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Why do doctors leave the profession?

Health Policy and Economic Research Unit
April 2004

Summary
Study aims
A study was conducted to find out:

- why doctors leave the profession
- what may prevent doctors leaving
- what would entice those who have left back to practice.

Method
Fourteen doctors were interviewed on their reasons for leaving the profession. This report discusses the results in relation to retention initiatives introduced by the Department of Health.

Findings
The main reasons why doctors leave the profession are:

- they are not valued
- they are not supported
- Unacceptable work-life balance

The doctors in the study felt dispensable and that no one cared what happened to them. Their treatment in the NHS contrasted starkly to their experience working as doctors in other countries and in the private sector.

All of the doctors who had left the profession showed some interest in a return to practising medicine. In order to return they would need to be met with understanding, training and support.

Recent initiatives by the government, such as the returners schemes, address some of the problems identified in this report. None of the doctors interviewed were aware of these schemes, suggesting that a broader advertising strategy is required.

There remains an ingrained culture in the NHS that fails to value doctors and to provide appropriate career advice and occupational health services. There needs to be opportunities to train part time at the PRHO and SHO level.

Recommendations
- All junior doctors must have access to a confidential advocate who can point them to career advice and occupational health services. The advocate should not be in a position to influence the doctor’s career.

- All consultants responsible for training should attend ‘training the trainers’ courses to improve the support given to junior doctors.

- There should be widespread use of mentoring schemes to offer ongoing support for doctors

- The opportunity to experience different specialties needs to be built into medical training. Junior doctors should be offered psychometric testing to suggest suitable areas of practice.

- The availability of flexible training in the PRHO and SHO years needs to be increased.

Incentives for doctors should be based on an understanding of contemporary professional motivation