Moving back to England after K1

[elmcitymaven 9,712]

We have had, and continue to have, a similar issue in the US. We have a growing elderly population, like the rest of the world, and don't have huge numbers of upcoming doctors to make up for that. In the last 10-20 years we've started opening more.

Problem is it's not just medical school. There is a lot of post-graduate training required to be an "Attending physician/Consultant" and that requires infrastructure as well. In the US while we've been growing the number of medical schools, to my knowledge the number of residency programs is not growing (or it is growing much slower). That is partly due to funding. Without opening the doors at every level there isn't really a huge point to making the funnel bigger at the time if the bottom is still a tiny hole. We'll just end up with a much of "Doctors" who don't match into residencies and have no practical training. In the US we had the additional problem/concern when Obamacare was passed with the massive numbers of previously uninsured people now having insurance and needing a doctor.

In the UK, post-graduate training is even longer than in the US so I imagine the restrictions are the same if not worse. You can't just graduate more doctors if you aren't able to support more trainees. That requires money which may not be there. That's partly why the UK enjoyed hiring European physicians. Let other countries handle the cost of their training, and then the UK can bring them in and use them as consultants/senior trainees. When they lose that ability, the cost of their system will likely increase if they expect to train all the doctors they need themselves.

Interesting. It's very similar to the law school situation here in the US, where there are so many more graduates (with eyewatering amounts of debt) than there are positions as attorneys or in JD-requisite roles. The funnel has gotten outrageously large and there are students in pisspoor schools who simply aren't up to passing the bar, and never will due to poor education and lack of aptitude. Of course, the world can live with fewer attorneys more so than doctors.

[bcking 3,157]

Interesting. It's very similar to the law school situation here in the US, where there are so many more graduates (with eyewatering amounts of debt) than there are positions as attorneys or in JD-requisite roles. The funnel has gotten outrageously large and there are students in pisspoor schools who simply aren't up to passing the bar, and never will due to poor education and lack of aptitude. Of course, the world can live with fewer attorneys more so than doctors.

I think that is one of the counterarguments that people use. Right now generally speaking once you are in medical school you have very few drop outs (for academic reasons), and then very few who don't match for a residency. The numbers are fairly equal. There is a little leeway to allow some international people to get spots in residencies, as well as DO schools funneling into Allopathic Residencies. For the most part the fit is "okay". Obviously some residencies are more competitive so people won't match into them, but there will be space somewhere.

If you just increase the number of schools it won't match up and you will end up as you mention law school has become.

I'm not as familiar with the funding structure for "junior doctors" (IE Residents in the USA) in the UK but everything I hear regarding the budget issues with the status quo, I can't imagine adding more positions would go over well or would be feasible without more money being spent.

While ethically/morally I prefer the UK system compared to my own healthcare system where people are left with massive bills for healthcare for just being unlucky or having bad genes, the UK system is in dire straights. Brexit isn't going to help.

[Miamigirlie 1]

I'm a physician, trained in the US so we'll see. Jeremy Hunt seems to have some idea in his head that they will be able to fill the gaps with more UK-trained physicians. While the UK probably could do with a few more medical schools, you can't just create them in a year. It takes a lot of infrastructure to increase medical training since they have to be integrated into hospitals. There aren't many US-trained physicians that go to the UK though because the pay is so much lower. To start we are trying to see if my wife gets a job here first, at least until we have school aged kids (She'd rather send her kids to school in the UK than the US).

I agree with a lot of what you said. My partner is UK born and UK trained Doctor( so he is doing the opposite of what you guys are doing lol). He is moving to the US and we did discuss all the re-training and differences in medicine in both places. HE has struggled for a long time with the NHS and how it is run . He did mention that in the US he would get paid almost double( when all is said and done) but its not even about that. He has mentioned the many times everything has seemed disorganized, he hasn't felt supported , and of course the head of it trying to do more hours and less pay.

And i say this by saying there is no perfect system ( the US one has many flaws, believe me ! lol) but its certainly some things to consider. Especially if your partner can't work or you are unhappy. But honestly i agree with you and think they would welcome a US trained person with great qualifications. And maybe when you do consider moving in the future things will look better on that side of the pond:)