pay is awful and they can earn twice as much with better chances of carrer progression in the private sector.

In reply to Deadeye:

It's allright, few years down the line when they are on 30,50,70,100k a year it'll all seem small beans and well worth the effort.

Who are all these graduates expecting to start the job and be earning mega bucks from day one?

In reply to ebdon:


In the OPs post it appears the awful public sector effectively gives you £100k towards continuing professional development...

In reply to Ridge:
Yeah, but then youre stuck on a salary 10k less then you would get on a graduate training scheme at Aldi. So allthough it may make sense to train it my not make (financial) sense to stay.

In reply to Deadeye:

From wiki

"The basic starting salary of a foundation doctor is £22,636 but having to work extra and unsociable hours attracts some additional payments.[10] In 2015, NHS Employers reported the total annual earnings for foundation doctors in England averaged just over £36,000. While the basic starting salary for doctors in speciality training is £30,002 NHS Employers were reporting that average earnings in this group of doctors was nearly £53,000. "

Which doesn't sound too bad to me cashwise. Hours perhaps less appealing

In reply to MG:


but there are other costs involved in being a doctor, compulsory courses and training (which are good things) but you have to pay, membership fees etc.,

Then there' the stress and the interfering government, not being able to do your work because of cuts and lack of resources.

You're welcome to it.

In reply to Ridge:


Say what? What on earth have you misunderstood to get that figure?

In reply to Deadeye:


The (fees paid by NHS) bit.

In reply to Ridge:

They pay the £9250 in the fifth and sixth years - by which time you're doing a lot of (supervised) front line patient work.

In reply to Deadeye:
We have three newly qualified Pommy doctors in the area Teams I work with, they are out here minting it.

It's very shortsighted to deny yourself the opportunity of a valued and respected professional qualification if you are up to gaining one, especially on short term financial reasons.

My daughter starts her medical training next year."The annual income you can expect to earn as a GP ranges between AUD $200,000 (£121,000) - $300,000 (£181,000) depending your contract details. These figures can increase depending on:

Location of the practice
Type of work undertaken
Extra or after hours you work
Ratio of private or bulk billing
Hospital work
Status as practice owner, employee or contractor
Your VR status"

In reply to Deadeye:
Two ways to view it, you pay for UK education because tax is too low to fund it. So when you qualify and earn, you will pay low tax. Or the opposite. Can't have both.

A distant relative of mine qualified as a pharmacists in the USA with $210k of debt 3 or 4 yrs ago. He is about a third of his way into it now by making some real sacrifices to clear it.

In reply to summo:
Whereas most of my daughter's friends who have graduated in medicine in the UK have left the country. Genuinely, most of the year have simply fled abroad.

In reply to Siward:

The solution is?

In reply to summo:

Difficult. Maybe their education is in fact- dare I say it - too cheap, if it's so marketable elsewhere. However, I think much of the pull of far off places is the opportunities to be had and perceived better quality of life which has little to do with the cost of qualification.

There were some pretty unpopular proposals for compulsory working for the NHS for a period post qualification. It's a lot to ask an 18 year old to sign up for a 10 year tour I think.

In reply to Siward:

Many young people do that now, not just doctors. On the other hand, many newly qualified doctors from less developed nations look to the developed world for work too. As well as the three Pommy doctors above, in the last few years I've worked with doctors from India, African nations, Indonesia, China, etc.

In reply to summo:


Well, a start would be to only charge interest at a sensible rate, not +3%.

In reply to Deadeye: im going to stick my neck out and say that the pay for doctors isn't that great. Some of societies finest, lots of years of training and a terriffic amount of life and death responsibility for a fairly mediocre wage.

In reply to MG:
Which doesn't sound too bad to me cashwise. Hours perhaps less appealing

Just to clarify as it's a bit confusing 'foundation doctors' refers to doctors in their first TWO years after qualifying. The starting salary for doctors on a standard (40hr) working week for the first year is about £22,000, and for the second year about £28,000. Most hospital jobs have a rota that includes increased hours, weekends/nights etc. and will attract a premium of up to 40% for certain rotations throughout those two years depending on hours worked.

From personal experience I think my gross pay was about £27,000 in the first year, and £36,000 in the second year with two-thirds of my jobs (you rotate through 6 jobs over 2 years) attracting the extra pay for night/weekend on call shifts etc (which is pretty standard). I'm certainly not complaining of being in poverty - far from it - but thankfully most doctors aren't in it for the money or they wouldn't still be here.

The extra costs mentioned by krikoman are also very real, they are probably about £2000/year at the beginning of training but things get even more expensive as you get to registrar/consultant level. Inexplicably most of these don't seem to be claimable against tax despite being professional development.

In reply to Siward:

Would agree, if you want the government to spend a small fortune training you, then you sign an appropriate contract. Say 3 or 4 yrs for nurses, 5 or 6 for doctors. If you decide to leave early then you pay penalty clauses. If folk embark on this career with honest intentions then the contract won't really bother them.

In reply to Deadeye:

It is an unsecured loan with people who often have no assets, no previous employment, who could just leave the country on qualifying etc... the interest rate reflects the risk etc.

I have younger relatives who stayed on the fringes of the social scene, worked when they could and accrued much less debt than some who lived the uni lifestyle. People make their own choices.

In reply to summo:


Sure.

But we do kinda need doctors. So ramping up the disincentive for them to study and stay seems perverse.

In reply to Deadeye:

Yeah. Free training and sign a contract. Or put up taxes to fund them and hope they stay?

In reply to Summo:
God only knows why it's so politically unpalatable to improve their working conditions and stop using them as a political punchbag. Maybe that's why they all leave - huge hours for a wage 1/2 that of some spreadsheet pusher in HR or the city somewhere doing 40 a week and no risk of anyone dying.

You want people to sign a restraining contract you'd better provide a damn good reward or you'll be joining a long queue when you get sick. And to be honest, there were some stats recently on how many people a year in the uk earn 100k plus, so 30 or 50 aren't going to be cutting it.

In reply to wbo:

Could run the American system - average pay for orthopaedic surgeon $500,000

In reply to wbo:

It's not a restraining contract, it's an employment contract and return for training.

I'd rather see a system where more tax is paid, the nhs gets better funding, all doctors etc work a normal working week etc... But it won't happen as the majority of voting British public thinks services can be improved from the magic money tree. So education, health, infrastructure etc. Etc.. will continue to see a decline in funding and a further slide in quality of service. Will the penny drop, I doubt it. After 30 years of politiciana of all colours promising more from less, too many believed them and still do.

In reply to wbo:


I'm all for proper rewards for doctors but this comparison is just grasping at thin air. The earnings ceiling of a well rounded HR professional in, say Leeds, is around 50-60k. In fact this sample suggests the norm is a little lower http://www.indeed.co.uk/m/jobs?q=HR+Manager&l=Leeds but I'm erring in your favour. That's not for pushing spreadsheets around, it's for spending 15 years establishing yourself in the position of head of HR. Well, you could argue that spreadsheet-pushing is all HR professionals do and I wouldn't necessarily disagree but it's certainly 15 years of brown-nosing and backstabbing and generally working very hard to look vital to the organisation while having never in that time ever spoken to a customer let alone sold them a widget.

Meanwhile consultants with 10-15 years in the NHS are, quite rightly in my opinion, earning three time that sum. You can't look at first year qualified salaries and compare those to commercial graduate salaries without appreciating the end game. I know two NHS consultants just in my village who earn over a quarter of a million. I think it's reasonable to assume that anyone prepared to study for 5-7 years to attain exclusivity in the job market has some respect for the law of delayed gratification and that their eyes are firmly on the consultant's job, not the apprenticeship.

That they often depart these shores is unfortunate. But wage and working conditions probably don't tell the whole story. Didn't you want to see the world when you were young and free. Wouldn't you have been tempted if a flight to Sydney was less than the standard peak hour rail fare to Leeds?

In reply to John Kelly:

Could do what we do here, charge $80 to see your GP.

In reply to Big Ger:

You might have a point

Given doctors, nurses and a good chunk of their patients think now and have thought for years that NHS is in crisis, maybe there is room to consider your suggestion.

People are funny with free stuff - maybe a small charge, with the funds raised shipped off to help counties in need, would be a way to balance demand with a finite resource.

Is Australian healthcare considered 'good' by consumers and those who work in it?
Few people on here have said it pays well.

In reply to John Kelly:

Maybe use the money to have more staff. If for an organisation to function staff have to persistently work 10 or 12hrs plus every day, then something is wrong. I'd prefer my doctor to be doing 10hr days max, ideally 8.

In reply to summo:

I was trying to avoid the privatisation argument
8 hrs per day - yes absolutely
Guardian today - doctor's emergency cover £95 per hour due to staff shortages!
It feels to me that we may not be training sufficient numbers, wonder why

In reply to John Kelly:

NHS still spending around £3 billion a year in agency fees.
https://improvement.nhs.uk/news-alerts/agency-caps-one-year-600m-saved-nhs-...

Seems pretty privatised to me.

In reply to john arran:

That agency business seems pretty bonkers - privatisation, probably but NHS has to buy in pretty much everything else it uses from private companies, I do get staffing feels different.

I go back , training are we doing enough? Pretty sure medicine is still seen by school kids as a good career choice.

In reply to John Kelly:

It might be a good career, but working a stupid number of hours won't appeal to many. But that's the UK culture to some degree, where salaried staff work in excess to 'get on'.

In reply to summo:

Yes - it's like some form of bragging rite 'how much extra I've worked' ???? - I reckon if you can't do your job in the allotted time either you have been over promoted or failed to manage your boss- I always feel I've failed if I exceed my hrs

In reply to John Kelly:


Good lord.
You genuinely have no idea about healthcare and the NHS then, if you think it is possible to manage your boss, or sometimes do little more than firefight the worst problems. When demand is an order of magnitude higher than capacity and throughput falls as a result then you can't just leave the patients to rot....

b

In reply to John Kelly:


It's not about doing your job in the allotted time, it's a culture where one person is doing the work of two, be it in the nhs or a private firm. Getting into the office early, working through lunch with sandwich at your desk, staying a little late, then perhaps doing a few hours work offline once home. It's not incompetency; often it's only the most able who can cope with a high workload who do this, others give up or burn out.

In reply to ben b:

Your right I genuinely have no idea about health care and the culture within these professions.
In my job nobody dies.
What I do know is that health care workers appear unhappy with wages and conditions, I wonder if the culture within healthcare plays a part in that?

In reply to summo:

I kind of disagree a bit, I think in load of jobs your boss will attempt to make you work harder than is actually possible, my take on this is you need to find ways to A pass this excess work to others B work out what really makes a difference and do that well C find clever/easy ways to do your job, D explain to boss the impossibility of being in two places at once
here's one someone dreamt up - I'm in A&E the other day ( time wasting as it happens) they are kind of stalling throwing me out, to monitor me, when really nice nurse (I think ) guy comes round offering tea and biscuits, nice touch but really is that important to my care, no (it might be valuable for little old ladies/men/vunerable who need that level of care) but this was blanket care every body got it. Honestly, good tea, but i wish he had been doing something better, having a fag out the back even. My wife teaches they seem to spend there lives doing bonkers things because some bod somewhere has dreamed up a new wheeze.

In reply to BnB:


Summed up my opinions in a nutshell. There's a lot wrong with the working conditions for junior doctors, especially the working hours and pressure, but the rewards are there. Maybe somewhere, (London?), there are employers who genuinely do pay complete numpties £60k a year to colour in badly-spelled powerpoint slides; but they are the exception.

In reply to John Kelly:

I suggest you brand yourself as a time management consultant and go save the nhs, if you think they are just inefficient, wasting time and are badly managed. You could save them billions. After you've saved the uk's national treasure you can move on to rescue all the mid level workers in finance, hr and IT who are doing 60 or 70hr weeks.

In reply to summo:
Time management - You know what that's a great idea - tomorrow's job

not sure I said that, hard working and being asked to do too much would be closer

In reply to Deadeye:

The same issue is faced by other graduates.What is so unique about medical students?

You could equally make the same argument about engineers where there are shortages etc etc.

The hard fact is that there is a significant potential for medical graduates to earn very good money and to be able to pay off those loans .

Now if you were complaining about the removal of bursaries for nursing training then I think you have a point.

In reply to summo:


You say that, but given the government already treat junior doctors like crap (cf the contract debacle last year, which is cutting pay incidentally), do we really think they will treat them any better once junior doctors are chained to the oars for 5 years?

It is such doublethink, in the context of the private sector people talk about investing in resources and rewarding excellence, but when it comes to an incredibly valuable resource in the public sector it is 'drive down wages, whip them until they work harder'.

Finally the idea that the government spends a "small fortune" training doctors is largely misleading. Almost every figure given includes the medical student's debt, which they will pay off at said punitive rate of interest, then later junior doctors' salaries, while they are providing a service in exchange for that money. Even where there is direct funding, that goes in to NHS Trusts' budgets and is used to contribute towards the salaries of consultants (who teach) and educational resources (which benefits the NHS as a whole).

In reply to John Kelly:

I wouldn't be so sure.

This year was the first year in decades that there have been medical school places available through Clearing.

The Foundation Programme (the bit immediately after medical school) has been oversubscribed in the order of ~300 applicants (for 8000 jobs) for about the past 6 years, this year there were only 25 excess applicants - once finals have thinned the numbers there will be empty posts.

In 2010 85% of FY2 doctors progressed in to specialty training, in 2016 ~50% did so.

At all levels, there is evidence that it is no longer seen as a 'good career' - huge student debts, crap working conditions, downward pressure on pay (imposed contract + 7 years of pay freezes & below inflation rises) and being able to see that both of the above are being inflicted as the current generation reaches each new level (this generation will graduate on to a less generous consultant contract than the existing one).

Why wouldn't a clever kid in sixth form decide to do economics at university then become a consultant with one of the Big Four, earning more for pushing numbers around excel and making powerpoints telling organisations answers they could have got for free if they only listened to their own employees?

In reply to summo:


better working conditions. more doctors working shorter hours in an all round better funded nhs. we spend less on health than plenty other rich countries. we can afford this if we choose to.

it is still a well paid profession and will escape the automation threat to other professional sectors.

In reply to munro90:

No reason why a well written contract doesn't benefit both parties. Either way it won't happen. Folk won't pay more tax, the nhs won't have lots of extra money and doctors will continue to work crazy hours...

In reply to sebastian dangerfield:


I would agree. Like education, the solution lies in taxpayer funded improvements. Wouldn't hold your breath.

In reply to summo:


Society's increasing and impossible expectations of being able to get something for nothing now seem to have been extended to politics. I wonder how long it will be before the inevitable pennies start to drop on a wider scale.

In reply to munro90:


Because that sounds the most boring, soul-destroying job you could have the misfortune to do. The sort of job where you stay up as late as possible on Sunday night to make Monday come around slower; the sort of job where the depression mounts on the morning commute. The sort of job that would have your hypothetical clever kid who could have become a consultant surgeon waking up in the middle of the night, aged 40, and wondering what could have been.

That's why people become nurses and policemen rather than checkout operators at Aldi. Why people become cyber experts for GCHQ rather than BetFred. It's not all about the money.

Unfortunately that's why, certainly at the entry level, pay for those sort of jobs is lower than you'd expect. However, unlike nurses or paramedics, those entering as doctors have a reasonable expectation of earning very good money after 10 to 15 years.

If the worst comes to the worst they can always become a GP, which seems to be a lot of money for looking symptoms up on Google and handing out leaflets whilst completely avoiding eye contact with the plebs, (going by one at my local practice).

In reply to munro90:

Why wouldn't a clever kid in sixth form decide to do economics at university then become a consultant with one of the Big Four, earning more for pushing numbers around excel and making powerpoints telling organisations answers they could have got for free if they only listened to their own employees?

-- Well, I was a clever kid in sixth form, and now I'm sitting at my work PC on Easter Sunday doing something which is more-or-less what you describe here (this is a coffee break), and I've been working most of the Bank Holiday weekend, because the spreadsheets won't do themselves, and *have* to be done. No, I don't get paid overtime. And you know what? Having seen the decency and compassion of the NSH staff dealing with my elderly, wobbly, confused mother this week, part of me wishes I was doing a worthwhile job like that. Except for the blood and so on, of course.

In reply to neilh:


A very interesting article on R4 last month explained how a software programme not only picks up signs of cancer faster than a Radiologist, but it does so a thousand times better (seriously) as it can compare scans/x-rays to a database of every cancer scan worldwide. Many more cancers are being spotted much sooner apparently.

I wouldn't put it past the BMA to try to stop it being implemented here in the UK. An interesting test of their ethics.

Of course, such advances hint at a time when the shortage of doctors may become less critical. But their workload is sure to keep on growing for now.

In reply to john arran:


I don't think it will. When anyone says x or y is better in another country someone will say that's because they pay more tax. But the idea of perhaps we should do that never arrives. Folk love the idea of higher tax, but only for other people, not them.

In reply to BnB:

What??? Where on earth did you get those figures. Consultant pay starts at 76k and tops out at 102k for a 10pa contract (ie equivalent of 5 full days per week). On call supplement is a maximum of 3% of salary in addition (the hours vastly exceed 40 hours tho).

Debate whether or not those figures are appropriate but 250k for nhs work as a consultant is impossible.

As for retaining contracts for juniors we have those de facto in the UK. As a junior (the 10 years or so post grad) your contracts can be training or non training. Only the nhs or military can offer training. Therefore whilst you can go and work in the private sector as a medical officer at your level at exit from the nhs, you remain at that level. Any progression in your career requires a return to the nhs to a training contract where the majority if your time you are undertaking service delivery. The majority who go overseas return in the long run. So the vast majority give a return of service (and a damn lot more than that to boot).

And the cost-yield arguments for repayment of training are bollocks. If you go and study ppe or english or whatever and train as a barrister or run a business and earn a fortune, as the tax payer funded your 3 year degree, where you learnt report writing, data interpretation, analytical etc skills that were imperitive to your financial sucess, should you pay all your costs back? The model we use is taxation. If you earn more you pay more. You don't bill people extra just because they worked hard, but because they can afford to pay.

In reply to Badgers:


From the horse's mouth of course. Where did I say their earnings were all from a NHS salary? There are several ways in which a consultant can up their earnings, from performing private work to working as a locum to incorporating as a limited company and delivering outsourced services, which happens to be the case in ny neighbour's instance.


An interesting observation. But the situations are not analogous. I studied a non-vocational subject (unless you consider foreign languages an essential tool in the IT industry) at a famous institution and went on to business ownership and a payback to the state in the form of taxation that dwarfs the cost of my education. In the case of medicine, the training costs are substantially greater and our payback comes in the form of services to the health of the nation. Incentives to retention seem essential, but pay-back of training costs would seem illogical other than to deter the loss of skills to the private sector or abroad, at least until payback in the form of a service contract is fulfilled.

In reply to neilh:

That was exactly the evidence given to the select committee for leaving the EU. The NHS cut the training to UK based nurses then HAD to recruit from abroad.

It rather puts a different spin on those who say the NHS will grind to a halt with ought foreign staff. It will of course, if we continue to starve the market of UK trained nurses.

The NHS ( who will argue government funding) are to blame for the reliance on foreign nurses through lack of training , unless they think the select committee were being lied to ?

Nb , my sister, daughter, mother, grandmother are all in ( or were ) in the NHS , and it was not for the money that's for sure, but I agree there is more financial help needed at the early training stage.

In reply to BnB:

Fair point. Interestingly the consultants that I know do comment that young doctors are more technicians these days than true doctors. Although I am not sure young doctors would agree!!

In reply to munro90:

Interestingly as I have a 17 year old daughter there is another view this. I still hear of 17-18 year olds who are not being offered places in medical schools despite getting outstanding grade predictions. There are one hell of a lot of 17-18 year old out there who are devestated at not being offered places.

The view on the street is that you have to really immerse yourself in voluntary work etc to get offered a place.

Perhaps the medical profession needs to step back to attract more youngsters instead of blaming this on the govt.

In reply to neilh:

Is some of that possibly related to grade creep, too many A*s to spot the top few percentage of pupils?

In reply to Deadeye:

I read the terms and conditions so was aware of this, does not reduce the sick feeling in my stomach thought seeing that interest rate. I could have remortgaged and paid my fees that way, I would have paid .5% that way. However the education I am getting is not worth 9k a year of my money (I have borrowed with the proviso I may never repay due to low salary in my chosen industry) although a poor reason for borrowing the money I know. I am Just about to finish my second year. I am 52 years old mature student doing a course that will get me a bottom rung salary of around 18k lol. That they are selling off more of the debt bothers me though as once its in the private sector the f*ckers start charging you fees for certain things. I worked for student finance for 6 years so know the stuff the head lines don't normally mention, like the pitiful amount the private comanies pay for this debt which is tax payers money at the end of the day (sorry for using that cliche) student loans company are, with a few talented exceptions on staff, pretty clueless in terms of the industry they operate in.

In reply to BnB:

"Meanwhile consultants.....in the NHS are.....earning three time that sum. ..... I know two NHS consultants just in my village who earn over a quarter of a million"

All goes to suggest that their nhs work is paying these salaries. It's like arguing about MPs' pay being in the millions just because Osborne is coining it on the after dinner circuit. Yes, people do work outside the NHS at market rates. That work is not open to, or appropriate for, many doctors.

And I do see the situations as analagous, your tax payer funded education which you have benifitted from and been successful as a result of (plus no doubt huge amounts of skill, hard work, risk and maybe a dose of luck) from mine (from which i have benefitted, been successful, worked hard, exposed my self to risk etc... just the same). I have no doubt without the structured training, development of independent learning, analytical skills etc, gained from your degree success would have been harder won. That is one of the reasons for funding non-vocational tertiary education.

You are absolutely right about incentivising retention in the NHS. Improved working conditions, ability to take leave when needed, being resourced to do our jobs properly, proper autonomy, whistle blowing protection, pay to keep pace with inflation etc.... would be better incentives. What is misunderstood by many outside of the clinical arena is the value added by those who bugger off for a bit (be it to learn a skill or way of delivering care overseas, as aid work, or in Aus/NZ/canada, or research etc...) generally return and challange NHS dogma and improve services.

As an aside, ignore the "it costs x amount to train a doctor stats" (seen upto 750k quoted). These are utter bollocks as they include 8-10 years of salary whilst we are delivering service. DoH like to use it to skew the cost-benefit arguments in industrial disputes. Like saying a prime minister costs the MPs' entire salary for the time they have been elected prior to becoming PM.

In reply to Badgers:

I think we're broadly in agreement other than over what I originally wrote, which I note you've altered (by omission) in your quote above when it might have been better to drop it. That degree taught me the careful use of language and to keep an eye out for a cheeky edit

Picking up on your thoughts I do sometimes wonder whether my business life would have turned out the same without the fancy degree. My business partner hasn't an O-level to show for his brief secondary education. Yet his career path mirrors mine quite closely. Counter-intuitively and contrary to the normal pattern, I'm the risk-taker, he's the cautious one, so I was earlier into the entrepreneurial phase. I think that my degree has helped with the self-belief more than anything else. Places on that course were hard won, as no doubt was yours.

My nephew recently started training as a doctor with a first degree in History. Apparently bedside manner is more highly prized today!!

In reply

Have you recently sat an A level to back up that view?

In reply to BnB:

I did try quite carefully not to alter any meaning in your statements, only edited for speed of reading and made the edits clear.

I was a grad entrant to medicine and agree that people coming coming in from alternative backgrounds and paths offer benefits to the profession, nhs and patients.

Interesting how you and your partners pathways have differed. I think the nhs's big failing in man management is to be so restrictive and not allow individuals from different backgrounds and following different paths to succeed. Obviously a doctor, nurse, physio, OT or whatever, has to have a qualification but i worry the rigidity of progression and one size fits all contracts means we lose a lot of great staff who wanted to progress differently. If we could address this it would lead to better staff retention too.

In reply to BnB:
Good on him.

Very good pedeatric consultant friend of mine did her first degree in modern American art!

One of the cleverest people I have ever met.

In reply to neilh:


I presume that was to me and you'll note I asked it as a question. No I haven't. I did mine in the 80s. I did see lots of papers for various exams as my mother was an exam invigilator, but that of course is not the same as sitting one.

So back to my point, more people pass at the highest grades than say 10 or 20years. Have the number of doctor training places increased at the same rate proportionally?

The topic of why we have grade creep is irrelevant to the point. If you have more A*s chasing the same number of places, that is why selection is tough for both sides.

Perhaps the medical profession needs to step back to attract more youngsters instead of blaming this on the govt.

Currently there is a government decreed cap on medical training numbers (expected to be removed next year). This number of places was cut by 5% in The early years of the coalition. So I would say this can be directly blamed on the government.

If they increase the numbers next year, this is expected to be tied to compulsory time in the NHS which makes some sense.

In reply to BnB:


The practice of Medicine is dramatically more pleasant outside the NHS, on the whole.

I spent 5 years in a consultant training program in the North of England, with a year of overseas experience in NZ. I learnt more in the year in NZ than I did in the other 4 simply because I had time to think and to learn, and those around me had time to teach. When it came to my consultant post it wasn't a difficult decision to go back to NZ.

Even though for 10 of the prior 12 years of postgrad work had involved me working my butt off and giving my all for the NHS, I still had a terrible Stockholm syndrome where I felt responsible for my abuser's behaviour and a deep sense of guilt for leaving. I don't think that is the sign of a good employer!

b

In reply to ben b:


That's a troubling analysis.