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The number of doctors joining the UK medical register is rising but flexible working will be key to long-term retention, according to the General Medical Council (GMC) workforce report.
It says that a growing numbers of doctors are moving away from the traditional postgraduate training model and instead choosing increased flexibility and less linear career pathways, which is helping reduce burnout and improve work-life balance.
Greater flexibility in career and training pathways includes training breaks, working part-time or as locums, undertaking research or choosing to work as specialty and associate specialist (SAS) or locally employed (LE) doctors.
The GMC say this will ultimately benefit both the wellbeing of individual doctors and the wider healthcare system long term, leading to better patient care. It will also increase the likelihood of doctors remaining in UK practice.
Expansion of flexible working is good for the NHS
Charlie Massey, Chief Executive, said: “Many of these changes will have long-term benefits. We know, for example, that post-foundation training breaks can reduce the risk of burnout and help young doctors build confidence in their next steps. For some, they help provide certainty over their choice of specialty.
“Workforce thinking needs to keep pace with these changes. The ability to provide good patient care, now and for the foreseeable future, depends on the ability to respond quickly to changing career pathways, and to think clearly about making the most of the resources available.”
In the last year, the numbers of SAS and LE doctors, who are not on the traditional training pathway, have also increased dramatically – at four times the rate of the rest of the workforce. Between them, SAS and LE doctors now make up almost a quarter (24%) of licensed UK practitioners.
The King’s Fund says it agrees that the expansion of flexible working is a good thing for the NHS workforce, and can lead to higher levels of job satisfaction, attract people to an organisation, and allow people to fit work alongside other commitments.
Suzie Bailey, Director of Leadership and Organisational Development at The King’s Fund, said: “We already know that trainees in some clinical professions intend to work more flexibly when they qualify. A survey by The King’s Fund asked GP trainees about their career plans one year after qualifying and found that 41% intend to work five to six clinical sessions a week out of a possible 10. And yet, the most recent NHS Staff Survey showed that less than half of staff said their organisation is committed to helping them balance their work and home life. “
UK must remain attractive option for overseas doctors
The GMC report also says the UK must remain an attractive option to doctors who qualified overseas for the foreseeable future.
It reveals that doctors who qualified outside the UK made up just under two thirds (63%) of the 23,838 new additions to the register in 2022. International medical graduates (IMGs) made up over half (52%) of new joiners, while doctors who graduated from within the European Economic Area were a smaller component, at 10%.
The report says that, even with current and upcoming increases to medical school places, the length of time it takes to train a doctor means the UK must remain an attractive option for doctors who qualify abroad for some time to come. It projects that, 14 years from now, 39% of UK doctors are likely to have qualified overseas.
However, the British Medical Association said that increased recruitment is heavily reliant on international medical graduates who accounted for more than half of all new joiners in 2022. International colleagues are highly valued in our workforce, but when they continue to face systemic discrimination of the UK visa systems and local contracts, they often move again.
Emma Runswick, deputy chair of BMA council, said: “Continuous recruitment of international medical graduates is not sustainable solution to the UK workforce crisis and we also have ethical concerns that reliance on them could cause serious shortages elsewhere; we must focus on developing and retaining our existing doctors.
“More doctors than ever continue to leave UK practice, and a growing number are quitting because of dissatisfaction and the high risk of burnout. Others are taking longer periods away from training after working just two years post-graduation, with many citing their health and wellbeing as a common reason. Employers should look to offering these doctors an alternative career pathway, drawing on their skills with appropriate Specialty or Specialist contracts, but employers are often resistant to this approach. The government must take the findings of this report seriously and implement a thorough workforce retention plan before our current staffing crisis reaches breaking point. The GMC itself acknowledges that the clock is ticking.”
Other key findings from the report are that the number of doctors joining the UK medical register is rising. In 2022 there were 296,182 doctors with a licence to practice, an increase of 18% since 2018. Since 2019, for every doctor who leaves, on average more than two join the workforce.
In addition, the number of doctors leaving the profession increased last year, from 9,825 in 2021 to 11,319 in 2022, the proportion of the workforce leaving (4%) is still only returning to pre-pandemic levels. However, the GMC is aware of increasing numbers of doctors taking hard steps towards leaving UK practice.