Will the new contract debate have an impact on medical school applications

Will the new contract debate have an impact on medical school applications. Will it result in a reduced number of applicants, or will it have no affect....

Will the new contract debate have an impact on medical school applications. Will it result in a reduced number of applicants, or will it have no affect....

Anyone actually serious about medicine wouldn't change because of this.

You pursue medicine because you don't see yourself doing anything else.

Anyone actually serious about medicine wouldn't change because of this.

You pursue medicine because you don't see yourself doing anything else.

I've always hated this attitude. Medicine isn't some self-sacrificial vocation that only the most stalwart lovers of its art can do. There are many, many other jobs I could see myself doing for the rest of my life. But I want to be a doctor first and foremost.

why bother and put myself in further debt if being a doctor isnt valued in this country

I think this is key. I chose medicine because I wanted to work hard for something that was valuable. However, it is increasingly difficult to do a good job for patients as so many components of the system are broken or underfunded. The job is fun when you are listening to someone's problems, have an answer for them and can either make them better or provide much wanted reassurance. It is less fun when you have to go from patient to patient apologising for delays and errors.

On top of that, we are now getting a very clear steer from our monopoly employer that they think we are greedy, lazy, and uncommitted. This is very far from the truth but it is a very uncomfortable thing to hear repeated again and again - even if it's only from politicians and the occasional commenter at dailymail.co.uk.

If I were advising potential applicants I would still encourage them to apply. Medicine is an awesome job and can be a lot of fun. However, I would honestly counsel them to have a Plan B (either US exams or an elective to set up some contacts in Australia, etc) so that they can get out easily if they don't have a chair when the music stops.

i was planning to apply for graduate medicine ( if i got a 1st in my degree ) but after all this **** broke loose about pay and work conditions, im like why bother and put myself in further debt if being a doctor isnt valued in this country

I think it will definitely have an impact - I don't think it will be a massive change, and medical school places will remain very oversubscribed, but there has already been a bit of a drop in applications in the last two years, and I'm certain that in this climate, the general trend will continue.

Applications-
2013: 17,000
2014: 17,140
2015: 15,220
2016: 14,820

Numbers of EU and international applications haven't fallen though.

Ploughing ahead with university applications without taking job conditions into account just doesn't make sense to me. You might not have a crystal ball and you can only look at current conditions and trends, but to make a informed decision about your future job, you need to base it on information which includes money, hours etc, as well as your time in your local care home. Basic common sense, right?

It'd be great if the way life worked was 'if you have the "right attitude" and the determination, you (and everyone else) can and should be happy to do anything, just push through and it'll work itself out' but it doesn't. We're only human.

How do you go about us exams....

So your not applying then... It's such a shame aspiring medics are made to feel like this

It's a huge nuisance as you have to sit the USMLE, which is in four parts: www.usmle.org/bulletin/eligibility

It might not be so bad if you study for the USMLE as you progress through medical school (e.g. sitting USMLE Step 1 after your pre-clinical phase) but the material is subtly different and I think you would need to be a very strong student. You also need to achieve a very high score (particularly in Step 1) to be competitive in the US as they expect higher scores from non-US graduates.

You would then need to arrange your medical elective in the US because many programmes require letters of recommendation from US doctors.

Then you've got to match into a US programme you like before dealing with the visa paperwork...

It's a huge pain but can work very well for students who are committed to the process. Advantages of being in the US are shorter training programmes (emergency medicine is only 3 years...!!), much higher social status for doctors, and much higher salaries (median salary around £300,000). Some US cities (Miami, San Francisco, Boston, etc) are lovely and their hospitals are very well funded.

Australia, NZ, and Canada are however much easier destinations as your UK qualifications (plus lots of paperwork) are usually transferable.

For those of us in final year with none yet under our belt when do you think is the best time to try and transfer. From what i have heard it is pretty much impossible for IMGs to match onto competitive programmes for residency (ortho in my case). Other than waiting for fellowships do you know of a way to get across and onto these programmes? Would research fellowships over there be a route in or would the programmes still be too biased against IMGs?

I think it depends on how keen you are to leave, how much of a hurry you are in to finish training, and how much you want to gamble...

I personally would finish FY2 so that you have the option of smoothly transitioning back to the UK at a later date if necessary. That would also give you time to get started with the USMLE. You could then do a post-FY2 research fellowship in the US and use that to do some clinical observing, get a feel for whether you actually want to work there, and organise US letters of recommendation.

Their residency selection process is pretty chaotic and can mean attending 10+ interviews all over the US over the course of a few months. It would make sense to be based in the US during that time, which could be facilitated by a research job. There is a lot of underhandedness in the US system and doors can open if someone senior makes telephone calls on your behalf and/or you make a good impression on programme directors, e.g. at academic meetings.

Obviously some US hospitals have cash to fund research fellowships but there are also a lot of unpaid people hanging around with a view to winning residency spots. I would explore UK sources of funding to support a US degree (MSc/MBA/MPH) or a research year, e.g. Kennedy/Knox/Fulbright Scholarships.

The most important thing is Step 1 as that's often the only score US students have when they apply for residencies and so it's the one that's used to directly compare applicants. You can do the Step exams in any order - some people will do Step 2 CS and CK first and save Step 1 for when they know they can prepare thoroughly (e.g. during a research year). You can only sit Step 1 once and so your score stays with you forever.

Could you get a US ortho residency with a UK degree, US experience (+ good letters of recommendation), and a very high Step 1 score? Yes. Your chances would be much higher if you were open minded about where in the US you were willing to work.

There is an anti-IMG bias (some programmes will not even accept applications from IMGs) but a lot of the bias beyond this point is possibly aimed at doctors with qualifications from South America, Africa, and the Indian sub-continent. I don't think that they encounter UK applicants very often and you might find that you encounter fewer obstacles.

To become board certified in the US you must have completed a US residency. You can go there for a year as a fellow later in your career but it is (almost) impossible to get a permanent job there having completed your training overseas.

Thankyou for the detailed response. I had looked at the fullbright/kennedy scholarships (hadn't encountered Knox), though it seems that these are rather competitive! Hopefully i can improve my portfolio for applying over the coming two years as i think it'd be an all round good experience to gain even if i were to opt to stay in the UK.

I think it will definitely have an impact - I don't think it will be a massive change, and medical school places will remain very oversubscribed, but there has already been a bit of a drop in applications in the last two years, and I'm certain that in this climate, the general trend will continue.

Applications-
2013: 17,000
2014: 17,140
2015: 15,220
2016: 14,820

Numbers of EU and international applications haven't fallen though.

Ploughing ahead with university applications without taking job conditions into account just doesn't make sense to me. You might not have a crystal ball and you can only look at current conditions and trends, but to make a informed decision about your future job, you need to base it on information which includes money, hours etc, as well as your time in your local care home. Basic common sense, right?

It'd be great if the way life worked was 'if you have the "right attitude" and the determination, you (and everyone else) can and should be happy to do anything, just push through and it'll work itself out' but it doesn't. We're only human.

hi there. sorry to be completely random but where did you get the data of the number of applications. Initially, i thought the number was still rising year by year instead of a massive drop.