Location is the leading consideration for specialist registrars when considering a consultant post, according to the latest census of physicians in the UK.
The Royal College of Physicians (RCP) research suggests STs value where they work over all other factors when considering a consultant post, most wanting to stay close to where they have been training.
Location trumps the opportunity for part time working, on call responsibilities and the amount of generalist or specialist work undertaken.
The annual census, which measures the number of consultants in all medical specialties, shows strong geographical variations when it comes to recruiting to posts.
For example, the North West and Yorkshire & Humber regions saw the greatest difficulty in recruiting to posts – whereas London and the Thames Valley regions saw the greatest number of appointments made, due to having a higher number of training posts.
The census also highlights the growing need for consultants who can treat the needs of older patients. Following trends noted in last year’s Census, the largest number of appointments were made in geriatric and acute medicine, (113 and 108 respectively) suggesting a move away from specialist working to more generalist roles treating acutely ill patients.
The nature of patients presenting at hospital is changing. 65% of people admitted to hospital are over 65 years old and many have multiple complex conditions. Such patients require more generalist input – and improved acute medicine and advanced internal medicine skills.
The largest specialty is geriatric medicine with 1,145 consultant physicians UK, representing 10% of the workforce.
Commenting on the new data Dr Harriet Gordon, director of the RCP’s Medical Workforce Unit, said: “The census reinforces the fact that doctors prefer to work where they were trained and have set down roots. Location still seems to be the overriding factor and as a result appointments to posts still seem appear to be biased towards areas like London and the South East where the number of training posts is slightly higher.
“It is not surprising that NHS trusts across the UK are still looking for more generalists given the fact that those presenting at hospital are now older and often have multiple complex conditions. As noted in the Future Hospital Commission report, the key to treating an ever expanding group of older patients will be an increased role for the generalist who will be able to specialise in treating multiple problems when treating patients.”
Other key findings from the census include:
– the proportion of doctors working less than whole time continues to grow (18%)
– the greatest expansion was in hepatology, at 38%
– satisfaction rates remain high with 80% of consultants reporting to enjoy their jobs ‘always’ or ‘often’
– the youngest part of the consultant workforce (those under 35) is now largely female (58%)
– 68% of respondents supported 7 day working, though there was notable variation between specialties.
At the time the data was collected, there were 11,412 consultant physicians working in England, Wales and Northern Ireland, an increase of 359 on the previous year. The expansion of hospital consultants has fallen considerably during the past three years from 10.2% in 2009 to 3.2% in 2013.
Data for this latest vensus of consultant physicians in the UK was collected in December 2013. This particular set of data does not include Scotland and is for England, Wales and Northern Ireland.