One in four doctors who completed foundation training this year have not progressed on to specialist training, new figures reveal.
Anecdotal evidence suggests that these doctors are opting to work abroad, take a gap year or are postponing their careers because they have not gained a post in the speciality or location of their choice.
The figures presented to the Medical Programme Board, the professional advisory group that oversees specialty training in England, show that 23% of doctors who graduated in 2008 did not apply for a specialist training post this year. In addition 244 trainees who did apply and were successfully appointed went on to turn those posts down.
Another worrying statistic is that 1,295 of the 5,906 doctors who applied for specialty training in 2010 did not receive job offers.
The figures are puzzling the BMA which says there has been little indication among junior doctors of significant issues. It is unclear why a signifcant number of applicants did not receive offers given the relatively good matching of ST1/CT1 posts and foundation posts and also why so many offers are rejected.
Dr Johann Malawanna, deputy chairman of the BMA junior doctors committee, said; “We are aware that there is a potential issue with regards the numbers of trainees that are choosing not to undertake further training in the UK and we are actively trying to speak to the Department of Health about exactly what is going on.”
He said there was evidence that some doctors were opting to work abroad – the BMA had recently received a significant number of requests for help from doctors wanting to apply for jobs in Australia. These trainees could be making these career choices are a result of their experience of the NHS.
“Retention of very highly qualified medical staff who we have invested a lot of money in is a real issue for the government especially in the current climate. The question we have to ask is why junior docs are choosing not follow career pathways when there are jobs available.”
The campaign group Remedy is blaming the pressures of the European Working Time Directive. Dr Richard Marks, the group’s head of policy, said the figures indicated that a number of doctors from foundation year were rejecting a career in the NHS: “After a year of the Working Time Directive it appears that doctors are voting with their feet and starting to abandon ship,” he said.
But Carrie Moore, director of strategy and communications at the Foundation Programme, said the figures did not tell the whole story: “The anecdotal information that we are getting back is that those doctors who don’t apply for specialty training usually want a bit more time to think about which specialty they might want to go in to. The jobs they want may not always be in the location or the specialty of their choice.”
A Department of Health spokeswoman said this was the first year that they had analysed the pattern of applications from trainees coming out of Foundation Programme.
“We know that junior doctors choose to move around within the medical profession in this country and abroad in order to build up their experience. The occurrence does not lead to a shortfall in the number of trainees as the competition for training posts is open to all trainee doctors, not just those coming out of Foundation Programme. For most specialities, the competition is very tough and fill rates can be as high as 95% in the first recruitment round.”
A spokeswoman for Medical Education England said some doctors chose to take time off, undertake further studies, went abroad or took up an NHS service post to gain more experience.
“Information has been provided to the Medical Programme Board which shows that in the initial phase of recruitment this year up to 17% of foundation programme applicants were still to receive an offer. As the recruitment process was still continuing it was likely that many of these applicants will have been successful in securing a post,” she said.
Read more on the challenges for specialist training.