Medical school does not prepare doctors for the reality of working life in the NHS

Medical school does not prepare doctors for the reality of working life in the NHS, a survey published at the BMA's annual conference suggests yesterday (Wednesday, 29 June, 2005).

Six in ten doctors told the BMA that life in the NHS had not been what they expected when they first qualified.

Over the last ten years, the BMA has tracked a cohort of 543 doctors who qualified in 1995. In the final annual survey, the doctors were asked how their working lives compared with what they had expected when they graduated from medical school.

Of the 486 doctors who replied, six in ten (60%) said reality had not matched their expectations. Reasons included poor quality of life, greater stress, long hours, lack of autonomy, and pressures resulting from government targets. Some said that they had been very idealistic at medical school and unprepared for the reality of life as a doctor.

For others, the surprise had been a pleasant one, with doctors saying their working lives had been more flexible than they expected, and that they had been able to combine work and family life successfully. Some said they had found satisfying careers as GPs, and called for students to get more experience of general practice at an earlier stage of their careers.

Commenting on the results, Mr Simon Eccles, chair of the BMA's Junior Doctors Committee, said:

“I'm dismayed that so many medical students are entering the profession without feeling properly prepared. Medical schools should listen to this strong message from doctors who are coming to the end of their training and act accordingly. I'm delighted that so many new GPs seem so happy with their careers; under the current shake-up of doctors' training, there will be far more exposure to general practice, and that's to be welcomed.”

The proportion of doctors planning to become GPs has doubled since graduation, from fewer than one in five (18 %) in 1995 to more than one in three (35 %) in 2004. By contrast, the proportion of doctors planning a career in surgery has halved.

The report calls for measures to ensure that medical education prepares doctors for careers in modern medicine. It suggests that a mentoring scheme might be introduced at medical school and then followed throughout the doctor's career.

Other findings include:

• Women are nearly twice as likely as men to want to become GPs
• Women are not moving into hospital specialties such as surgery and anaesthetics
• The vast majority (94%) of female doctors surveyed either work less than full time, or may do in future, compared with 46% of their male colleagues
• Almost a third of the doctors surveyed are married to other doctors