Does it matter that medical graduates don't get jobs as doctors?

Thousands of young people compete fiercely for medical school places each year because they want to work as doctors, not to gain an expensive general education, argues Graham Winyard a former postgraduate dean.

There are serious risks to medical education if medical school simply becomes a route to a range of future employment, he warns.

However, evidence is growing that several thousand UK medical graduates may not be able to pursue a career in medicine. This is due to a “catastrophic failure in government policy on medical migration” that has resulted in a huge surplus of applicants for specialist training, writes Winyard.

Attempts by the Department to Health to give priority to local medical graduates were thwarted by the Home Office’s highly skilled migrants programme that gave skilled people the right to enter the UK job market, he says. Although the entry rules have now been amended, an estimated 10 000–20 000 overseas graduates have already been accepted on to the programme to compete with local graduates.

“Much has been made by the British Medical Association and others of the importance of abiding by the undertakings made to overseas doctors. It is surely just as important that we keep faith with our own medical students and graduates, whose recruitment and training has been on the explicit understanding that they are needed to work as doctors”, he concludes.

But Alan Maynard, from the University of York, argues that the purpose of the National Health Service (NHS) is to deliver patient care that is compassionate and efficient and not to guarantee the employment of medical graduates.

Medical graduates, like all graduates should only be given jobs if they have the suitable knowledge and personal skills appropriate to their employers' and customers' needs, and within the finite resource constraints of the NHS, he states.

He points out that the inefficiency of health care delivery worldwide means that the market for medical graduates is uncertain. Recent changes in skill mix have added to this uncertainty, he says. For example, the emergence of nurse prescribers, nurse practitioners, and the training of nurses to carry out minor surgery, coupled with tighter NHS resource constraints, have the potential to reduce employment opportunities for medical graduates.

In addition, the recent success of negotiations for increasing pay and making medical graduates more expensive to employ, means that employers will gradually look for economy and changed skill mix, Maynard writes.

He concludes that the government’s failure to plan the medical workforce efficiently should not include a responsibility or need to guarantee medical graduates employment.

Source: British Medical Journal

Study links primary care shortage with salary disparities
The nation's shortage of primary care physicians has been linked to a host of poor health outcomes, and a new study published in the Journal of the American Medical Association suggests that salary disparities play a major role in the shortage.
Medical doctors who do research could be a dying breed
The road from disease research to disease cure isn't usually a smooth one. One role which bridges the laboratory and the clinic is that of the "clinician-scientist" – a doctor who understands disease both in the patient and in the Petri dish. Yet an editorial published in Disease Models & Mechanisms (DMM), http://dmm.biologists.org, contends that clinician-scientists in the UK and elsewhere are not prospering, but rather are "under threat in a hostile environment".
US could face shortage of 44,000 primary care physicians by 2025
By 2025, the wait to see a doctor could get a lot longer if the current number of students training to be primary care physicians doesn't increase soon, according to a new University of Missouri study. Jack Colwill, professor emeritus of family and community medicine in the MU School of Medicine, and his research team found that the U.S. could face a shortage of up to 44,000 family physicians and general internists in less than 20 years, due to a skewed compensation system that rewards specialists increasingly more than primary care practitioners. The researchers are more optimistic about the future supply of general pediatricians.
Feinstein to collaborate with Karolinska
The Feinstein Institute in Manhasset, N.Y., says it will join with Sweden's Karolinska Institute in exchanging graduates for post-doctoral research.
Are there too many female medical graduates?
More women now graduate from medical school than men, and soon male doctors will be in the minority. But are we risking future staffing problems, or is there still some way to go before we reach true equality? Two experts debate the issue in this week’s BMJ.
Want docs to treat the underserved? Make sure they train at community health centers
University of Washington researchers have found that community health center-trained family physicians were more likely to work in underserved settings than their non-community health center-trained counterparts (64 percent versus 37 percent), based on a study published in the April issue of Family Medicine.
British doctors should be nationally licensed
All British doctors should be licensed by taking a national examination according to research outlined in the online open access journal BMC Medicine. A UK-based research team assessed the performance of UK medical graduates from 19 British universities in the Membership of the Royal Colleges of Physicians (MRCP (UK)) exam, which forms a critical part of the training of aspiring specialist physicians in the UK.
New training method for hip surgery
Delegates at the British Society for Computer Aided Orthopaedic Surgery Conference will hear that results from a pilot study saw graduates 95 per cent more confident using this robotic technique than when using conventional surgical methods in training.

Does it matter that medical graduates don't get jobs as doctors?

Related stories:

News discussion: