Job satisfaction and the current job market for hospital based doctors in the UK

Dr Celia Gregson

Specialist Registrar in Elderly and Internal MedicineFrenchay Hospital, Bristol

The Current Job Market

2005 Consultants and GP Numbers in the UK

GPs – 35,944

Consultants – 31,427

2005 UK Consultants - Medicine

Cardiology 740Clinical oncology 417Medical oncology 217Endocrinology & DM 551Gastroenterology 702GUM 327Geriatric medicine 920Haematology 647Infectious diseases 111Neurology 468Palliative medicine 195Renal medicine 345Respiratory 625Rheumatology 507

2005 UK Consultants - Surgery

General surgery 1,681Cardiothoracic surgery 231Plastic surgery 253Trauma and orthopaedic 1,569Urology 502Otolaryngology 530Oral & maxillo facial surgery 283Neurosurgery 180Opthalmology 815

O & G 1,446

2005 UK Consultants - Others

Paediatrics 1,893

Histopathology 1,090Medical microbiology & virology 445Clinical radiology 1,967Public health medicine 681Dermatology 453

General Psychiatry 2,004Child and adolescent 595Old age psychiatry 521

The Information Centre for health and social care Vacancies Survey, March 2006Vacancies in NHS Trusts - all staff groups

Table 1: Comparison of 2005 and 2006 data for main staff groups1,2,3

Number4 Rate Number4 Rate

Total Medical and dental staff (excluding training grades) 1,230 3.1% 730 1.8% Consultants 970 3.3% 560 1.9%

Other doctors and dentists (excluding training grades) 260 2.6% 160 1.7%

GPs (estimated rates) .. 2.4% .. 1.1%

March 2006March 2005

Consultant Vacancies Survey, March 2006

All Consultants A&E Anaesthetics Oncology Dental

General Medicine O&G Paediatrics

Pathology group

PHM & CHS

group Psychiatry Radiology Surgery

England 564 27 37 7 12 109 9 33 72 8 141 51 57

North East 52 1 3 - - 11 1 3 4 - 16 4 9

North West 120 8 5 2 - 18 2 11 22 - 28 16 9

Yorkshire & Humber 70 1 9 1 3 15 1 1 8 1 15 5 11

East Midlands 43 2 3 - 3 6 - 4 3 - 15 4 3

West Midlands 43 2 8 1 1 6 1 1 2 3 8 6 4

East Of England 63 6 3 2 3 14 1 2 12 0 6 8 8

London 91 4 4 - 1 17 3 8 9 1 31 6 7

South East Coast 28 - 2 1 - 8 - 2 4 0 4 1 6

South Central 18 - - - - 3 - 1 3 1 8 1 1

South West 31 4 - - 1 11 - - 3 - 11 1 -

Sept 2005: Numbers of Doctors in all grades in UK

Consultant 31,993

Associate Specialist 2,554

Staff Grade 5,527

SpR 18,006

SHO 21,642

HO/F1 4,663

All Staff 90,630

NHS; The Information Centre www.ic.nhs.uk/statistics-and-data-coll

ections/workforce

Organisation for Economic Co-operation and Development www.oecd.org

Postal questionnaire4221 Drs, qualified in 1999Surveyed towards end of first year2727 respondents, of whom 1326 codable

65.2% ‘did not definitely intend to practise medicine in the UK’

Considering leaving the UKWomen Men Total

Considering leaving the UKAll not definitely intending to practise medicine in the UK: (n=587) (n=460) (n=1047)

Working conditions 214 (36.5) 219 (47.6) 433 (41.4)

Lifestyle choices 412 (70.2) 270 (58.7) 682 (65.1)Work related purpose 124 (21.1) 60 (13.0) 184 (17.6)Other 5 (0.9) 7 (1.5) 12 (1.1)

Probably or definitely leaving: (n=100) (n=69) (n=169)

Working conditions 30 (30.0) 24 (34.8) 54 (32.0)

Lifestyle choices 80 (80.0) 52 (75.4) 132 (78.1)

Work related purpose 12 (12.0) 3 (4.3) 15 (8.9)

Other 2 (2.0) 7 (10.1) 9 (5.3)

Considering leaving Medicine

Considering leaving medicine

All not definitely intending to practise medicine in the UK: (n=157) (n=121) (n=279)

Working conditions 114 (72.6) 96 (79.3) 210 (75.3)

Lifestyle choices 47 (29.9) 16 (13.2) 63 (22.6)Work related purpose 16 (10.2) 8 (6.6) 24 (8.6)Other 8 (5.1) 7 (5.8) 15 (5.4)

Probably or definitely leaving: (n=22) (n=20) (n=42)

Working conditions 16 (72.7) 12 (60.0) 28 (66.7)Lifestyle choices 8 (36.4) 6 (30.0) 14 (33.3)

Other 1 (4.5) 3 (15.0) 4 (9.5)

Women Men Total

Reasons: UK working conditions

Poor working conditionsPoor state of NHSPoor working environmentBetter payShorter working hoursLack of respect / appreciationDemoralisedTaxes

Reasons: Lifestyle choicesBetter QOLBetter standard of livingOutdoor lifeExperiencing other countries and culturesChange of sceneTravel & AdventureDesire to help developing worldFamily & Friends abroadBetter weather

The Numbers Now?

Presently >30,000 Drs have applied for 20,000 training posts through MTAS

Up to 11,400 of these Drs may have qualified outside of EEA (may be working in UK) 7700 SHOs & 3700 Staff Grades Immigration rules….

Medical school expansions….

6000 of applicants are F2 applying for ST1 – result of medical school expansion

Last 6 years – yearly medical graduates increased from < 4000 to 6000 a year in UK

Who is applying for the 20 000 training posts across the UK?

Doctors in F2 posts: 6000 SHOs in England: 18 200 SHOs in Scotland, Wales, and NI: 4000 Doctors in staff grade posts in UK (out of a total of >6000): Not known Doctors working outside the European Economic Area (EEA): 2000 Doctors currently working inside

the EEA (but outside UK): Not known

Total: >30 200

Number of available training posts?

BMA: 18 500

DoH: 23 000

To Conclude…..