For many graduates, the task of finding a job is often an arduous battle against managing debt and escaping the cycle of temping jobs. Rarely do you find a degree that gives its graduates a passport to regular degree-level employment. Except, that is, for the NHS, which has been training its own new recruits for years.
Yet there are stirring signs that there are now more graduates in nursing, physiotherapy and other healthcare professions than there are available jobs.
Kirsty McMakin completed a BSc in physiotherapy in June at St George's Hospital medical school in London. Since qualifying, McMakin has found it impossible to find a job in her profession and has been forced to work as a healthcare assistant.
"I've applied for 25 to 30 physiotherapy jobs but haven't been successful," she says. "When I first started my degree, three years ago, wanted physiotherapists and we were told a lot about how great the opportunities would be for us."
Worsening situation
"By around midway through our degree a handful of graduates were finding it hard to get jobs. Most people thought it was a blip, and you just had to believe them, but as time went on it became obvious that things were not getting better."
McMakin joins many graduates who have found that the jobs they trained for are hard to find, and this has not been helped by budget overspends and NHS deficit problems.
Some physiotherapists have had to take any job they can find that allows them to practice their skills, and even then it is difficult. Because McMakin works as a healthcare assistant, she cannot even practise physiotherapy on her wards.
"I feel as if I am more a nurse than a physiotherapist. I can't think like a physiotherapist at work because I don't get an opportunity to practise my skills.
"As I am wearing a healthcare assistant uniform, it is against regulations for me to practise physiotherapy in the hospital - even though I am fully qualified," she says. "On average, I use my physiotherapy knowledge for about 10 minutes in a whole day, and this is for simple tasks like sitting patients in the right posture."
The Chartered Society of Physiotherapists is well aware of the problem. Jenny Carey, CSP education officer, says: "A lot of people came into a degree with the promise of a guaranteed job at the end. It seems a shame that so many are now graduating without a job to go in to.
"There is no doubt that physiotherapy is needed, but it is not as essential as nursing or medicine, so they will cut it. There are more graduates coming out than in the past; there are the jobs available but there isn't the money to fund them.
"We continue to lobby and the government is sympathetic to new graduates. It may all change in April with the new financial year, and there is a smaller intake this year, so in three years' time there will be fewer physiotherapists coming into the profession."
The cut in student intake may come as a relief to current graduates but it brings its own problems - and it is not just physiotherapy that has been badly affected. The Royal College of Nursing (RCN) predicts that a skills gap may appear in the future as many graduate nurses leave the profession.
Susan Watts, RCN's student adviser, says: "Cutting student numbers is a very short-sighted answer. In five years' time, there will be a huge gap. It also puts lecturers in a difficult position because if you reduce the numbers of students on the course it puts their own job security in jeopardy."
Hannah Harwood, 22, a second-year nursing student at Nottingham University, says: "Students have put a lot into the last three years, family and job wise, to qualify. So many people are relying on the job at the end, and it is going to be very disappointing for them.
"Many students are wondering if they should even bother finishing the degree after the first year. Many graduates have been told to take any job they can for the moment, including nursing homes and the private sector."
Harwood said that out of around 400 graduate nurses who qualified in Nottinghamshire last year, almost 55% failed to find jobs in their profession.
In October, the RCN found that strategic health authorities (SHAs) have been taking up to 10% of the multi-professional educational training budget (MPET), which should be spent on funding professional development.
"A lot of student nurses approach me saying that they are worried about their job prospects but are scared of speaking out," Watts adds. "They have been told that if they are seen or deemed to be making trouble, their chances of getting a job are less likely.
On the scrapheap
"Many are leaving the profession; the result is an excellent workforce on the scrapheap."
Tim Curry, the RCN's policy adviser, said that the trend is a worrying reality for many in the healthcare sector: "It feels very much like we are returning to the worst failings of short-term and uncoordinated workforce planning we saw in the late 1990s. The reason behind this is that the NHS is heading towards a £1bn deficit and so SHAs are holding back MPET and training funds to offset the end-of-year overspend.
There is, however, some hope on the horizon. Anticipating problems in the nursing profession, Edge Hill University's faculty of health and careers centre organised its first nurses' careers fair for its graduates last June. The event gave many student nurses the opportunity to find jobs in areas they had not previously considered, such as the army or the navy.
"Many of the students had concerns about finding employment in the NHS," says Jacqui Howe, head of careers at Edge Hill. "We found that the fair helped students to become aware of the opportunities in the nursing job market."
The success of the fair has prompted Edge Hill to expand the programme for next year to include operating department practitioners and midwifery students.
"If it is becoming more difficult for nurses to get jobs, then it is important that we help our students to stay focused, positive and confident about the skills and knowledge that we know they have to offer," Howe adds.
A spokesman for the NHS said: "We are working closely with NHS employers to find better ways of ensuring work opportunities for newly qualified staff. Trusts are using more innovative ways to support local graduates. This includes ring-fencing vacancies for at-risk staff who have the necessary qualifications.
"The Department of Health is aware that newly qualified physiotherapy staff are facing more competition in finding their first job than in the recent past, and we are working hard to try to keep their skills in the NHS."
McMakin has had to start thinking seriously about her future. "I've started thinking, do I want physiotherapy that badly to carry on? I want to be doing something I really enjoy and learn , but at the moment I am at a standstill.
"Out of my class, 90% were mature students who had given up highly paid City jobs to become physiotherapists but had to support a family and could not afford to be out of work.
"Country-wide I can see many people leaving the profession. I don't want to wait around for the NHS to sort itself out."
