Why Do Nhs Junior Doctors Leave Their Training-Programs in the Nhs to Train Overseas?

Abstract

BACKGROUND: There is an accelerating exodus of junior doctors from the NHS. In the last five years the number leaving has increased by 45% and yet no academic studies to date have sought to ask why. OBJECTIVE: This study aimed to assess both the reasons that junior doctors in the NHS left their training programs in the NHS to train overseas and the characteristics and attributes of such doctors. METHOD: A mixed-methods study was performed to collect 1) semi-structured interviews on junior doctors who had left the NHS and who had begun training/working as doctors overseas and 2) an online survey to assess the characteristics and attributes of doctors who had left the NHS. 19 doctors were recruited for interview using purposive sampling, online social media and word of mouth snowball sampling. To date 407 doctors have responded to the online survey which remains open. The doctors interviewed were all UK medical school graduates who had left the NHS in the last 15-years and who were now training in clinical or academic medicine overseas. RESULTS: Four key themes emerged in our data and were categorized into push factors: DISINTEREST IN RETENTION; and BLEAK OUTLOOK; and pull factors: FINNACIAL VS. SOCIAL CAPITAL and THINGS ARE DIFFERENT OVERSEAS. CONCLUSIONS: Listening to the frontline junior doctors’ voices lends insights to better understand the push and pull factors that appear to be nurturing the exodus of junior doctors from the NHS and exit interviews should be performed routinely. There needs to be a shift to focus on ‘training’ of doctors rather than service provision, with efforts to support, appreciate, and value trainees. Further exploration is needed as to what is happening in training programs overseas in order to improve retention within the NHS.