In 2007, 1300 UK medical graduates were unable to secure training places, and this shortfall looks set to be repeated this year. But is this a betrayal of students' expectations or is this inevitable if patients are to get the best care?
Two experts debate the issue in this week's BMJ.
Thousands of young people compete fiercely for medical school places each year because they want to work as doctors, not to gain an expensive general education, argues Graham Winyard a former postgraduate dean.
There are serious risks to medical education if medical school simply becomes a route to a range of future employment, he warns.
However, evidence is growing that several thousand UK medical graduates may not be able to pursue a career in medicine. This is due to a "catastrophic failure in government policy on medical migration" that has resulted in a huge surplus of applicants for specialist training, writes Winyard.
Attempts by the Department to Health to give priority to local medical graduates were thwarted by the Home Office's highly skilled migrants programme that gave skilled people the right to enter the UK job market, he says. Although the entry rules have now been amended, an estimated 10 000-20 000 overseas graduates have already been accepted on to the programme to compete with local graduates.
"Much has been made by the British Medical Association and others of the importance of abiding by the undertakings made to overseas doctors. It is surely just as important that we keep faith with our own medical students and graduates, whose recruitment and training has been on the explicit understanding that they are needed to work as doctors", he concludes.
But Alan Maynard, from the University of York, argues that the purpose of the National Health Service (NHS) is to deliver patient care that is compassionate and efficient and not to guarantee the employment of medical graduates.