Motivations of medical students and doctors leaving the NHS explored in a residency training application webinar series

Abstract

BackgroundRecent reports show that about 10% of UK-graduate doctors leave the country to pursue specialty training elsewhere. Our article aims to evaluate the motivating factors for UK graduates to leave the National Health Service (NHS), especially during the COVID-19 pandemic and Brexit.Study designCross-sectional study.MethodA novel 22-item questionnaire was disseminated at a webinar series regarding the application process to pursue residency training in six different countries/regions from 2 August 2020 to 13 September 2020. The data was analysed using Kruskal-Wallis rank-sum with post-hoc Wilcoxon test to compare the difference in significance among the motivating factors.Results1118 responses from the UK medical students and doctors were collected; of which, 1001 (89.5%) were medical students, and 88 (7.9%) were junior doctors. There was a higher propensity for leaving after the Foundation Programme compared with other periods (p<0.0001 for all comparisons). There was no difference between desire for leaving after core surgical/medical training and specialty training (p=0.549). However, both were significantly higher than leaving the NHS after medical school (p<0.0001). Quality of life and financial prospects (both p<0.0001) were the most agreed reasons to leave the NHS, followed by clinical and academic opportunities and, subsequently, family reasons.ConclusionFuture work on the quality of life for doctors in the UK should be explored, especially among those considering leaving the NHS. Policymakers should focus on assessing the difference in working hours, on-call hours and wages that may differ among healthcare systems.

Value of a UK medical degree for international students (VISION): a cross-sectional study

“…It should be noted that the future salary offered to graduates may not offset the total cost of the degree for international students 2 16. Given the current trend and the assumption that international medical graduates (IMGs) use 10% of their basic salary to repay student debts, it could take up to 28 years to complete repayment of the total debt accumulated during their degree 2 16.…”

“…It should be noted that the future salary offered to graduates may not offset the total cost of the degree for international students 2 16. Given the current trend and the assumption that international medical graduates (IMGs) use 10% of their basic salary to repay student debts, it could take up to 28 years to complete repayment of the total debt accumulated during their degree 2 16. The implementation of ACT levy will further contribute to the financial burden on international medical students; it is therefore important that applicants are well aware of these long-term financial implications before applying to medical schools.…”

“…Free-text responses were provided by 26.1% (92/352) of respondents, and qualitative analysis demonstrated the students' general concerns. The majority of the premedical student group had no concerns (49.9%), 16.5% felt that the cost of the degree was the major concern, followed by 11.0% who feared unconscious bias and racism (online supplemental table 5). Other concerns include challenging application process for medical school admissions, learning style and potential terrorism.…”

Towards Levelling the Playing Field for Prospective Overseas Applicants to Medical Schools in the United Kingdom

“…Medical schools across the United Kingdom (UK) hold a prestigious reputation worldwide. In 2021, there were 28,690 applicants for only 9,500 medical school places, raising the question of how the most suitable candidates are selected [ 1 ]. The competitiveness of applying to a UK medical school as an overseas applicant is further compounded by the small quota of international student intake, capped at 7.5% per UK medical school [ 2 ].…”

The new health secretary must tackle junior doctors’ dissatisfaction before winter

“…But scrutiny of why junior doctors are leaving the profession indicates that their motivations for quitting clinical practice don’t entirely centre around salary. Surveys of doctors and medical students highlight that quality of life, NHS culture, challenges around training opportunities, and a desire to be close to family all represent important motivators for quitting doctors 234. Although a subjective term, “quality of life” typically requires good physical and mental wellbeing, work-life balance, and professional satisfaction, as well as stable and proportionate income.…”