One in three UK medical students ‘intends on emigrating to practise medicine’

One in three UK medical students intends on emigrating to practise medicine and many will not come back, a large survey suggests.

The study of 10,486 people from the UK’s 44 medical schools found 32% intended to leave for countries including Australia, New Zealand, the US and Canada.

Reasons given for leaving the UK included better pay offers abroad, work-life balance and improved conditions.

Around 60% of those surveyed were either not satisfied or not at all satisfied with the prospect of working in the NHS.

Dr Latifa Patel, the British Medical Association’s representative body chair, said of the study: “It is disheartening that medical students already recognise the extent to which our profession has been devalued through constant pay erosion and declining working conditions, and have made up their minds, as a result, that the NHS is not the right place for them to work.

“They are investing seven years of their lives, starting out with the intent to be a doctor in our NHS, only to have that enthusiasm and commitment crushed out of them…

“It is not too late to fix this, but the power to do so rests with the Government.

“Retention must be prioritised, and plans must address pay restoration, career progression and working conditions.”

A quarter of all the UK’s medical student population were included in the latest survey, which has been published in the journal BMJ Open.

The study looked at the intentions of medical students after university graduation and/or on completing the two-year NHS foundation training programme.

A total of 32% intended to emigrate to practise medicine, either immediately after graduation (6% of those intending to leave), after completion of foundation year one (32%) or after foundation year two (61%).

Half planned to return to the UK after a few years, while 8% intended to return after completion of their medical training abroad.

The remaining 43% of those planning on emigrating said they had no intention of returning to the UK.

Some 2,543 medical students surveyed listed the places to which they would like to emigrate, with Australia the most commonly mentioned destination (42%), followed by New Zealand (18%), the US (10%) and Canada (10%).

Fewer than 3% of all those surveyed planned to leave medicine altogether, but those who did intended to pursue careers in consulting, technology, financial services and law.

Writing in the journal, the authors, including from the University of Cambridge and Imperial College London, said: “The NHS is facing a critical workforce shortage, with approximately 10,000 doctors relinquishing their licence to practise in 2021, representing a loss of nearly one-tenth of the doctor workforce.

“A British Medical Association survey of 8,000 senior doctors determined that 44% of NHS consultants in England plan to leave or take a break from working in the NHS over the next year.

“Similarly, a recent survey of 4,553 junior doctors in the NHS reported that four in 10 plan to leave the NHS, with 33% of these wanting to emigrate to another country to work.

“The combination of these previous surveys of the doctor workforce, and the results of our medical student survey suggest this trend is presently unlikely to improve.”

The authors said it was perhaps “unsurprising” medics wanted to leave for countries such as Australia “given the higher salaries, reports of improved work-life balance, and the fact that these countries’ primary language is English”.

The poll was carried out between January and March 2023 and people were aged 22 on average, with 67% being women.

The authors concluded: “The findings of this study emphasise the urgency of addressing the factors that are driving the exodus of doctors from the NHS and suggest that increased recruitment of medical students may not provide an adequate solution to staffing challenges.

“The causes of the problem are complex, and finding a solution will require a multifaceted approach. Steps could include improving work-life balance, increasing salaries, addressing the growing competition for specialty training posts and promoting greater flexibility in career pathways.”

A Department of Health and Social Care spokesman said: “There are record numbers of staff working in the NHS with over 6,000 more doctors compared to this time last year and the first ever NHS Long Term Workforce Plan, backed by over £2.4 billion, will double the number of medical school places to recruit and retain hundreds of thousands more staff over the next 15 years.

“Doctors who started their hospital training this year will receive a 10.3% pay increase, with the average junior doctor set to get 8.8%.

“We have also reformed the pension tax system enabling staff to remain in work for longer if they wish, helping to reduce pressures so staff can enjoy a work-life balance.

“We are also focused on improving culture, leadership, and wellbeing to ensure up to 130,000 fewer staff leave the NHS over the next 15 years.”