Deep discontent is driving UK doctors abroad, GMC research shows

Thousands of doctors who are considering leaving UK practice say general improvements to workplace conditions could have the biggest impact on their retention, according to General Medical Council (GMC) research.

The report, Identifying groups of migrating doctors, looked into the reasons why doctors may be considering, or have already made, a move abroad. It found that feeling undervalued, a lack of progression opportunities and disillusionment with the UK’s healthcare systems, are just some of the motivations researchers identified that make doctors want to leave.

In addition, over 75% of doctors reported feeling under-valued professionally, demonstrating a concern with pay. The research said increasing pay would reduce its importance as a reason to move abroad.

A negative view of UK practice was also a key factor estimated to impact the three largest groups of doctors. The report showed a widespread perception that the UK’s health systems are ill equipped to provide patients with the care they need.

Charlie Massey, Chief Executive of the GMC said: “This is a stark reminder of the challenges we face in the UK, but it also presents valuable insight into how healthcare leaders, employers and workforce planners can target interventions to improve conditions. Though the number of doctors actually leaving to practise abroad in 2023 was comparably low, these findings are a warning to all should conditions fail to improve.”

Reasons UK doctors are leaving to practice abroad

In the survey, more than 3,000 doctors – including those who have left the UK to practise abroad, had left and since returned, or are currently still working in the UK – answered questions on how satisfied they felt day-to-day, their experiences of working in the UK and their attitudes towards migration.

When asked how likely they were to move abroad to practise medicine in the next 12 months, 13% of those practising in the UK answered ‘very likely’. A further 17% said they were ‘fairly likely’.

Following analysis of the data, researchers split doctors into six distinct groups based on shared attitudes and experiences towards work and life as a doctor in the UK:

• Deep discontent: the most negative and most likely to say they will leave in the next year. These are doctors who are dissatisfied on multiple fronts with the political environment, UK healthcare systems and its effects on their wellbeing.
• System sceptics: concerned about the direction of the health systems and dissatisfied with their own working conditions, these doctors feel undervalued and unsupported. Most likely to be attracted to English speaking countries where they feel there are better conditions.
• Burnt-out: working in the UK has left this group exhausted and unsatisfied with a low level of personal wellbeing and work-life balance.
• Mobile career developers: neutral about working in the UK but obstacles to career progression could tempt this group to leave. A high proportion qualified overseas.
• Open to opportunity: a relatively happy group of doctors, who may consider working abroad for a new challenge.
• Happy in the UK: the most positive, this group has a high proportion of doctors who qualified overseas and who are happy working in the UK but may return to their home country at some point due to those connections.

The report recommends targeting the top three categories of ‘deep discontent’, ‘system sceptics’ and ‘burnt-out’ as a priority, viewing these as having the greatest chance of significant impact to the workforce.

It also showed that some migration is inevitable and natural, for example a third of leavers were returning to a home country, 9% to carry out caring responsibilities, and that numbers migrating into the UK are high.

GMC research shows impact on patients will be severe

The Royal College of Physicians of Edinburgh said that if the level of migration of doctors suggested by the survey is borne out the impact on patients could be severe.

President Professor Andrew Elder said: “Importantly, it is not only the working conditions in the NHS that provokes discontent, but also the view that our NHS is not meeting the needs of the patients it was created to serve. Burnout among clinicians is a significant factor, and relates in part to the “moral distress” that occurs when a doctor cannot provide the care to patients they feel they should. The recent Physicians’ Census showed that 20% of respondents said they were at risk of burnout with more than 40% unable to take their full annual leave entitlement.

“Fundamentally, doctors want to be, and feel, valued and to have working conditions that reflect that. The GMC’s report is right to recommend a focus on improvements to workplace conditions as having the biggest impact on retention. We will continue to press for a review of the amenities and services available to the medical workforce in each hospital including wellbeing and mental health support.

“Although it is encouraging that so many doctors who qualified overseas are happy working in the UK, many of them will return to their home country, if career opportunities and conditions of work are better than in the UK. The report must act as another wake-up call to the governments of the UK to do far more to focus on the retention of doctors in our health service and persuade doctors to stay in the UK. We have consistently called for additional and urgent action on retention as well as new recruitment and this report reinforces the need for this.”