Coercing doctors

The government has recently suggested that medical graduates should be compelled to work for five years in the NHS; it seems that doctors owe society for their training.

Stella Vig offered her opinion on this in her blog, here. I wrote this as a response to her thoughts:

This question has been raised at least once in the past.

I thought then, and I still think, that it is thoroughly disgusting, morally repugnant and typical of any government without the ability to think and who lack any ethical compass: it is a poverty of understanding.

The question can only be asked because the NHS is a monopoly employer. The numbers of medical students is determined by the NHS years in advance, taking account of what are expected to be the needs of the service and the population — and presumably allowing for some ‘wastage’. This limitation of student numbers is called a ‘numerus clausus’ on the continent, though there restriction seems to be based on the limitations of teaching establishments. Thus, being a medical student carries the implication that you will always work for the NHS; there are other opportunities, but these are small in numbers. A few people ‘escape’ into other fields, often in literature or the arts.

The question also begs the question, what is a university education for? For many, it is about stretching their academic abilities, learning about learning and demonstrating that they have a brain which is (potentially) multi-functional. (Classics students apparently make very good traders on the financial markets.)

The government has never suggested that all law graduates should work for a ‘national legal service’, or that vets should work for a veterinary service, or architects should work for the government. These are all university subjects, but all lead, in general, to employment in that specialty. Like medicine, these are as much training specialties as they are academic specialties.

Those who study, for example, ancient Greek or Latin, or English literature demonstrate that they have brains that can be used somewhere; it is an absurdity to suggest that they must work for the government for years.

Medical students are captive; they cannot work elsewhere than the NHS for some years. That is not an argument to treat them differently from other students. It is more like force majeure.

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