Hospital Dr News

Less new physicians securing consultant posts

Data from the Royal College of Physicians (RCP) and Joint Royal Colleges of Physicians Training Board (JRCPTB) shows that just 56% of newly qualified physicians are securing substantive consultant posts.

The figures represent a worrying drop of 7% from 2012 survey which showed 63% of newly qualified physicians secured substantive consultant posts. This decrease has likely been caused by the funding squeeze with hospital trusts unwilling to financially commit to long term substantive consultant posts.

Physicians typically spend five to six years in medical school followed by two years in foundation training, and seven-plus years in core and specialty training before being awarded their Certificate of Completion of Training (CCT), when they can progress to a substantive consultant post.

Since 2004, there has been an expansion in the number of trainee doctors to meet the increasing demand for a consultant delivered medical service. However, fiscal pressure appears to have slowed expansion in the number of consultant posts, leading to a greater number of newly qualified physicians unable to secure a substantive consultant post.

The success rate for being offered a post varies between medical specialties, with just 24% of applications to genito-urinary medicine resulting in a substantive post, compared to 81% for geriatric medicine. This can in part be explained by the popularity of some medical specialities.

It has prompted the call that the NHS needs better national workforce planning to prevent over supply of trained doctors in some medical specialties and under-supply in others.

The 2013 Survey of Medical CCT Holders Career Progression also found that:

– the number of qualified physicians taking locum consultant posts has increased from 19% in 2012 to 22% in 2013.

– for the third consecutive year, a small number of newly qualified doctors were left unemployed.

– 46% of applications made by females resulted in the offer of a post, compared to 33% for male applications.

The number of doctors achieving their CCT in the 12 months to March 2013 had dropped by 6% compared to the previous year. The decrease may be a result of trainees delaying their CCT date in order to improve their job prospects through further training.

Dr Andrew Goddard, director of the RCP’s Medical Workforce Unit, said: “The drop in the number of newly qualified physicians securing substantive consultant posts, combined with an increase in the number of newly qualified physicians taking locum posts points to financially restricted trusts unwilling to commit to long-term contracts.

“Hospitals are facing an increasing number of emergency admissions, we know that a consultant-delivered service is best for patients and we know that the service must be delivered across seven days a week. The need for consultants is clearly there, yet more than four in ten newly qualified physicians are not securing a consultant post.

“This survey provides yet more evidence that we need national workforce planning to use all available data to prevent over supply of trained doctors in some medical specialties and under-supply in others.”

The recent Shape of Training review suggested that there needed to be an increase in the number of ‘generalist’ doctors skilled in the diagnosis and management of patients with complex multiple conditions. This followed a similar call by the RCP’s Future Hospital Commission.

Survey of Medical CCT Holders Career Progression 2009-13: Responses to the question ‘What is your current work situation’:

– Substantive consultant post 56.1%

– Locum consultant post 21.6%

– Specialist registrar in period of grace 4.0%

– Specialist registrar beyond period of grace 1.5%

– Locum registrar 0.0%

– Maternity leave 1.7%

– Research 3.5%

– Overseas 4.0%

– Senior/Clinical Lecturer 1.2%

– Post CCT fellow 3.5%

– Unemployed 0.5%

– Other 2.5%

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