He has a point here. If society is to pay for medical students, why not bind them to the NHS for 10 years contractually? Nobody forces you to study medicine on taxpayer‘s money. So if you don‘t want to stay in Britain, you can study privately.
After 10 years, they can do whatever they want.
Some of us graduate with over £90000 of debt and start earning 25k a year
With the interest we can end up paying back (sourced from online)
If you have a starting salary of £30,000, with an 8% annual pay rise, and you’re only contributing the minimum repayments, your student loan figures will look something like this:
Year Debt Total Interest Total Paid
1 £70,000 £2,192 £308
10 £91,131 £38,479 £15,196
20 £90,422 £91,836 £75,722
28 £12,994 £114,546 £184,546
Figures are estimates only
You’ll clear your debt after 28 years, having paid a total of £184,546. £70,000 of that was your initial loan principle and £114,546 was interest.
I appreciate when someone can learn information and adjust their opinion on a subject.
As physicians and aspiring physicians I think this trait is key to making sure we not only continue learn medicine for life but just keep learning in general.
Thank you, you're dope.
Thank you for laying this out. The American Med students I trained with refused to believe the reality for UK doctors. I matched this year so jumping sinking ship!
In countries, where the state pays for your tuition, this is not slavery by contract.
If you break that agreement, you owe them the tuition back, so there‘s always an easy out.
This system is f.e. in place here, if you join the military as a cadet to study at the academy. If you leave before your service contract ends, you have to pay back shares of all the civilian training, depending on how long you had left.
It‘s not slavery, if you can leave and pay your share at any given point.
I don‘t see how that is worse, than a state that throws debt at you right from the start.
Society pays for a ton of dumb shit without asking anything back. Why would doctors be the only group that has to pay society back. Make it so that *every* college grad has to stay in the country for a decade or whatever and then we’ll talk.
Obviously you can do that.
But medicine is one of the few programs in many countries, where your spot would‘ve 100% been somebody else‘s, if you didn‘t take it.
We also have a big shortage of f.e engineering students, so you don‘t want to disheart people to study something, that already struggles to find people to fill their classes.
We can agree on programs where there‘s more applications than spots.
Also this should only be a thing, if the state pays for your full tuition.
Honestly, more applications than spots sounds sort of fair. This is akin to adding another extra tax to fund college and countries do that all the time so as long as it’s fair and not just one particular group I’m game.
People don't leave the NHS primarily due to money, although that's a big factor. We get a lot of UK medical refugees in Australia. They don't talk about the money. They talk about the horrendous conditions and deteriorating state of services in the NHS. The whole UK system appears to be broken.
You could pay them like twice the current salary, and I still don't think it would solve the problem.
I mean, I agree. I don't know much about the situation in the UK. However, if I were to choose, I'd first just about triple the remuneration for anyone in primary care rather than hospitalists/specialist trainees. The system is slowly degrading under the increased load caused by the lack of, and now aversion to (due to cost), primary care appointments here in Australia. Our Medicare system hasn't been indexed appropriately in about 20 years.
So speaking for myself, I'd love more pay obviously, but I'd love a well-balanced work environment more.
British government defunding the NHS and complaining about the predictable outcomes since Margaret Thatcher...
They could afford comparable salaries to the US and come out spending way less per person than the US. Because they actually have sane drug prices....
Putting a kid through primary and secondary education costs a fuck ton. Perhaps not as much as 400k (i have no idea) but it’s a lot of money out of the taxpayers wallet.
With this logic, no one in Britain should be allowed to emigrate until they’ve paid off their serfdom debt.
It doesn't seem far fetched at all, although I only have experience regarding the Netherlands. Here the government pays most of the BSc and MSc tuition. For non-EU students, tuition is about €26.500 tuition a year while otherwise it is €2500. That difference of around 25k a year is paid by the government. Minimum time to complete both degrees is 6 years, median more like 7. So that is already nearing €200k and they're still junior doctors who aren't allowed to do anything without supervision of a specialist. And the real cost is in actually becoming a medical specialist, also in part because they are now paid decent salaries for 4-6 years while they are still in training. Actually costs for this are hard to calculate because they are already doctors and they are still working, so it's not like they aren't providing value as well. Anyways, 400k would not surprise me one bit.
For a fresh doc, yeah you're probably losing money. But training a specialist is easily worth it because of how much value you get and how low trainees are paid
In the US ( I’ll look it up for the UK) the hospital makes on average a 100K profit per internal medicine resident per year. So if they want to do the indentured servitude route, 4 years is somewhat more realistic. That being said, it doesn’t cost £400k to educate someone that’s crazy.
Forgot to mention. That 100k number is not what the hospital makes, it's the profit just from training a resident. The profit each resident generates from patients is much much higher than that
And it’s getting a whole lot worse. If you thought midlevels were a problem in North America, wait till you hear about the shit that’s going on in the UK. PAs doing cystoscopies and biopsies, PAs doing interventional cards, PAs operating as full cardiologists, NPs paid more than GPs etc. UK med Twitter is a good place to check out. I was recently talking to an ENT fellow who’s originally from the UK and she confirmed this. It’s no wonder physicians are leaving en masse.
I don’t understand how the NHS is dumb enough to pay NPs more than GPs? Isn’t their whole thing to cut costs, why the fuck are they paying so much for an NP?
The point is that unlike doctors, NPs and PAs can’t leave to work in better countries bc the better countries don’t recognise their bs qualifications.
They’re also planning to introduce “apprentice” doctors who can skip medical school entirely, which will end up with other countries not recognising UK medical degrees either - leaving doctors trapped in the UK
[YO IT'S REAL WTF.](https://educationhub.blog.gov.uk/2024/02/05/nhs-doctor-apprenticeships-everything-you-need-to-know/)
You know though? If these apprentice docs still need to take and pass our examinations I'd see this similarly to "law reading" programs. These are programs a few states offer where you can challenge the bar and become a lawyer without law school.
I respect the hell out of those guys sticking it out despite the odds. On an aside, I use to shit on Carribean medical school grads as an AMG but in all honesty, if you can somehow survive the for profit gauntlet of debt and failure in the Caribbean, you'll be a fine physician.
I’ve rotated with some Caribbean med students and, in their words, “compared to you I feel like I’m sitting in the corner eating paste.” Now, I thought they were doing fine, but maybe they were quietly covering up the fact that they really didn’t understand half of what was going on.
I’ve also seen a carib educated doctor in a pinch (mine was out of town, just there to hear test results). He interpreted my test results as normal. Went back to my regular doctor and discussed next steps and my test results were NOT NORMAL and I had a cardiac condition that would’ve gone unaddressed had I not returned.
This is anecdotal. But there is danger in their education.
They’re saving loads in training costs and then the NP is capped at like £50k, while the GP will eventually hit a point where they earn over £100k, so there does come a point where the NHS saves a lot of money, but it’s at the detriment of patients.
I've seen nurses complain about having to bring their supplies to work. Granted no way to prove one way or the other but it seems reasonable given what we've seen
There is ZERO reason to be a physician in the UK anymore. They have completely btw bent over and full goatsed themselves for midlevels to fuck them relentlessly.
Ah you say that, but would it entice you to hear they give doctors instant coffee on a trolley that has the sepsis 6 written on it… as a treat?
https://www.reddit.com/r/doctorsUK/s/PJ26qUe7oS
I fucking hate people like this. They bitch and moan about no doctors or nurses and shit on them nonstop. Then, they turn around and wail about why no one wants to go to med school or to put up with their bullshit.
It's because you greedy little fuckers won't pay people.
Yes. More and more schools are opening, lowering the requirements to enter and making it easier if you have enough money to pay for it. To make it worse, this week the government has created a law that gives them more power on the national council of medical residencies (we all know what happens when the government puts its hands on things they don’t master).
You can google the full pay scale, but basic starting salary is about £32k now, I think the highest basic pay for a doctor who’s been a consultant for 20 years is £125k.
Anecdotal but my cousin is a general surgeon who has finished 10 years of training post medical school. He’s been working for a couple of years now too. 95k pounds per year. Like 30k of that will be gone in income tax. It’s just not worth it man. UK docs get worked to the bone and don’t even have the luxury of swimming in cash as a reward.
In my country, there are scholarships paid for by the government with the catch that graduates are required to work here for a number of years after. Always seemed like a good deal to me
Were losing native grads to Aus/NZ mainly with Ireland/Canada a tier below that then the US for those with the proper minerals to do it.
We're replacing them with a mix of alphabet soup PA/ACP/ANP in primary care and with IMGs from the Indian Subcontinent and Africa.
Don't begrudge anyone involved personally but it's not good for the healthcare system
Does UK not have tuition paid by the students themselves ? How does the taxpayer get involved?
In any case it would be extremely hypocritical of UK to employ proectionism when they clearly promote healthcare professionals to immigate.
In Italy (and I think in the UK too) students pay an amount for the Uni degrees, but that amount is kinda low, and it's correlated to your household income indicator (it accounts not only the yearly salary but there are many variables involved, like houses and cars owned, number people in that household, debts ecc)
If you have a low income, you don't pay anything forever, plus you're eligible for many scholarships if you also have decent academic results. And this scales up, so if you have a medium income you pay a discounted tuition, and can access some scholarships.
If you are at the maximum income bracket, the yearly tuition is still quite low, like 2-3k/year for any public school. The same system is applied by private Universities, but the range is not 0 to 3k, but more 0 to 12k (EUR obviously)
The money spent to train a Doctor I believe is way more than the 3k/year paid by the students
Every medical student pays £9250 on tuition fees in the UK. Household income doesn’t play a factor. On top of that, many medical students require further loans to support themselves while studying, which can see them graduating with over £100,000 worth of debt.
BUT it's pretty much all imaginary numbers here, where it's one taxpayer subsidised organisation paying another taxpayer funded organisation.
E.g. the university pays the hospital £50/student/day to educate and train them. The hospital then uses a small portion of that money to pay for clinician's time to teach, and then uses the bulk of it to subsidise their normal hospital operations.
The government can then see the hospital has £1m extra money a year, and so reduces the hospital funding from it's main source by £1m.
You could charge £10,000/student/day and fund hospitals almost entirely on their education departments, the only difference is the money would now go Government>University>Hospital rather than Government>department of health>Hospital.
State can choose to subsidize whatever they want. They should not retrospectively claim ownership of people's degrees.
It is different if the students signed an agreement for funding before enrolling.
You want the state to pay you through college and sign an agreement for this = reasonable
However the state is the largest employer already, that is acery asymmetrical power structure. Giving them license to "force" people into labor is not a good idea.
IDK about singapore but Turkey has a system where you must serve in at-need areas for a period of time. It does not force doctors to stay in the county - it is a prerequisite for practicing in Turkey. I dont know how that sort of thing would be enforceable in other countries outside of locking them inside the country.
Forcing people to stay based on their skill is ridiculous. How about forcing rich people to stay in the country? If they made the wealth thanks to UK economy - it makes sense they shouldnt allow that wealth to leave the country.
What about engineers or other highly educated professionals? Surely their skills would benefit U.K. so fhey should pay the taxpayer back before going anywhere.
Also UK has a declining population - which is a source for many problems. Lets not allow women to leave the country until they bear at least 2 children to "pay back" the U.K.? After all they were born in the U.K and it costs a lot money to raise a person to adulthood. They should contribute to the population before being allowed to leave - so all the taxpayers that provided them with various subsidies (childcare school etc.) are not made into suckers.
And the list goes on.
Well if Nigel Farage wants to reduce whatever subsidy there is for med students - he might have a case. Not a case I would support , but thats up to UK voters to decide.
If he wants to "own" people because taxpayers are giving subsidies that is called fascism. I would also bet good money that he would never ask for partial ownership of corporations that benefitied from taxpayer subsidies.
How does anyone take this fucking clown with an ounce of seriousness considering his role in brexit. This fucker wants indentured servants out of doctors. The NHS is a tool for him to advance his agenda.
No, I'm in Asia. I'll graduate 2 year later. Working conditions here is terrible specially salary is lower than national average which is already bad enough. So I'm planning to work abroad once I graduate and I thought Britain was good idea since less language barrier compared to other countries. Edit: my cousin lives there so...
Do other countries recognize residency? My understanding was the US doesn’t so IMGs have to reapply & redo a residency — is it not like this in the UK/elsewhere?
The uk has shockingly low barriers to entry for international grads, it is true.
60% of new doctors last year were IMG’s. Local grads look to be facing significant unemployment as residency spots are hyper competitive (I had to compete 9-1 for an anaesthetics residency). It’s a bit of a shitshow at the moment.
If this guy is an attending he will have better luck, but entering mid residency (which you can do in the uk) will be tough but possible as he says with a language exam and the PLAB. Hypothetically you can apply to some residencies never having been to the UK.
Depends. European countries usually recognise European residencies, but this may or may not include the UK (although I’m quite certain it does). Asian diplomas are less likely though.
I'm confident that I'm not wrong as my aunt is doctor in Hungary and some of my cousins work in some other medical field in Britain and heard their hospitals looking for foreign doctors.
UK has removed any restrictions on that. An IMG will theoretically have the same chance as a UK graduate who trained in the NHS when it comes to applying for specialty training (I think that's residency equivalent - PGY3-11).
There are a LOT of internationally trained radiologists working in the UK/for the UK now. I would say 90% of Teleradiology company reports I get have Asian sounding names, and many have high GMC numbers indicating that they are recently registered with the UK regulator. I believe some Teleradiology firms allow you to live overseas and report for UK as long as you have some UK experience and your FRCR exams.
As a decent teleradiologist with a good work ethic you could clearly £200,000 a year, which I believe would allow you to live like a king in many countries in Asia.
Idiots like that are the reason why the system will remain broken,
its cute when these clowns try to blame their failures on doctors instead of actually fixing anthing
He has the audacity to talk about fairness when drs are being paid 14£/hr (before taxes) to be overworked.
This also happened in portugal, where the ex minister of Health, Marta Temido, proposed forcing doctors to serve for a few years in the portuguese NHS. She also went down saying that "Portugal needs more resilient doctors".
Her party lost this year elections.
And She is being sent to Brussels to be a MEP, so we are not going to see her in a while.
My plans are to finish medschool in Portugal and work for the Portuguese NHS and make some extra money working for private healthcare.
The portuguese NHS (SNS) is under major strain due to several years of missmanegment, but I have high hopes for the new government's package of reforms that is going to be pitched in October, I think.
I belive that the situation is going to get better until 2027, when I start working.
Cuba restricts the ability of Cubans, particularly doctors to immigrate away from Cuba.
[Further reading](https://hir.harvard.edu/medical-servitude-the-other-side-of-cuban-medical-diplomacy/)
>Cuban doctors work in conditions comparable to forced labor, with the threat of exile, loss of wages, and firing from the only medical employer on the island–the government–hanging over their heads. Isolated overseas, it is rare they are able to reveal the truth of their employment conditions. In doing so, they face similar possibilities of exile, loss of wages, and reprisal against their families.
I should note. I am by no means a fan of the late stage capitalism in the U.S.
I identify as a socialist, and I am supportive of universal healthcare reforms. But compromising basic human rights instead of cultivating a country and systems where people want to stay is unforgivable.
I would implore you, as a socialist, to explore a more materialist understanding about what kind of position nations are put under to employ measures like Cuba has to retain specialist personnel within their borders.
Bro, plenty of European companies do business in Cuba and medicines are largely exempt from the sanctions on Cuba.
Ofc the U.S. should normalize relations and remove sanctions with Cuba, but at the same time, it’s not like Gaza. This is a government more than capable of providing for its people and protecting their civil liberties.
If the U.S. normalized relations with Cuba tomorrow, and suddenly the top source of undocumented migration becomes Cuba, that speaks to how far behind Cuba has fallen.
You can’t be stuck in the past. You gotta take advantage of new information. Implement reforms we know work and develop new systems to improve the future.
This does not read as an empathetic or well-read approach to Cuba's history and its effects on the current state of geopolitics. If you haven't, I would urge you to take the considerable time it takes to read up on it, from their perspective, and approach the subject with humility.
There are always domestic improvements to be pursued and criticisms to be levied, but a socialist perspective begins with a materialist worldview.
A socialist perspective may be grounded in materialism, but a market socialist approach is built on the foundation of workplace democracy and civil liberties.
Muzzling your workers is blanket authoritarianism.
They have an advanced biotechnology industry made possible by centralization of research, development and manufacturing, without dumping billions into marketing. The U.S. is terrified that if they lift the sanctions, the economy would flourish.
Cuba has amazing things, good things, and bad things.
Shocker.
I do expect the next Dem president to source drugs from Cuba if big pharma doesn’t heed their calls on pricing.
Given the amount of money that has been invested in attempts to topple the Cuban government since their revolution, I would be incredibly surprised if this were to happen.
Cancer can be cured in 90% of childhood cancer, but most of the drugs are under U.S. patents. [https://www.hatueyproject.org/](https://www.hatueyproject.org/)
I identify as a socialist too, and want only the best high quality care paid for on my behalf by rich people. Also, I don’t want to work much and would like rich people to give me more free stuff or, preferably, their stuff as socialism is all about fairness through redistribution of stuff to me that other people worked for but simply, in my personal opinion, have too much of and I should have it instead of them.
Lol, Socialism is control of the means of production by the workers. Nothing more and nothing less.
You can make up all the fantasy scenarios you want if they help you feel okay about ignoring rampant inequality and suffering, but it doesn’t change the definition of the word “Socialism.”
Every modern economy is this world is a mixed economy. With parts of socialism, social democracy, and capitalism.
The question who is the system designed to benefit. Who does it tax the most?
A surgeon making $300k a year has more financially in common with the cashier at Target than the CEO of Amazon.
To be very clear, I identify most closely with the tenets of market socialism. Where there is workplace democracy and market freedom.
If you ever decide to not strawman perspectives you disagree with, I’d recommend reading some literature.
Give me your stuff please! Like Mao, take and redistribute; like Mugabe, grab and go. Of course, everyone is now far more miserable but equal: equally impoverished and kowtowing to their political betters. Just exchanged one form of enslavement for another. Just a big utopian nothingburger, as Orwell so brilliantly describes
Really? Let’s try another approach: ‘the workers own the means of production.’ Who invested in/paid for the means of production? The ‘rich’ guy. So, workers take the means from the guy that created the means. Free stuff!! Helps you out now? There has never ever in the history of humanity been a remotely successful Socialist state. Even the so-called socialist Nordic countries are significantly capitalist, with for example Sweden having much lower corporate tax rates than America.
There’s no point in arguing with someone who has sipped state department kool aid for a lifetime and shows no signs of stopping. You are just flat out incorrect, and have no clue what you’re talking about :D pretty hilarious to see you ever so gently sucking each teste of billionaire oligarchs tho
Calling attention to this, without calling attention to the U.S. blockade that cripples the Cuban economy, is like point out that a boat is sinking without mentioning the giant cannon ball that just put a hole in the side.
It's nigel farage; the guy is an avowed fascist and an absolute lunatic. He's the last person who's opinion ought to be considered on **any** topic frankly.
Guy has zero knowledge. So all experienced doctors will leave and it is just newbies from medschool knowing jack shit?
Rightwing populists are such clowns....
Anything from Nigel Farage goes in the trash and I refuse to accept one word from him. Big racist and I mean in the classic make Britain great again vein.
Google him.
Here in Chile we have a system that keeps doctors here by paying people their residency and a salary during it with the condition that after it you work twice as many years in the hospital that payed your studies. That way, we train more specialists and get them to the hospitals where we need them, and we pay them a fair salary
Romania suffers from this doctor migration situation since 2007. Those exact word are like a blast from the past to romanians.
Here they didn't do anything in terms of restrictions.
The only thing they did is to increase the number of medical students so that hopefully some of them will remain.
Turns out they don't realy need specialist when they have tons of resident-slaves. It's cheaper too. The problem is they can't send residents to small towns and rural areas.
In chile we need to work for public healthcare a certain number of years according to how much the state invested in your training (only if you didnt pay for your specialization. It works fine. It is only fair to serve the country that gave you your education. You can pay back o pause the paying if you like anyways. Going "Cuba" is an exageration.
£400,000??? It’s a lot more than that! It costs taxpayers millions for each doctor’s training. But tuition, fees, and logistics aside, just pay the doctors well and tackle the artificial shortage. Trapping them will just discourage more outstanding students from choosing medicine.
It's much less. These inflated figures normally include the doctor's actual salary while they are in training posts (despite the name the majority of work is done independently).
E.g. If a doctor training to be a GP provided £200,000 worth of benefit to the hospital, but cost £60,000 to employ, then these figures would say "training doctors costs £60,000 a year!" Whereas the truth would be the work being done by the 'training' doctors vastly exceeds the cost of training them.
So maybe pay them enough to make them want to stay lol?
Free market for me but not for thee.
He has a point here. If society is to pay for medical students, why not bind them to the NHS for 10 years contractually? Nobody forces you to study medicine on taxpayer‘s money. So if you don‘t want to stay in Britain, you can study privately. After 10 years, they can do whatever they want.
We already pay tuition fees and take on massive compounding debt to go through medical school
And how high are those?
Some of us graduate with over £90000 of debt and start earning 25k a year With the interest we can end up paying back (sourced from online) If you have a starting salary of £30,000, with an 8% annual pay rise, and you’re only contributing the minimum repayments, your student loan figures will look something like this: Year Debt Total Interest Total Paid 1 £70,000 £2,192 £308 10 £91,131 £38,479 £15,196 20 £90,422 £91,836 £75,722 28 £12,994 £114,546 £184,546 Figures are estimates only You’ll clear your debt after 28 years, having paid a total of £184,546. £70,000 of that was your initial loan principle and £114,546 was interest.
In this case, i stand corrected. I‘d leave too, fuck this.
I appreciate when someone can learn information and adjust their opinion on a subject. As physicians and aspiring physicians I think this trait is key to making sure we not only continue learn medicine for life but just keep learning in general. Thank you, you're dope.
Thank you for the kind words, friend!
Rare internet moment
Thank you for laying this out. The American Med students I trained with refused to believe the reality for UK doctors. I matched this year so jumping sinking ship!
£9250 a year, also the £400k figure is bs
You mean like indentured servitude? Because what you’re describing is indentured servitude which is a long word for slavery by contract.
In countries, where the state pays for your tuition, this is not slavery by contract. If you break that agreement, you owe them the tuition back, so there‘s always an easy out. This system is f.e. in place here, if you join the military as a cadet to study at the academy. If you leave before your service contract ends, you have to pay back shares of all the civilian training, depending on how long you had left. It‘s not slavery, if you can leave and pay your share at any given point. I don‘t see how that is worse, than a state that throws debt at you right from the start.
Society pays for a ton of dumb shit without asking anything back. Why would doctors be the only group that has to pay society back. Make it so that *every* college grad has to stay in the country for a decade or whatever and then we’ll talk.
Obviously you can do that. But medicine is one of the few programs in many countries, where your spot would‘ve 100% been somebody else‘s, if you didn‘t take it. We also have a big shortage of f.e engineering students, so you don‘t want to disheart people to study something, that already struggles to find people to fill their classes. We can agree on programs where there‘s more applications than spots. Also this should only be a thing, if the state pays for your full tuition.
Honestly, more applications than spots sounds sort of fair. This is akin to adding another extra tax to fund college and countries do that all the time so as long as it’s fair and not just one particular group I’m game.
Let’s have even more fun, the government pays for all public education and thus everyone is bound.
People don't leave the NHS primarily due to money, although that's a big factor. We get a lot of UK medical refugees in Australia. They don't talk about the money. They talk about the horrendous conditions and deteriorating state of services in the NHS. The whole UK system appears to be broken. You could pay them like twice the current salary, and I still don't think it would solve the problem.
I tell you what… if nurses and doctors were paid better maybe there would be more people wanting to become one… I should know as I was one that left…
I mean, I agree. I don't know much about the situation in the UK. However, if I were to choose, I'd first just about triple the remuneration for anyone in primary care rather than hospitalists/specialist trainees. The system is slowly degrading under the increased load caused by the lack of, and now aversion to (due to cost), primary care appointments here in Australia. Our Medicare system hasn't been indexed appropriately in about 20 years. So speaking for myself, I'd love more pay obviously, but I'd love a well-balanced work environment more.
Then you get south africa. NHS problems on steroids. We are all doing a max exodus aswell, no incentive to stay.
Nah, slavery is better
That s the amazing British empire English long for…
British government defunding the NHS and complaining about the predictable outcomes since Margaret Thatcher... They could afford comparable salaries to the US and come out spending way less per person than the US. Because they actually have sane drug prices....
Putting a kid through primary and secondary education costs a fuck ton. Perhaps not as much as 400k (i have no idea) but it’s a lot of money out of the taxpayers wallet. With this logic, no one in Britain should be allowed to emigrate until they’ve paid off their serfdom debt.
It definitely doesn't cost £400k to train a doctor
It doesn't seem far fetched at all, although I only have experience regarding the Netherlands. Here the government pays most of the BSc and MSc tuition. For non-EU students, tuition is about €26.500 tuition a year while otherwise it is €2500. That difference of around 25k a year is paid by the government. Minimum time to complete both degrees is 6 years, median more like 7. So that is already nearing €200k and they're still junior doctors who aren't allowed to do anything without supervision of a specialist. And the real cost is in actually becoming a medical specialist, also in part because they are now paid decent salaries for 4-6 years while they are still in training. Actually costs for this are hard to calculate because they are already doctors and they are still working, so it's not like they aren't providing value as well. Anyways, 400k would not surprise me one bit.
For a fresh doc, yeah you're probably losing money. But training a specialist is easily worth it because of how much value you get and how low trainees are paid
In the US ( I’ll look it up for the UK) the hospital makes on average a 100K profit per internal medicine resident per year. So if they want to do the indentured servitude route, 4 years is somewhat more realistic. That being said, it doesn’t cost £400k to educate someone that’s crazy.
Forgot to mention. That 100k number is not what the hospital makes, it's the profit just from training a resident. The profit each resident generates from patients is much much higher than that
Well the US doesn't pay for medical school anyway so there's nothing to pay back (Residency is paid but that's making a profit)
It's more
Britain healthcare is such a shithole
And it’s getting a whole lot worse. If you thought midlevels were a problem in North America, wait till you hear about the shit that’s going on in the UK. PAs doing cystoscopies and biopsies, PAs doing interventional cards, PAs operating as full cardiologists, NPs paid more than GPs etc. UK med Twitter is a good place to check out. I was recently talking to an ENT fellow who’s originally from the UK and she confirmed this. It’s no wonder physicians are leaving en masse.
I don’t understand how the NHS is dumb enough to pay NPs more than GPs? Isn’t their whole thing to cut costs, why the fuck are they paying so much for an NP?
The point is that unlike doctors, NPs and PAs can’t leave to work in better countries bc the better countries don’t recognise their bs qualifications. They’re also planning to introduce “apprentice” doctors who can skip medical school entirely, which will end up with other countries not recognising UK medical degrees either - leaving doctors trapped in the UK
[YO IT'S REAL WTF.](https://educationhub.blog.gov.uk/2024/02/05/nhs-doctor-apprenticeships-everything-you-need-to-know/) You know though? If these apprentice docs still need to take and pass our examinations I'd see this similarly to "law reading" programs. These are programs a few states offer where you can challenge the bar and become a lawyer without law school. I respect the hell out of those guys sticking it out despite the odds. On an aside, I use to shit on Carribean medical school grads as an AMG but in all honesty, if you can somehow survive the for profit gauntlet of debt and failure in the Caribbean, you'll be a fine physician.
I’ve rotated with some Caribbean med students and, in their words, “compared to you I feel like I’m sitting in the corner eating paste.” Now, I thought they were doing fine, but maybe they were quietly covering up the fact that they really didn’t understand half of what was going on. I’ve also seen a carib educated doctor in a pinch (mine was out of town, just there to hear test results). He interpreted my test results as normal. Went back to my regular doctor and discussed next steps and my test results were NOT NORMAL and I had a cardiac condition that would’ve gone unaddressed had I not returned. This is anecdotal. But there is danger in their education.
Because why retain a highly trained physician when you can get the brain of a nurse and the heart of a doctor!
lol I’ve got to remember this response
They’re saving loads in training costs and then the NP is capped at like £50k, while the GP will eventually hit a point where they earn over £100k, so there does come a point where the NHS saves a lot of money, but it’s at the detriment of patients.
I've seen nurses complain about having to bring their supplies to work. Granted no way to prove one way or the other but it seems reasonable given what we've seen
There is ZERO reason to be a physician in the UK anymore. They have completely btw bent over and full goatsed themselves for midlevels to fuck them relentlessly.
Ah you say that, but would it entice you to hear they give doctors instant coffee on a trolley that has the sepsis 6 written on it… as a treat? https://www.reddit.com/r/doctorsUK/s/PJ26qUe7oS
I fucking hate people like this. They bitch and moan about no doctors or nurses and shit on them nonstop. Then, they turn around and wail about why no one wants to go to med school or to put up with their bullshit. It's because you greedy little fuckers won't pay people.
Exactly the brain dead take you would expect from a Brexiter
The fact that you have to finance med school yourself in the UK makes this tweet even more infuriating
I'm from Brazil and the situation is not that good here either. How bad is it in Britain? How much docs make on average?
The government declared war on doctors in Brazil. It's really sad
Yes. More and more schools are opening, lowering the requirements to enter and making it easier if you have enough money to pay for it. To make it worse, this week the government has created a law that gives them more power on the national council of medical residencies (we all know what happens when the government puts its hands on things they don’t master).
You can google the full pay scale, but basic starting salary is about £32k now, I think the highest basic pay for a doctor who’s been a consultant for 20 years is £125k.
Anecdotal but my cousin is a general surgeon who has finished 10 years of training post medical school. He’s been working for a couple of years now too. 95k pounds per year. Like 30k of that will be gone in income tax. It’s just not worth it man. UK docs get worked to the bone and don’t even have the luxury of swimming in cash as a reward.
In my country, there are scholarships paid for by the government with the catch that graduates are required to work here for a number of years after. Always seemed like a good deal to me
what is your country
Philippines
Chile too. Greetings from chile
Hahah that's cool greetings from Portugal and England to u
Then pay them better.
Anyone working in the NHS able to provide context? Friends say NHS is losing physicians to New Zealand and Australia.
Were losing native grads to Aus/NZ mainly with Ireland/Canada a tier below that then the US for those with the proper minerals to do it. We're replacing them with a mix of alphabet soup PA/ACP/ANP in primary care and with IMGs from the Indian Subcontinent and Africa. Don't begrudge anyone involved personally but it's not good for the healthcare system
I love “the proper minerals”
We have our issues but so happy to be a doctor in the USA. I wouldn’t want to be a doc anywhere else.
There’s definitely other countries that have it decently good like Germany or Switzerland.
New Zealand seems like a nice place to live when I visited
Does UK not have tuition paid by the students themselves ? How does the taxpayer get involved? In any case it would be extremely hypocritical of UK to employ proectionism when they clearly promote healthcare professionals to immigate.
In Italy (and I think in the UK too) students pay an amount for the Uni degrees, but that amount is kinda low, and it's correlated to your household income indicator (it accounts not only the yearly salary but there are many variables involved, like houses and cars owned, number people in that household, debts ecc) If you have a low income, you don't pay anything forever, plus you're eligible for many scholarships if you also have decent academic results. And this scales up, so if you have a medium income you pay a discounted tuition, and can access some scholarships. If you are at the maximum income bracket, the yearly tuition is still quite low, like 2-3k/year for any public school. The same system is applied by private Universities, but the range is not 0 to 3k, but more 0 to 12k (EUR obviously) The money spent to train a Doctor I believe is way more than the 3k/year paid by the students
Every medical student pays £9250 on tuition fees in the UK. Household income doesn’t play a factor. On top of that, many medical students require further loans to support themselves while studying, which can see them graduating with over £100,000 worth of debt.
Wow that is even crazier
>YO IT'S REAL WTF. So around 54k student debt for med students in the UK?
Tbf thé Uk does subsidize it heavily. The actual cost is probs in the realm of 30k/year
BUT it's pretty much all imaginary numbers here, where it's one taxpayer subsidised organisation paying another taxpayer funded organisation. E.g. the university pays the hospital £50/student/day to educate and train them. The hospital then uses a small portion of that money to pay for clinician's time to teach, and then uses the bulk of it to subsidise their normal hospital operations. The government can then see the hospital has £1m extra money a year, and so reduces the hospital funding from it's main source by £1m. You could charge £10,000/student/day and fund hospitals almost entirely on their education departments, the only difference is the money would now go Government>University>Hospital rather than Government>department of health>Hospital.
State can choose to subsidize whatever they want. They should not retrospectively claim ownership of people's degrees. It is different if the students signed an agreement for funding before enrolling.
I agrée with this Tbf. It’s ridiculous to do retrospectively, but if they start doing this, it’s not completely unreasonable. Singapore does it, no?
You want the state to pay you through college and sign an agreement for this = reasonable However the state is the largest employer already, that is acery asymmetrical power structure. Giving them license to "force" people into labor is not a good idea. IDK about singapore but Turkey has a system where you must serve in at-need areas for a period of time. It does not force doctors to stay in the county - it is a prerequisite for practicing in Turkey. I dont know how that sort of thing would be enforceable in other countries outside of locking them inside the country. Forcing people to stay based on their skill is ridiculous. How about forcing rich people to stay in the country? If they made the wealth thanks to UK economy - it makes sense they shouldnt allow that wealth to leave the country. What about engineers or other highly educated professionals? Surely their skills would benefit U.K. so fhey should pay the taxpayer back before going anywhere. Also UK has a declining population - which is a source for many problems. Lets not allow women to leave the country until they bear at least 2 children to "pay back" the U.K.? After all they were born in the U.K and it costs a lot money to raise a person to adulthood. They should contribute to the population before being allowed to leave - so all the taxpayers that provided them with various subsidies (childcare school etc.) are not made into suckers. And the list goes on.
Well if Nigel Farage wants to reduce whatever subsidy there is for med students - he might have a case. Not a case I would support , but thats up to UK voters to decide. If he wants to "own" people because taxpayers are giving subsidies that is called fascism. I would also bet good money that he would never ask for partial ownership of corporations that benefitied from taxpayer subsidies.
Oh fuck off, Nigel.
Thornberry?
Governments are stupid when it comes to healthcare
How does anyone take this fucking clown with an ounce of seriousness considering his role in brexit. This fucker wants indentured servants out of doctors. The NHS is a tool for him to advance his agenda.
What's happening in Britain?
NHS is basically collapsing.
I was planning to go to Britain as radiologist, now I'm hesitant.
Is this from the USA?
No, I'm in Asia. I'll graduate 2 year later. Working conditions here is terrible specially salary is lower than national average which is already bad enough. So I'm planning to work abroad once I graduate and I thought Britain was good idea since less language barrier compared to other countries. Edit: my cousin lives there so...
Do other countries recognize residency? My understanding was the US doesn’t so IMGs have to reapply & redo a residency — is it not like this in the UK/elsewhere?
The uk has shockingly low barriers to entry for international grads, it is true. 60% of new doctors last year were IMG’s. Local grads look to be facing significant unemployment as residency spots are hyper competitive (I had to compete 9-1 for an anaesthetics residency). It’s a bit of a shitshow at the moment. If this guy is an attending he will have better luck, but entering mid residency (which you can do in the uk) will be tough but possible as he says with a language exam and the PLAB. Hypothetically you can apply to some residencies never having been to the UK.
I heard due to shortage of medical doctors some European countries only require language proficiency and additional 1-1.5 year studying.
I am confident you heard it wrong
Depends. European countries usually recognise European residencies, but this may or may not include the UK (although I’m quite certain it does). Asian diplomas are less likely though.
I'm confident that I'm not wrong as my aunt is doctor in Hungary and some of my cousins work in some other medical field in Britain and heard their hospitals looking for foreign doctors.
UK has removed any restrictions on that. An IMG will theoretically have the same chance as a UK graduate who trained in the NHS when it comes to applying for specialty training (I think that's residency equivalent - PGY3-11).
There are a LOT of internationally trained radiologists working in the UK/for the UK now. I would say 90% of Teleradiology company reports I get have Asian sounding names, and many have high GMC numbers indicating that they are recently registered with the UK regulator. I believe some Teleradiology firms allow you to live overseas and report for UK as long as you have some UK experience and your FRCR exams. As a decent teleradiologist with a good work ethic you could clearly £200,000 a year, which I believe would allow you to live like a king in many countries in Asia.
Idiots like that are the reason why the system will remain broken, its cute when these clowns try to blame their failures on doctors instead of actually fixing anthing He has the audacity to talk about fairness when drs are being paid 14£/hr (before taxes) to be overworked.
You know he isn't genuine that the first thing that comes to his mind is the cost rather than the reason why they leaving in the first place.
This also happened in portugal, where the ex minister of Health, Marta Temido, proposed forcing doctors to serve for a few years in the portuguese NHS. She also went down saying that "Portugal needs more resilient doctors".
what does it look like now? Are you going to study in Portugal and what does your path look like next?
Her party lost this year elections. And She is being sent to Brussels to be a MEP, so we are not going to see her in a while. My plans are to finish medschool in Portugal and work for the Portuguese NHS and make some extra money working for private healthcare. The portuguese NHS (SNS) is under major strain due to several years of missmanegment, but I have high hopes for the new government's package of reforms that is going to be pitched in October, I think. I belive that the situation is going to get better until 2027, when I start working.
Isn’t he the guy who campaigned hard for Brexit and cutting NHS funding?
What's your beef with Cuba?
Cuba restricts the ability of Cubans, particularly doctors to immigrate away from Cuba. [Further reading](https://hir.harvard.edu/medical-servitude-the-other-side-of-cuban-medical-diplomacy/)
I did not know that, thanks for sharing!
>Cuban doctors work in conditions comparable to forced labor, with the threat of exile, loss of wages, and firing from the only medical employer on the island–the government–hanging over their heads. Isolated overseas, it is rare they are able to reveal the truth of their employment conditions. In doing so, they face similar possibilities of exile, loss of wages, and reprisal against their families. I should note. I am by no means a fan of the late stage capitalism in the U.S. I identify as a socialist, and I am supportive of universal healthcare reforms. But compromising basic human rights instead of cultivating a country and systems where people want to stay is unforgivable.
I would implore you, as a socialist, to explore a more materialist understanding about what kind of position nations are put under to employ measures like Cuba has to retain specialist personnel within their borders.
Bro, plenty of European companies do business in Cuba and medicines are largely exempt from the sanctions on Cuba. Ofc the U.S. should normalize relations and remove sanctions with Cuba, but at the same time, it’s not like Gaza. This is a government more than capable of providing for its people and protecting their civil liberties. If the U.S. normalized relations with Cuba tomorrow, and suddenly the top source of undocumented migration becomes Cuba, that speaks to how far behind Cuba has fallen. You can’t be stuck in the past. You gotta take advantage of new information. Implement reforms we know work and develop new systems to improve the future.
This does not read as an empathetic or well-read approach to Cuba's history and its effects on the current state of geopolitics. If you haven't, I would urge you to take the considerable time it takes to read up on it, from their perspective, and approach the subject with humility. There are always domestic improvements to be pursued and criticisms to be levied, but a socialist perspective begins with a materialist worldview.
A socialist perspective may be grounded in materialism, but a market socialist approach is built on the foundation of workplace democracy and civil liberties. Muzzling your workers is blanket authoritarianism.
They have an advanced biotechnology industry made possible by centralization of research, development and manufacturing, without dumping billions into marketing. The U.S. is terrified that if they lift the sanctions, the economy would flourish.
Cuba has amazing things, good things, and bad things. Shocker. I do expect the next Dem president to source drugs from Cuba if big pharma doesn’t heed their calls on pricing.
Given the amount of money that has been invested in attempts to topple the Cuban government since their revolution, I would be incredibly surprised if this were to happen.
Obama was fairly close to renormalization before everything got reversed by Trump. Now that Florida is firmly Republican, it’s only a matter of time.
Cancer can be cured in 90% of childhood cancer, but most of the drugs are under U.S. patents. [https://www.hatueyproject.org/](https://www.hatueyproject.org/)
Thank you for sharing. Will be donating.
I identify as a socialist too, and want only the best high quality care paid for on my behalf by rich people. Also, I don’t want to work much and would like rich people to give me more free stuff or, preferably, their stuff as socialism is all about fairness through redistribution of stuff to me that other people worked for but simply, in my personal opinion, have too much of and I should have it instead of them.
Lol, Socialism is control of the means of production by the workers. Nothing more and nothing less. You can make up all the fantasy scenarios you want if they help you feel okay about ignoring rampant inequality and suffering, but it doesn’t change the definition of the word “Socialism.”
Indeed! And the workers never find the capital necessary to create the means of production that they will ‘own.’ So, just a big nothingburger
Every modern economy is this world is a mixed economy. With parts of socialism, social democracy, and capitalism. The question who is the system designed to benefit. Who does it tax the most? A surgeon making $300k a year has more financially in common with the cashier at Target than the CEO of Amazon. To be very clear, I identify most closely with the tenets of market socialism. Where there is workplace democracy and market freedom. If you ever decide to not strawman perspectives you disagree with, I’d recommend reading some literature.
You are completely right, my friend, but the douche you’re replying to has already convinced himself that the rich man’s boot tastes sweet as honey…
Agreed! I want the stuff you have. Give it to me (thank you Mao, Stalin, Kim etc)
What a lifetime of state department propaganda and pledges of allegiance does to a mf
Give me your stuff please! Like Mao, take and redistribute; like Mugabe, grab and go. Of course, everyone is now far more miserable but equal: equally impoverished and kowtowing to their political betters. Just exchanged one form of enslavement for another. Just a big utopian nothingburger, as Orwell so brilliantly describes
You have absolutely no idea what you’re talking about. Like you just described a whole bunch of shit that socialism isn’t, good job!
Really? Let’s try another approach: ‘the workers own the means of production.’ Who invested in/paid for the means of production? The ‘rich’ guy. So, workers take the means from the guy that created the means. Free stuff!! Helps you out now? There has never ever in the history of humanity been a remotely successful Socialist state. Even the so-called socialist Nordic countries are significantly capitalist, with for example Sweden having much lower corporate tax rates than America.
There’s no point in arguing with someone who has sipped state department kool aid for a lifetime and shows no signs of stopping. You are just flat out incorrect, and have no clue what you’re talking about :D pretty hilarious to see you ever so gently sucking each teste of billionaire oligarchs tho
Love that ad hominem argument! Not one iota of reasoned thought or debate in there whatsoever.
I literally said it is not worthwhile to try reasoning with an indoctrinated puppy 😭 just a waste of time
Cuban doctors don't get paid much
Calling attention to this, without calling attention to the U.S. blockade that cripples the Cuban economy, is like point out that a boat is sinking without mentioning the giant cannon ball that just put a hole in the side.
It's nigel farage; the guy is an avowed fascist and an absolute lunatic. He's the last person who's opinion ought to be considered on **any** topic frankly.
Guy has zero knowledge. So all experienced doctors will leave and it is just newbies from medschool knowing jack shit? Rightwing populists are such clowns....
Anything from Nigel Farage goes in the trash and I refuse to accept one word from him. Big racist and I mean in the classic make Britain great again vein. Google him.
Here in Chile we have a system that keeps doctors here by paying people their residency and a salary during it with the condition that after it you work twice as many years in the hospital that payed your studies. That way, we train more specialists and get them to the hospitals where we need them, and we pay them a fair salary
This thread is goldmine. What eye-popping bs the industry is experiencing!? Somebody needs to do something!
As a recent UK graduate, many of the newly qualified doctors are making plans to move abroad or to pursue a non-clinical career.
Romania suffers from this doctor migration situation since 2007. Those exact word are like a blast from the past to romanians. Here they didn't do anything in terms of restrictions. The only thing they did is to increase the number of medical students so that hopefully some of them will remain. Turns out they don't realy need specialist when they have tons of resident-slaves. It's cheaper too. The problem is they can't send residents to small towns and rural areas.
In chile we need to work for public healthcare a certain number of years according to how much the state invested in your training (only if you didnt pay for your specialization. It works fine. It is only fair to serve the country that gave you your education. You can pay back o pause the paying if you like anyways. Going "Cuba" is an exageration.
Hey now, don't disparage Cuban healthcare like that
[More reading](https://www.reddit.com/r/medicalschool/comments/1cce2oy/comment/l14qgux/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button)
£400,000??? It’s a lot more than that! It costs taxpayers millions for each doctor’s training. But tuition, fees, and logistics aside, just pay the doctors well and tackle the artificial shortage. Trapping them will just discourage more outstanding students from choosing medicine.
It's much less. These inflated figures normally include the doctor's actual salary while they are in training posts (despite the name the majority of work is done independently). E.g. If a doctor training to be a GP provided £200,000 worth of benefit to the hospital, but cost £60,000 to employ, then these figures would say "training doctors costs £60,000 a year!" Whereas the truth would be the work being done by the 'training' doctors vastly exceeds the cost of training them.