Young British doctors choosing general practice over hospital careers

The British Medical Association reports today that an increasing number of young doctors choose to become GPs because hospital careers offer fewer opportunities to work part-time.

The research also highlights concerns about patient care when new limits on junior doctors' hours are introduced in less than two weeks' time.

The ninth annual report from the BMA's cohort study of 1995 medical graduates paints a picture of a generation of doctors who increasingly want better work-life balance. Almost three quarters of the 490 doctors surveyed are either working part-time (25%) or would like to in future (45%), and the flexibility of general practice is the main reason for a sharp rise in the numbers choosing to become family doctors. Almost half (46%) of the GPs surveyed were working less than full-time, compared to less than ten per cent of the hospital doctors.

The proportion of the cohort already working as GPs has increased from less than a quarter in 2001 to more than a third in 2003, and the proportion planning to enter general practice has risen from less than a fifth (18%) at graduation, to more than a third (34%) in 2003. Seven per cent of the cohort had spent time practising overseas in the last year, in many cases because of the lure of improved working conditions.

Dr Jo Hilborne, deputy chairman of the BMA's Junior Doctors Committee, says the results highlight the need for better work-life balance for all doctors: "Working in a hospital is often very demanding, and balancing responsibility to patients with the needs of a family can be stressful. Given the changing expectations of doctors, hospitals are going to have significant staffing problems if they don't extend opportunities to work flexibly."

The survey shows long hours are still a problem. As of August 2003 – when the survey was distributed – more than a half of senior house officers (the second job after graduating) were still working above their contracted hours.

And for many junior doctors, the European Working Time Directive, which will introduce a maximum 58 hour working week on 1 August, has actually meant a more intense working life. As a result of the legislation, trusts are replacing traditional on-call rotas with shift systems that require long stretches of continuous work of up to thirteen hours. Where these approaches have been adopted, only two in five doctors (44 out of 110) believe they have been effective. Many complain that although their hours have gone down, quality of training and patient care has suffered.

Mr Simon Eccles, chairman of the BMA's Junior Doctors Committee says

"Reducing doctors' hours to safe levels is long overdue. However, many trusts have suddenly realised the deadline is coming, panicked, and arbitrarily introduced working patterns that are bad for both doctors and patients. Managers need to work with junior doctors to develop ways of meeting the limits that ensure neither training or quality of care suffer."

Click here to view the full report: http://www.bma.org.uk/ap.nsf/Content/cohort2004?OpenDocument&Link