In response to the deleted ‘UK Doctors’ rant
Last night, there was a post on the forum titled "PSA: UK Doctors Are Not Our Friends and Are Part of the Problem." It gained a lot of engagement but was understandably controversial and was deleted by the original poster. The language it used was quite strong but in summary the post slammed UK doctors working in Australia, saying they’re not really our friends and are actually making things harder for local doctors. They claimed UK docs have left their struggling healthcare system to take jobs here, which weakens our bargaining power and devalues our roles. They mentioned the NSW Psychiatry situation, suggesting the government is hiring temporary locums just to bring in UK doctors who’ll accept lower pay and easier visa deals since it’s better for them than staying in the UK.
I wrote a response to the post however they self-deleted just before I submitted it. I feel it’s important that this discussion is seen and happens:
I couldn't agree more. I’ve been following this issue for the past four or so years, and the response from Australian JMOs is strikingly similar to how UK doctors initially responded to foreign graduates when this first became an issue. In 2019, doctors were added to the UK Shortage Occupation List, exempting them from the Resident Labour Market Test that requires employers to advertise domestically before hiring foreign workers. Since then, there has been a torrential influx of IMG doctors (see the image below).
The NHS publicly releases competition ratios for training positions, which show the number of applicants per available spot. These ratios have skyrocketed since the RMLT change—from 2014 to 2024, for example, the number of applications per position for radiology training jumped from 3.5 to 11.92, psychiatry from 1.3 to 9.45, and obstetrics from 2.4 to 7.00 applications per position. If you looked at discussions on the topic around 2019/2020, anyone who tried to point out these trends risked being labeled racist, with people insisting “IMGs are our friends/ my favourite consultants are IMGs". Over time, it’s become more acceptable for UK doctors to criticise the system, however I suspect it is far too late. From what I’m seeing in this and similar threads, Australia appears to parallel the “early days” phase. Mentioning these concerns can easily lead to being called xenophobic for suggesting that domestic graduates should be prioritised. Interestingly, when I discuss this with UK doctors, most of them actually agree with the idea.
I am already on a competitive training scheme, so personally this doesn’t affect me, but I’d be up in arms if I were a current medical student or a prevocational junior doctor. The number of IMG doctors important every year has grown exponentially since COVID, we're currently allowing in nearly twice as many international medical graduates each year than the number of local graduates, and there is no signs this is slowing down. Back in the early 2010s, there were worries that increasing the number of domestic graduates would lead to a lack of jobs. The number of local annual graduates only rose from 1,587 in 2005 to 3,547 in 2015, and we dubbed that the "medical student tsunami." Fast forward to between 2023 and 2024 alone, and there were 5,717 new IMGs entering the system in a single year. Meanwhile, there’s been only a minimal increase in the number of training positions, eg. RACGP filling all its training positions this year, causing some locals to miss out.
One of our issues is unlike in the UK, our job applications aren’t standardised, and there’s no easily accessible data on competition ratios or the proportion of IMGs getting these positions. This makes it difficult to spread awareness about the problem since the information isn’t readily available. Anecdotally, at my previous central/ metropolitan hospital, over half the ICU registrars were UK IMGs (not hyperbole; I counted). This year, half the anaesthetic training scheme spots at the same hospital went to very senior (PGY6+) ICU/ED registrars who didn’t get into a training program in the UK. Another hospital with the most prestigious anaesthetic schemes in the state/country gave a position to a PGY7 doctor directly from the UK. Some people argue that if your job is taken by a foreigner, then you probably deserved it. But how is a local PGY3 who was born in Australia, raised in Australia supposed to compete when these doctors with years of work on their resumes are applying for the same roles? All it does is push locals into the bottom of the unaccredited crab bucket, requiring years more work to get onto programs that locals traditionally enter in their junior years.
I think a good first step would be to introduce a motion to the AMC similar to what some of UK doctors are trying — to ensuring domestic graduates are prioritised for training positions over internationals. A five-year training position costs three quarters of a million dollars of taxpayer money, and I don't understand why we're allocating these resources to financial immigrants. We prioritise Australians for university education and schooling, and we prioritise Australians for internships. We should be prioritising Australians to be trained as Australian specialists.
Don’t look up.
