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Last Updated: Friday, 21 September 2007, 00:45 GMT 01:45 UK
Overseas pressure on doctors jobs
Junior doctors rushing down corridor
The application system for doctor training posts is under review
The government's immigration policy is to blame for unemployment among junior doctors, academics have warned.

They say doctors are competing for too few training posts because, while UK graduates are increasing, they have to compete against overseas applicants.

Doctors from within the UK and EU should have first pick of jobs, the British Medical Journal paper said.

The Department of Health said there was a balance to be struck to meet the needs of both doctors and patients.

The application system was thrown into disarray this year after many doctors applying for training jobs through the new computerised Medical Training Application Service failed to get their first choice or any interview at all.

The implications of making medicine a career in which, after seven years of training and thousands of pounds of debt, graduates face a serious risk of permanent exclusion are enormous
Dr Graham Winyard

But the chaos of MTAS concealed the problem of a "large surplus" of applicants for limited training places, said Dr Graham Winyard, a retired postgraduate medical dean.

In the past, the NHS had employed a large number of overseas doctors because there were too few graduates from UK medical schools.

To address this problem the government increased in the number of medical school places - 7,000 a year by 2010 compared with 5,000 in the 1990s.

Now this policy, alongside rules on allowing access to the UK for highly-skilled workers from outside Europe, has lead to doctors fighting for jobs, he said.

It is illegal for NHS trusts and medical deaneries to discriminate on the basis of the country where a doctor qualified.


Almost half the doctors competing for places this year were trained overseas.

After the end of the first round of the two-stage recruitment process, there were 14,000 doctors still looking for jobs - 4,000 of which were UK graduates.

"The implications of making medicine a career in which, after seven years of training and thousands of pounds of debt, graduates face a serious risk of permanent exclusion are enormous," said Dr Winyard.

Most other countries had two-tier systems where those trained in the country - or in the case of EU countries within Europe - were placed in training posts first, he added.

But Dr Edwin Borman, chairman of the British Medical Association's International Committee said overseas doctors were vital to the NHS as medicine became increasingly globalised.

Also writing in the BMJ, he said a policy to restrict training posts to UK graduates would be detrimental and the real fault was a lack of centralised workforce planning.

"Employing doctors from abroad stops a country having a parochial view of medicine, increases the relationships between countries and, with disease clearly being a global phenomenon, it's also really important for patient care."

He said it was to the NHS's credit that during the recent recruitment mayhem, all doctors had been treated equally.

A Department of Health spokesperson said there was a strong argument that taxpayers' investment in UK medical graduates should not be wasted because those graduates are unable to access specialist training.

"However, those factors have to be balanced against an argument that NHS patients should have access to the best doctors possible - no matter where they trained.

"We also have a responsibility to those doctors who trained abroad who currently work in the NHS. This is an important issue, and one which we need to discuss with the medical profession."

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