BMJ  2008;336:991 (3 May), doi:10.1136/bmj.39555.500613.AD

Head to Head

Does it matter that medical graduates don’t get jobs as doctors? No

¹ Department of Health Sciences, University of York, York YO10 5DD

Last year’s shortfall in training places looks set to be repeated. Graham Winyard (doi: 10.1136/bmj.39555.457060.AD) believes this is a betrayal of students’ expectations, but Alan Maynard thinks it is inevitable if patients are to get the best care

The first 150 words of the full text of this article appear below.

The government, as the main employer of doctors in the United Kingdom, is responsible for planning the medical workforce proficiently in order to deliver patient care. This requires it to model demographic trends, specialty needs, skill mix, technological change, and resource consequences. However, its manifest failure to plan efficiently does not create the responsibility or need to guarantee medical graduates employment.

Doctors cost hundreds of thousands of pounds to train. This training gives them specific skills as well as transferable skills. The training expenditure is a sunk cost—that is, once spent it cannot be retrieved. If medical graduates are unemployed this loss can be mitigated by their finding employment in other sectors of the economy, just as graduate lawyers do if they are unable to find jobs after academic and practical training.

Medical graduates, like all other graduates, gamble when they invest in their training. Their success brings riches, but . . . [Full text of this article]

Guarantees are incompatible with efficiency

Survival of the fittest

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