Initial person specifications drawn up by the royal colleges required applicants to have prior NHS experience e.g. for ST3 2 years or more, ST2 1 year or more and ST1 less than 1 year. DoH removed this clause at the 11th hour. Reinstating this requirement would ensure IMGs and EU graduates who have worked in the UK and started lives here, who have a customed to the NHS would get training posts. This has been the case for many years.
But the underlining fact is the secretary of state last year said that every junior doctor will get a training post. Therefore giving every doctor a training post and stopping recruitment from overseas would be the best solutions.

Sam Ediris, Gravesend, UK

If Sweden and Germany pay IMGs to train, if I were an IMG seeing what is happenning to the locals here, I would go to Sweden or Germany rather than fight the locals for the little they have. This would also be an honourable thing to do.

R R, Sheffield, UK

"British doctors" v IMGs
Happiness of one doctor does not automatically mean another should suffer. Efforts to protect BB NHS-T doctors from "bad IMGs" are based mostly on emotions, just read comments.
EU doctors are not British born and not NHS trained. What about Non-british born but still NHS trained? Who asked patients, not only british born, by the way, do they want doctors who was chosen on the basis of nationality on the first place, or professionality is more important?
Second. I ttried to stress it before, as other people, as well. The problem with IMGs today is not garanteed employment, as BB doctors demanded. We were deprived of the right TO APPLY for job after passing license exams for UK ONE MONTH before new rules were implemented. I can imagine possible reaction of UK doctors working in Australia or NZ to go back for better opportunities left at home.
Third. At least in Sweden and Germany IMGs are PAYD by government for courses in language and profession.

D Herzog, London, GB

I hope the judicial review rules out the very unfair GP round as well as round 1/1b. A large number of those offered a job are overseas doctors. This is mad, where are we supposed to go? You should've seen how many British doctors were crying at the hospital when the GP results came out. Very unfair. To IMG doctors, you came here and were treated well, you should see how doctors and nurses are treated in Arabia where their contracts can be terminated in a week and there is nothing they can do about it so this bit about the plab test is a bit of a balloon IMO

G Travis, Southampton, UK

David Herzog, Britain is not a country wholly mad up of immigrants like the USA, hence, British jobs for British doctors is logic as India, China, matter of fact, any where in this universe. And children and mortgages do neet to be paid by British doctors so it is silly to expect that IMGs should gain employment while the locals face a black hole!

G Travis, Southampton, UK

In response to Bob, London. Yes.But.
Not every British-born-NHS trained doctor has children, and not everyone has a mortgage. And, yes, some IMG`s do have children and pay mortgages. The problem of IMGs is not the guaranteed employment, as for BBNHST doctors. In USA, for example, if you are IMG, passed USMLE AND started your work, nobody is going to stop you to free the space for local doctors. If one passed qualification exams he should be considered professionally as good as local doctors. Yes, he is, otherwise it is not proper format of qualification exams and GMC or any responsible body should redraft it. When qualification is based on passport one can not expect to be treated by best doctors, only by BBNHST and EU doctors. But, in turn, if relationship of IMG and NHS (or British government) may be changed retroactively without ANY previous information, so it can be done to British doctors as well. I do not think it is easy task to decide who has more children or bigger mortgage

David Herzog, London, UK

I applaud the efforts of Morris Brown and his colleagues and Remedy UK. In short, MTAS has been a disaster. The long line of government mismanagement has caused unnecessary stress to junior doctors and the medical profession as a whole. Thousands of dedicated doctors will be unemployed or in non-training positions with little prospect of career progression at the hands of this highly flawed system. It is a waste of public spending to expand medical school places while limiting the career progression of qualified junior doctors. When will those responsible be held to account? The secretary of state for health has not listened to the medical profession and should have resigned long ago. The announcement by Patricia Hewitt today that MTAS has been abandoned was purely government ‘spin’ considering that the MTAS website had already been shut down for weeks following the serious security breach.

Kerri Kinghorn, London, UK

in response to those IMG's who feel hard done by, given they have worked hard for the NHS for several years only to find that there are no further training posts ring-fenced for them. I would ask them how they feel for the British born, UK medical school graduate who has trained in the NHS for five or six years at the expense of the UK taxpayer, married with children and a mortgage, who finds himself unemployed due to the incompetence of the goverement (TB and PH), MMC, MTAS and the plethora of IMG's

bob, london,

It's not only health 'modernisation' that is dominated by Government apparatchiks - skills and training suffers from the same problem.

Time and again I attend meetings where we employers are in a tiny minority and where decisions have to conform with a template or policy imposed by some invisible bureaucrat. Then the government proclaims that the decisions were 'employer-led'.

Fiasco might apply to MMC/MTAS but "institutionalised incompetence" applies to most departments or quangos that are running public education and health developments.

MarkS, Leeds,

I don't think unless you've been involved with this from an early stage that you can even begin to appreciate the gravity of a situation.

Consultants in the UK were this morning warned by the British Medical Association NOT to refuse to do interviews in case it was seen as industrial action and resulted in dismissal!

The BMA has all the backbone of a limp tea-soaked digestive biscuit, and is as culpable as the government for not speaking up sooner and doing so little to influence and prevent this state of affairs.

David, Chester, Cheshire

Let's face up to the fact that the whole NHS system is failing. Hospital manager cannot even keep hospitals clean. Patients are not managed properly and are kicked out of hospital only to be re-admitted because they were sent home too early. GPs have given up doing out of hours calls only to be replaced in our area by Thames Doc who we discovered will not come out if you cannot phone from a land line. So what happens if the phone is out of order? Answer call an ambulance. This is just pathetic.

It all comes down to incompetence at Ministerial level, incompetence at managerial level and an "I'm all right Jack attitude from GP's who can now afford their Porches.

We have paid in billion of pounds in additional taxes and what have we got for it. Very little! Gordon Brown should be ashamed of the failure to deliver value for money in the health service or anywhere else. If he was the finanace director of any plc in the UK he would have been fired for failing to control costs.

Richard, Effingham, UK

In reply to the letter by Sam, London - all I have to say is
NO COUNTRY IN THE WORLD (THAN UK) ACTIVELY ENCOURAGE OVERSEAS DOCTORS TO COME AND TAKE 'PLAB' TEST, KNOWING THAT JOB OPPORTUNITIES ARE CLOSE TO NIL!

balakrishnan, birmingham,

And worse again.

Would you prefer to be treated by a specialist who has had 30,000 hours of specialist training, or one who has received 6,000 hours of specialist training? The Five-year "run-through" posts purport to produce trained specialists in one fifth of the time that it takes to satisfy the Royal Colleges that a doctor is fit to practice as a consultant.

Ms Hewett says that the new training system is more efficient and more supportive of the young specialists. But a five-fold improvement in efficiency is simply not believable.

So not only have we failed to pick the brightest and the best because of the entirely random way the successful candiates have been chosen, we are dumbing down their specialist training too.

I have unbounded sympathy for the junior doctors and the IMGs in particular, but at the end of the day it is the patients that Hewitt, Blair, Hunt and the rest are letting down.

Benedicta Warsop, Keighley, UK

There are few better qualities in the UK than those shown by Prof Morris Brown and his co-writers in bringing this situation to the public ear. I congratulate them. We currently see a weak (and likely, failing) response, concocted at a moments notice, to a disastrous and imposed recruitment system that both fails in fairness measures and in meeting the needs of the NHS in early August. Potential for real disaster is evident and it is high time the DoH, its leaders, advisers and 'Apparatchiks' recognised that they were part of the problem and not the solution. Treating MMC/MTAS as a holy cow to presumably extend a political career for a few days is unacceptable. It should be removed and immediate action taken to ensure that a) the NHS has enough junior doctors in early August to meet the needs and b) training of junior doctors is expanded to ensure that the UK's Consultant population reaches levels comparable to other advanced countries as soon as possible! Ms Hewitt should resign!

Dr David L. Cox, Loggerheads, UK

CONT
I hope Gordon Brown (and whoever else cares about the NHS – which automatically excludes Patricia Hewitt and Tony Blair) will see this massive problem for what it really is and recognise what a severe negative effect this will have on the NHS. If Gordon Brown doesn’t understand what is happening he should personally investigate it, with open eyes, not just from the short sighted government’s viewpoint. I hope he will do the decent thing and treat our UK trained doctors fairly and in a manner that professionals ought to be treated, rather than with the contempt the government has shown them so far.

GY, Birmingham, England

CONT
Taxpayers have paid £25,000 for each of our junior to be trained (supplemented personally by each junior doctor by many thousands of pounds for further training) and we want to benefit from this investment and from the skills they have developed. The NHS needs ‘junior’ doctors as they are the workhorse of the NHS. As ‘junior’ doctors are all those doctors below the level of consultant it is clear for all to see that this is one of the most important cogs in the wheels of the NHS and without them the whole thing will come to a standstill. Government targets in the NHS will become a triviality! Due to the government’s mismanagement of workforce planning there is currently a huge scramble for doctors training posts and there will be many doctors unemployed, in jobs without recognised training or in temporary jobs. The government is hiding the true figures but this could be up to 15,000 from this year’s applicants, and there will be more in following years.

GY, Birmingham, England

There is not enough jobs for all! Overseas doctors came here to work and were paid in full for it! Happens all over the world were countries seek foreign workforce to bridge gaps for a while. This is done by mutual agreement to the benefit of both parties and does not give employment rights over the locals especially overseas doctors will gain the lucrative and very expensive training at the expense of the British tax payer then return home for lucrative careers thus begrudging British patients this expertise. Indeed their stay in the UK have already considerably benefitted them. They will not lose out in any way!
A huge number of GP jobs have now been given to overseas applicants trained outside the UK with qualifications that can not be properly verified and application forms filled by professionals, leaving British doctors with ruined careers and no opportunity to practice medicine in Britain FOREVER!

NO COUNTRY IN THE WORLD WOULD AWARD JOBS TO FOREIGNERS OVER ITS OWN!

Sam, London, UK

In hard times like these, when there isn't enough jobs to go round, it is only fair to award the little jobs there is to British doctors. Of course, overseas doctors will not lose out since they will always find lucrative jobs at home with the valuable experience and education they gained in Britain. They have not lost out financially either. Many countries use foreign labour to fill gaps in it's work force to the benefit of the employer and the employee but no country gives those from abroad priority over it's own. Indeed it is not fair that our doctors are forced to go abroad while those from abroad take their place! Apart from splitting families and leaving friends and loved ones through this forced immigration, our doctors will have no 'choice' but to go if they want to follow the career they love while those who came here have always had a 'choice' and could come or go whenever they wanted. Overseas doctors can always return when times are better of course.

Nadia, London, UK

In which other profession would the private details of someone be open to members of the public and there would be no repercussions like happened on the MTAS. Just imagine what would have happened if the details of patients were mishandled in that way......

MO, LONDON,

This is an impending disaster for the profession and the NHS. A failing of workforce planning of the greatest proportions. This has to stop with a major rethink as to how to proceed. Surely a better system is justified given the future of thousands of junior doctors and the NHS.

J Lyne, London, UK

This whole fiasco is down to the incompetence of the D0H and the NHS management. Workforce planning is a disgrace and the net result is that we will lose many of our brightest and best to NZ and Australia. Regarding IMGs, the fault lies with the government who thought they could use this group and then just dump them to cover up their appalling planning, Unfortunately the people paying for this scandalous situation at the moment are doctors and their families but in the long term patient care will suffer because of a demoralised and under-trained profession. The one chance and you are out interviews are a disgrace, how can any society expect highly trained professionals, trapped by a monopoly employer, to accept just one 30 minute interview to decide if they have a career; obviously they will leave the country or the profession. The government want 'biddable' technicians but medicine depends on intelligent professionals. Blair's legacy is the destruction of the NHS.

Sue Baker, purley, England

if these jobs were to advertised in India for instance, the preference would have been given to local or indian doctors rather someone say from China. i think its a fair system which has been badly managed like the rest of the other government departments( transport, pension,home, health etc) by TB (tony bush!) and his incompetent bunch of lunatics. i just hope that the change in leadership brings back the OLD LABOUR as the new one has been really disappointing in all walks of life. If managed correctly, MATS would have been one of the best system of junior doctors slelction( minus typical BRITISH PESSIMISM anything new and innovative!). by the way they should have contracted out this job of MATS either to an indian or chinese firm for SURE SHOT SUCCESS. goodluck to all those waiting to be specialists in the generalist NHS through MATS!

jackforjustice, Bristol, UK

Junior doctors have no other alternatives for work or training other than the NHS. Junior doctors are only allowed to work in the NHS and this is run by the government. If they want to continue in their careers the government is forcing them to move abroad, away from their families, their friends and their home country. Our county will lose a valuable workforce, decent citizens and the taxes they would have contributed. Their families lose their loved ones and the support they would have received as family members age, creating a further burden on the state. The doctors lose everything. They have to uproot and relocate somewhere else that values their skills

GY, Birmingham, England

Please don't let this article get sidetracked by one viewpoint, that of International Medical Graduates (IMG’s). The issue is the disaster that has been caused by this government (in particular Patricia Hewitt and Tony Blair) forging ahead (despite pleas to the contrary from those that know better) with Modernising Medical Careers (MMC) and the Medical Training Application Scheme (MTAS), both of which have now proved to be complete disasters and will badly affect our NHS but more particularly patient care, both in the short term and in the long term. What is required is to safeguard our doctors from unemployment, stop the planned reduction in their training posts and increase the number of Consultant posts.

GY, Birmingham, England

Mr Hawkes,
Please dont put your ignorance down in writing.
If you ever visited a NHS hospital you will find that haif of the doctors working there non EU.British doctors have defnite preferences on where they want to work and what type of jobs they want to do.Most of the peripheral hospitals survive on non UK doctors.They form the backbone of many of the less favoured specialities like OBG and Psychatry.The situation has worsened now because of the governments poor work force management.Even now they are conducting PLAB exams every day[which is the licensing exam for non EU doctors to work in UK]-Only because they are minting money out of the exam.

pran, london, uk

The simple fact of the matter is that British medical schools are now producing sufficient numbers to eliminate dependence on international graduates.

We should proudly safeguard the career development of all medical graduates from British universities. Castigation of such behaviour smacks of political correctness gone wrong. This should not be seen as controversial and would instead represent harmonisation with the policies of other postgraduate medical education programs in Canada, the USA and Australasia.

Ben, London,

Dear Sir,
You should do your homework before making such comments. Non EU doctors form the backbone of most of the NHS peripheral hospitals. British doctors have very definite preferences on where they want to work and what type of job they want to do. Some of the specialities like OBG and Psychiatry survive solely on Non UK doctors. So why are we being blamed for Governments poor workforce policies. Even now the Govt is minting money by conducting PLAB Exam every day [PLAB is the licensing Exam for Non EU doctors to work in UK.].

pran, london, uk

It's worse than that - there are now examples of UK resident doctors who are of Asian origin who have been denied the first GP training places awarded on the basis of not having a work Visa!. It seems someone with the already highly dubious decisions department of MTAS may have made an almight error regarding nationality/race and citizenship.

There is no transparency to any of this. And the sooner it is put on ice the better (along with Patsy).

David, Chester, Cheshire

Never mind the farcical application process, 32,000 recently graduated doctors applying for 20,000 training places suggests that the recent enormous expansion in medical school training places has been a huge, and hugely expensive, mistake.

doug salmon, Birmingham, west Midlands

I am astounded that IMGs, who were (? are) the mainstays of the NHS, have now become a 'big problem'. For years together they provided valuable sevice in areas that no local graduate fancied. They were misled by the govt, who constantly advocated equal opportunities in training and went to the extent of inviting doctors from abroad to fill the much needed service gap. And now, when there is problem with recruitment, the media is potraying these IMGs as some kind of demons grabbing the jobs which should apparently be 'RESERVED' for the local graduates.
Media is powerful, and should be responsible as well. Instead of saying, 'the govt failed to exclude IMGs' it should probably highlight the pathetic work force planning and a completely ridiculous recruitment system.
Given the present circumstances, it would probably be naive to expect so much as gratitude for the IMGs, leave alone a fair chance in recuritment. I would however be quite happy to be proved wrong.
An IMG

Abhishek, Sheffield, UK

Dear Sir,

Being a "nonEU doctor" I suffered all the abuse of the last time by DoH and Home Office. Attracted to UK by noisy claims about "shortage" of health specialists, I came here five years ago only to advise all my friends to keep out of UK. My nurse diploma from former USSR was rejected in 2003 as overloaded with non-clinical disciplines (marksism etc.). Before August 2003 it was all right. In two years full-time course paid by me I could be graduated in UK again. Though, I choose to go ahead with IELTS and PLAB 1 and 2 exams for "nonEU doctors" without interliminary step as a nurse. In April, 2006, Home Office rules for the "nonEUdoctors" were changed (occasionally, no connection with future NHS crisis).

We see inequality of highest rate. Today even the group of foreign professionals can not effectively challenge the system. It is predictable the SYSTEM, "aparatchiks", turned on their own doctors on the next round. Being a minister one do not need to be a specialist

Dr David Herzog, London, still in UK

Very understated - it is much worse than this!

Dr Gordon Caldwell, Worthing, West Sussex