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Anonymous #1
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I moved to UK at the age of 7. I have lived in England ever since, while frequently visiting my home country . I am currently an f1 doctor. I am thinking of taking a year out (with the possibility of not returning for fy2).
As I would have received my full licence by end of year 1.
My plan would be my to continue my training in my home country. (This involves sitting an exam in october, Compulsory youth service, applying for residency for speciality of choice. During this period I have the possibility of starting my own business).

This is a very hard step for me to make, because I am not aware of anyone leaving after f1 training. Plus I am not aware of the steps it would involve if I EVER wanted to return back to the UK. My family and Friends are all back home, and I am not really happy about living in the UK and I've always wanted to move back. But At the same time I do not want to make any drastic, and career halting decisions.

Do I enjoy being a doctor?
Yes, I love being a doctor, even if I didn't, I don't know what else I could possibly do. But the NHS doesn't care about doctors in general, junior doctors are REALLY over worked, with little pay (I got paid £1800(reduced to £1300 after automatically taking out my rent) for a whole months work, involving long nights, stress, and actual tears).
Plus I look at senior doctors and consultants and think to myself is this what I look forward to?
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Smile88egc
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Continuing training in your home country doesn't sound too appealing either. What does "compulsary youth service" involve? Have you spoken to junior doctors in your home country to find out what working life is like there?
Don't forget there is a good pay rise between F1 and F2. I'm not trying to put you off, but you may find that changing the country you work in becomes easier as you become more senior in your training.
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nexttime
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FY1 is probably the worst year of all of them, and as observed above there is a big jump in pay from year 1 to year 2. Things do get better.

On the other hand, conditions for doctors probably will be a lot better and I bet the number of years training is less. Have you looked into what being a doctor in your home country is like?

Theoretically coming back to the UK will be easy - you would just join an FY2 standalone position like europeans currently do. Brexit might make things complicated though.
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Etomidate
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FY2 life is generally much better than FY1 life. It's one of the biggest pay jumps you'll have (well, pre-new contract, anyway) and you're no longer the first port of call for general bull **** (assuming you have an FY1 as part of your firm). There's also a bit more respect and trust when you're "the SHO".

It does get better.
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Ghotay
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(Original post by Anonymous)
I got paid £1800(reduced to £1300 after automatically taking out my rent) for a whole months work, involving long nights, stress, and actual tears
Damn. I'm currently living on £110/month after deducting rent. Doesn't sound so bad to me
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nexttime
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(Original post by Ghotay)
Damn. I'm currently living on £110/month after deducting rent. Doesn't sound so bad to me
Continue that for half a decade after graduation and you might be able to afford the deposit on a house!

Spoiler:
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Nah I agree doctors are not poorly paid. Just treated like **** in every other way
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Snufkin
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If you knew all your family and friends were in your home country, why didn't you train there?

I don't mean to sound like a Tory (:afraid:) but I am surprised that so many people (the OP is by no means alone in this) feel morally justified in abandoning the county that funded their medical training. I'm not a medic so I won't pretend to understand the pressure you guys are under (although I'm sure it's a lot), and I fully accept that you have the right to live and work where you want, but I think leaving the UK having only put in one year of work is a bit selfish.
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seaholme
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(Original post by Snufkin)
I don't mean to sound like a Tory (:afraid:) but I am surprised that so many people (the OP is by no means alone in this) feel morally justified in abandoning the county that funded their medical training. I'm not a medic so I won't pretend to understand the pressure you guys are under (although I'm sure it's a lot), and I fully accept that you have the right to live and work where you want, but I think leaving the UK having only put in one year of work is a bit selfish.
The country funds training for lawyers, bankers, engineers, biomedics, chemists, physicists, linguists and many other disciplines. Many of which go on to command vast salaries, well in excess of what doctors will ever be paid. However the high moral standard you're on about seems only ever to be applied to medics.
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#9
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(Original post by seaholme)
The country funds training for lawyers, bankers, engineers, biomedics, chemists, physicists, linguists and many other disciplines. Many of which go on to command vast salaries, well in excess of what doctors will ever be paid. However the high moral standard you're on about seems only ever to be applied to medics.
No it doesn't. People who do degrees in law, economics/finance, engineering, biomedicine, chemistry, physics, languages etc have to take out student loans. Interestingly, arts, humanities and social science students pay more in fees than their degrees cost to run, whereas a medical student pays a fraction of the real cost of their degree. Plus the NHS pays the tuition fees for a medical student's last two years of a university. According to fullfact.org, by the time a doctor has completed their two foundation training years, the cost of training will have reached £312,000.

Since you mentioned lawyers, it's worth pointing out that solicitors and barristers have to undergo additional postgraduate training and pay for it themselves, and many (most?) do not go on to earn vast salaries.
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(Original post by Snufkin)
If you knew all your family and friends were in your home country, why didn't you train there?

I don't mean to sound like a Tory (:afraid:) but I am surprised that so many people (the OP is by no means alone in this) feel morally justified in abandoning the county that funded their medical training. I'm not a medic so I won't pretend to understand the pressure you guys are under (although I'm sure it's a lot), and I fully accept that you have the right to live and work where you want, but I think leaving the UK having only put in one year of work is a bit selfish.
I'll additionally point out that the OP will probably still be responsible for about £55,000 of student debt, whereas in many European countries they'd have got their education for free.
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(Original post by Snufkin)
No it doesn't. People who do degrees in law, economics/finance, engineering, biomedicine, chemistry, physics, languages etc have to take out student loans. Interestingly, arts, humanities and social science students pay more in fees than their degrees cost to run, whereas a medical student pays a fraction of the real cost of their degree. Plus the NHS pays the tuition fees for a medical student's last two years of a university. According to fullfact.org, by the time a doctor has completed their two foundation training years, the cost of training will have reached £312,000.

Since you mentioned lawyers, it's worth pointing out that solicitors and barristers have to undergo additional postgraduate training and pay for it themselves, and many (most?) do not go on to earn vast salaries.
All degrees in the UK are subsidised by the government, ergo the dramas when the tuition fees were raised. What is it about a medical degree that makes tax payers believe they own a doctor, their ability to make decisions in their personal life and their freedom?

The rest of your post is full of falsehoods, so what's the point.

OP, If I was in your situation I would finish FY2 before leaving to go elsewhere. I would have thought it would mean a smoother transition when you return, rather than looking for stand alone FY2 posts.



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Snufkin
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(Original post by Newtothis83)
All degrees in the UK are subsidised by the government. What is it about a medical degree that makes tax payers believe they own a doctor and their freedom?

The rest of your post is full of falsehoods, so what's the point.

OP, If I was in your situation I would finish FY2 before leaving to go elsewhere. I would have thought it would mean a smoother transition when you return, rather than looking for stand alone FY2 posts.



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What falsehoods? :confused:

All undergraduate degrees are eligible for a tuition fee loan, that is not the same thing as being subsidised. A medical degree, unlike most other degrees, really is subsidised (by a colossal amount) by the UK taxpayer/NHS, so yes, I do think doctors owe a debt to society. At the very least I think doctors should work for two years in the NHS after completing their foundation training before going abroad.
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Newtothis83
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(Original post by Snufkin)
What falsehoods? :confused:

All undergraduate degrees are eligible for a tuition fee loan, that is not the same thing as being subsidised. A medical degree, unlike most other degrees, really is subsidised (by a colossal amount) by the UK taxpayer/NHS, so yes, I do think doctors owe a debt to society. At the very least I think doctors should work for two years in the NHS after completing their foundation training before going abroad.
Oh I know what subsidise means. All degrees in the UK are subsidised by the government and therefore the taxpayer.

Do you actually believe £9000 (whether self funded or with student finance) pays the entire cost for any student at higher education?

So again, why the obsession with medical students and *their* debt to society?

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Snufkin
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(Original post by Newtothis83)
Do you actually believe £9000 (whether self funded or with student finance) pays the entire cost for any student at higher education
It depends on the degree. As I say, humanities and social sciences degrees do not cost £9000 p.a. to run, science degrees (especially those which involve wet labs) cost rather a lot more. But it isn't the government subsidising those degrees, it is the poor sods paying 9k a year to read English/History/French etc.

A medical degree costs a lot more than any other STEM degree and is subsidised directly by the government and the NHS.
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(Original post by Snufkin)
It depends on the degree. As I say, humanities and social sciences degrees do not cost £9000 p.a. to run, science degrees (especially those which involve wet labs) cost rather a lot more. But it isn't the government subsidising those degrees, it is the poor sods paying 9k a year to read English/History/French etc.

A medical degree costs a lot more than any other STEM degree and is subsidised directly by the government and the NHS.
As someone who pays non-EU fees, I always find these arguments bout mandatory service bemusing.

All degrees and all education in the UK is taxpayer subsidised to an extent. If you include defaults, and the lower income bracket of certain degrees and hence the lower repayment rates, one could even say certain degrees end up costing more than certain others.

You are absolutely right that those poor guys who chose arts/humanities are getting less funding than those who do STEM subjects (after all, only Price Group A,B,C1 are funded by the HEFCE), but why only limit those with a medical degree to serve a mandatory period?

By that logic, surely those from disadvantaged backgrounds who receive HEFCE funding (for that whole social mobility scheme thing) should serve, group B&C (which are the other STEM essentially) should do some, proportionally at the very least, and heck, those who idiots who got their free mandatory secondary schooling should at least get off their bum and work, no?

Heck, why not extend that to any other parts of the social system? If anyone's received social funding of any sort, surely they must repay it?
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nexttime
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(Original post by Snufkin)
All undergraduate degrees are eligible for a tuition fee loan, that is not the same thing as being subsidised. A medical degree, unlike most other degrees, really is subsidised (by a colossal amount) by the UK taxpayer/NHS, so yes, I do think doctors owe a debt to society. At the very least I think doctors should work for two years in the NHS after completing their foundation training before going abroad.
If you support doctors 'repaying' the country they trained in, I assume you're also in favour of the UK paying for the training fees of all the doctors working here who trained abroad? That would only be fair, of course.

That's about 35% of all doctors at the last count (and effectively higher, given that many such doctors trained for free whereas UK graduates who go abroad are supposed to repay the aforementioned £55,000 fees)?

Now some factual corrections FYI (will try to keep brief):

(Original post by Snufkin)
According to fullfact.org, by the time a doctor has completed their two foundation training years, the cost of training will have reached £312,000.
This is a very misleading figure.

Firstly, you have included foundation years. A foundation year doctor is a working professional who provides a service for the NHS. They need supervision but so do other junior docs and so do other NHS professionals. Did you know, for instance, that when you go through the free market (locum shifts) Foundation Year 2 doctor attracts a wage almost 4x greater than the basic wage the NHS pays them? They could just not fill those shifts... but they don't. That reflects how much hospitals value the work they do.

Secondly, the actual cost of medical training is not that high. The quoted figure comes from figures that are transferred to hospitals based on where med students are, but it doesn't necessarily reflect money spent. It reflects that places who have students are supposed to provide more advanced services to their patients. The reality is that a lot of what a med student does is just observing things that would happen anyway - time spent actually teaching is actually fairly similar to other science degrees, or maybe even less. A more realistic figure for the 5 years would perhaps be £70k. Certainly no more than £100k. With £36K of that covered by the students.

Since you mentioned lawyers, it's worth pointing out that solicitors and barristers have to undergo additional postgraduate training and pay for it themselves, and many (most?) do not go on to earn vast salaries.
Same for doctors, plus many other expenses lawyers etc don't have to deal with e.g. having your job move city up to every 6 months for the first to to 10 years :mad:

(Original post by Snufkin)
But it isn't the government subsidising those degrees, it is the poor sods paying 9k a year to read English/History/French etc.
The government does still subsidise univeristy education. This is not true.

http://www.universitiesuk.ac.uk/poli...-explained.pdf
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(Original post by Snufkin)
At the very least I think doctors should work for two years in the NHS after completing their foundation training before going abroad.
Why two years? Why not more or less? Is this figure based on any economic reasoning, or has it just been plucked out of thin air?

Instead of forcing people to work where they don't want to work, a more sensible approach would be to work out why they're leaving the country in droves in the first place...and then fix it.
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seaholme
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(Original post by Snufkin)
No it doesn't. People who do degrees in law, economics/finance, engineering, biomedicine, chemistry, physics, languages etc have to take out student loans. Interestingly, arts, humanities and social science students pay more in fees than their degrees cost to run, whereas a medical student pays a fraction of the real cost of their degree. Plus the NHS pays the tuition fees for a medical student's last two years of a university. According to fullfact.org, by the time a doctor has completed their two foundation training years, the cost of training will have reached £312,000.

Since you mentioned lawyers, it's worth pointing out that solicitors and barristers have to undergo additional postgraduate training and pay for it themselves, and many (most?) do not go on to earn vast salaries.
1. Medical students also pay student loans.

2. To me it seems unfair that just because it costs less to run a humanities course, those who do non-humanities courses should sacrifice their individual freedom and therefore their lives for several years as a consequence - the system is such that you pay the same fee for any course. If they wish to punish those whose courses cost more to the university then reflect that in the fees rather than in human freedom. I'd certainly rather have control over my life if we're going to start valuing degree this way - despite the fact no other degree is valued as such. At the end of the day it's not just medicine which costs more to offer than we pay in tuition fees.
By the by, that is bypassing the fact that the 'cost' of medical education is ridiculously unrealistic in all of these official factoids, and that the 'cost' in fact also reflects subsidies paid to the NHS. For instance I teach medical students in the NHS at no extra cost to the NHS whilst still doing my job and am expected to simply to my job AND teach at a cost to my own time, yet hospitals will be paid a hefty sum for such students that is taken by them purely for profit.

3. Medics have to undergo postgraduate training and pay for it themselves! And most do not go on to earn vast salaries either. Bankers have to undergo no postgraduate training AND will go on to earn a vast salary. Actually most of my friends doing Law, Accountancy etc. have had all their post-graduate training paid for by their firms. Whereas I've struggled to get the days off to even take these exams I'm paying for myself. How the hell is this even a point? Google MRCP, MRCS if you have any doubts.
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Snufkin
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#19
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(Original post by hslakaal)
All degrees and all education in the UK is taxpayer subsidised to an extent. If you include defaults, and the lower income bracket of certain degrees and hence the lower repayment rates, one could even say certain degrees end up costing more than certain others.

You are absolutely right that those poor guys who chose arts/humanities are getting less funding than those who do STEM subjects (after all, only Price Group A,B,C1 are funded by the HEFCE), but why only limit those with a medical degree to serve a mandatory period?

By that logic, surely those from disadvantaged backgrounds who receive HEFCE funding (for that whole social mobility scheme thing) should serve, group B&C (which are the other STEM essentially) should do some, proportionally at the very least, and heck, those who idiots who got their free mandatory secondary schooling should at least get off their bum and work, no?

Heck, why not extend that to any other parts of the social system? If anyone's received social funding of any sort, surely they must repay it?
If you include all the people who will never repay their loan then yes you could argue that the government subsidises all degrees to an extent, however that is a bit different to the kind of direct and non-repayable subsidy med students get. I don't really want to debate whether UK degrees are subsidised or not, I hope we can at least agree that medical degrees are subsidised more than any other degree.

As I understand it (I could be wrong, please correct me if I am), the NHS pays out of its own budget the tuition fees for home/EU medical students in their fifth and sixth year.

(Original post by Democracy)
Why two years? Why not more or less? Is this figure based on any economic reasoning, or has it just been plucked out of thin air?

Instead of forcing people to work where they don't want to work, a more sensible approach would be to work out why they're leaving the country in droves in the first place...
Why not? That figure is not based on any economic reason, it just seems like a good compromise.

I absolutely agree that a more sensible approach would be to work out why doctors are leaving and do something about it. The problem is this government is clearly not prepared to do that, and given the shambles Labour are in, another decade of Tory rule seems likely. If it's a choice between some kind of mechanism to keep doctors in the UK or do nothing and watch the NHS fall apart, I'd choose to protect the NHS every time. It is harsh, it is the Tories/Hunt's fault, but the alternative is worse.

(Original post by nexttime)
If you support doctors 'repaying' the country they trained in, I assume you're also in favour of the UK paying for the training fees of all the doctors working here who trained abroad? That would only be fair, of course.

That's about 35% of all doctors at the last count (and effectively higher, given that many such doctors trained for free whereas UK graduates who go abroad are supposed to repay the aforementioned £55,000 fees)?

Now some factual corrections FYI (will try to keep brief):



This is a very misleading figure.

Firstly, you have included foundation years. A foundation year doctor is a working professional who provides a service for the NHS. They need supervision but so do other junior docs and so do other NHS professionals. Did you know, for instance, that when you go through the free market (locum shifts) Foundation Year 2 doctor attracts a wage almost 4x greater than the basic wage the NHS pays them? They could just not fill those shifts... but they don't. That reflects how much hospitals value the work they do.

Secondly, the actual cost of medical training is not that high. The quoted figure comes from figures that are transferred to hospitals based on where med students are, but it doesn't necessarily reflect money spent. It reflects that places who have students are supposed to provide more advanced services to their patients. The reality is that a lot of what a med student does is just observing things that would happen anyway - time spent actually teaching is actually fairly similar to other science degrees, or maybe even less. A more realistic figure for the 5 years would perhaps be £70k. Certainly no more than £100k. With £36K of that covered by the students.



Same for doctors, plus many other expenses lawyers etc don't have to deal with e.g. having your job move city up to every 6 months for the first to to 10 years :mad:



The government does still subsidise univeristy education. This is not true.

http://www.universitiesuk.ac.uk/poli...-explained.pdf

No, I don't support the UK paying for the training fees of all the doctors working here who trained abroad. Other countries can deal with brain drain in their own way, if they don't want to stem the flow of doctors leaving then that's up to them. It is true that a few European universities offer comparatively cheap English-taught medical degrees, but these degrees are targeted at foreigners who don't speak the local language and therefore aren't expected to stick around. But more importantly, these degrees are not subsidised by that country's health service.

Where has that £70-£100k figure come from? Even if you don't include foundation years, the cost of a medical degree is much higher than that. The international fee charged by Medical Schools is probably the best indicator of the real cost of a medical degree. Imperial for example charges international students studying medicine £38,500 per year. That's £231,000 in total.
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(Original post by Snufkin)
Why not? That figure is not based on any economic reason, it just seems like a good compromise.
Certainly from where you're standing since you wouldn't ever be on the receiving end of it!

I absolutely agree that a more sensible approach would be to work out why doctors are leaving and do something about it. The problem is this government is clearly not prepared to do that, and given the shambles Labour are in, another decade of Tory rule seems likely. If it's a choice between some kind of mechanism to keep doctors in the UK or do nothing and watch the NHS fall apart, I'd choose to protect the NHS every time. It is harsh, it is the Tories/Hunt's fault, but the alternative is worse.
Dude, you can't protect the NHS by demoralising its workforce and treating them like indentured servants - it simply doesn't work that way.

If you stop doctors from practising abroad a good number will simply leave the NHS, stay in the UK, and do something else. We're not exactly underqualified. Unless you then go one step further and actually make it illegal for anyone who graduated med school to do anything except practice medicine for at least four years. Which would make for some very interesting historical parallels...

Besides which, since junior doctors aren't the ones who are causing the NHS to fall apart, exactly why should our liberty be curtailed?
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