Thousands of junior doctors and medical students could have to take jobs overseas as the cash-strapped NHS faces an oversupply of 20,000 doctors.

The stark message about a looming glut has been set out in an official workforce assessment for the Department of Health. It warns that the number of medical students and junior doctors who could potentially end up qualifying as top-level hospital consultants is set to swell from about 40,000 today to more than 60,000 by the end of the decade.

But with the NHS pay bill unlikely to rise as the service struggles to meet a £40bn savings target, experts are warning that candidates for consultant posts may have to find jobs in Eastern Europe or New Zealand – or accept lower-paid posts than the ones they have spent 15 years training for.

NHS England, which currently invests £2.8bn a year on doctor training, could see some of this outlay go to waste.

Deciding how many doctors Britain needs is notoriously difficult. The current situation has arisen in part from the boom-and-bust nature of NHS funding, coupled with deliberate moves by the previous Labour government to increase numbers of doctors and medical students.

The implications of the report by the Centre for Workforce Intelligence are being debated by NHS managers, medical colleges and the British Medical Association.

According to the report, NHS England’s pay bill would rise £2.2bn before inflation if students and junior doctors were to secure consultant posts at the current pace – a prospect described as “not tenable” by Peter Sharp, CWI chief executive. “The people are already in the system,” Mr Sharp told the Financial Times this week. “These numbers for 2020 are not notional; they are real people.”

The estimate takes into account consultants retiring during the next eight years.

Mark Porter, chair of the BMA’s consultant committee, said that urgent action was needed to “stop the stupidity of people qualifying for jobs that aren’t going to exist.”

The health department said that he government would “welcome a debate that looks at how hospitals can change the way they work”, in an effort to absorb at least part of the oversupply.

Options being considered include a “sub-consultant grade” post to be filled by medics with the same qualifications as hospital consultants but on substantially less pay than the current £108,000 median for NHS consultants.

Mr Sharp also revealed that the UK is in talks at a European Union level to develop “some sort of managed programme of movement”, under which junior doctors would embark on a “one to three-year sojourn” to countries where their services were in short supply.

The highest vacancy rates for doctors are currently in eastern European countries, but other options include Australia and New Zealand.

“This has been a growing issue for some time, and we can no longer ignore it,” said NHS Employers, which negotiates NHS staff pay on behalf of hospitals.

“We accept there is a problem. All parties involved need to have an urgent debate and get to grips with how the NHS plans its workforce.”

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