Posted by PLAB from IP 126.96.36.199 on July 06, 2012 at 15:37:04:
The following information is important for all medical graduates thinking of coming to the UK to take part 2 of the PLAB examination.
• Over the past few years, overseas-trained doctors have faced immense difficulties in obtaining paid employment in the UK. Competition for House Officer and Senior House Officer posts is intense, with an average of 210 applicants for each junior doctor post, with recent Pre-Registration House Officer (PRHO posts attracting over 1000 applications for each post. Recent changes to the postgraduate medical education and training (see below) has led to even locally trained graduates finding it extremely difficult to secure training posts.
• Even if one is successful, it is very likely that the first post in the UK will be an unpaid (honorary), temporary (locum), or a non-training (trust grade) post. Securing the first post – training or non-training – is no guarantee of continued employment subsequently.
• 36% of overseas graduates who passed PLAB part 2 in June 2003 were still unemployed 6 months later. A survey of 800 applicants for one PRHO post showed that those applying had already spent on average 11 months out of work. Applicants for one PRHO post had applied for an average of over 260 posts without success, and many had suffered financial and personal hardship during this time.
• Home Office regulations do not allow doctors to obtain alternative employment.
• So far as temporary (locum) vacancies are concerned, these are few, unpredictable, and required at short notice. Overseas doctors find it difficult to obtain locum posts as registration is only granted after a post has been obtained and the papers take too long to process. Most hospitals are unwilling to employ doctors without work experience in the UK.
These unpaid and purely observer posts are also hard to find. Very few hospitals and Consultants accept doctors for such attachments, and increasingly, many are levying charges for granting such attachments. Moreover, most hospitals do not provide accommodation for doctors on attachments, and arranging private accommodation is both difficult and expensive.
Recent changes to postgraduate medical education and training
Under the Modernising Medical Careers (MMC) programme, which came into effect from August 2005, medical graduates from UK medical schools must complete a 2-year foundation programme. This ensures competence in various generic skills besides offering exposure to a variety of medical and surgical specialities. The first Foundation year (F1) is similar to the internship overseas, and these posts are matched to the output of the UK medical schools. Overseas doctors will therefore not be able to obtain these posts. During the second year of the Foundation training (F2), there may be 10-15% extra posts than the F1 posts, and a few overseas doctors may be able to secure these extra posts. However, these posts will be far fewer than those available currently, and will be extremely competitive.
Selection for training jobs and career progress in the UK does not depend solely on ability of the candidate to demonstrate clinical skills necessary to diagnose, treat and care for patients; additional skills and knowledge are often expected. These include excellent spoken and written communication skills and knowledge and competency in fields like patient safety, clinical governance, infection control and working in a team.
Specialist training programme: Entry to speciality training programme will require successful completion of F2 year. It is not yet clear if there be any mechanism for the overseas-trained doctors who have not done a F2 year in the UK to demonstrate such competence and compete for the specialist training posts.
Difficulties with VISA
Each visa application costs £500 for an extension and it is common experience that many have got visa extensions only for a month or even less depending on the duration of the attachment.
Cost of living without an income in the UK is high and should be borne in mind as part of the overall planning. The areas that cost money are accommodation, subsistence and visa charges, applying for jobs, travel within United Kingdom for interviews and attachments, not forgetting the cost of attachments charged by the hospitals. The overall cost of waiting for the first job could be in the region of up to £10000 for a year.
This information is provided to inform the decision about coming to the UK for postgraduate training, and to bring to the notice of the prospective applicant the current very high level of competition for junior posts, the long periods of time that they may spend unemployed, and the impact of recent changes to the postgraduate medical training. Passing PLAB is not a guarantee of a training placement, and there is currently no shortage of doctors for the junior training posts at house officer or senior house officer level.
This information is accurate as of August 2005; however we are able to quote statistics accurate as on December 2004 only. Further up-to-date details on unemployment and competition for junior doctor posts are available on http://www.bmjcareers.com/juniorcomp and http://www.gmc-uk.org/register/default.htm.
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