Where are UK trained doctors? How do we get them to stay in the UK, and encourage more equal distribution?

I am trying to persuade people in Wales that we deserve better. The successful applicants for medical school come from city suburbs and from females. If we are to have applicants successful from all areas and schools, then we need adverse selection, and if we are to correct the gender bias we need graduate entry, or adverse sex selection at 18 years. If we are to encourage medical students to settle in an area, then my suggestion is a virtual medical school in Wales. The Cardiff Deanery can supervise the examinations and assessments, but the delivery of teaching can by internet talks, and local practical learning. We have a net 20% loss of all graduates, but in medical sciences I am suspicious that it is much higher. Doctors will often want to travel, but most will return. Training an excess will mean more competition for all posts. The problem in London is the cost of overhead for self employed GPs…  and lack of enough modern premises.

Image result for doctors emigrating cartoon

 

in the BMJ  31st May 2018 : (BMJ 2018;361:k2336  )

Where are UK trained doctors? The migrant care law and its implications for the NHS–an essay by Julian M Simpson

The proportion of locally trained doctors tends to vary inversely with the needs of the population served. Once doctors have qualified they are in an international jobs market. South Asian doctors made it possible for the (then) NHS to develop as a system built around primary care.

Locally trained doctors tend not to want to work in areas of high deprivation and need, and we continue to rely on foreign trained doctors to fill massive gaps. Medicine should acknowledge this historical trend and tackle the dysfunction arising from its contemporary manifestations, writes Julian M Simpson

When I started researching my recent book,1 and speaking to members of the first generation of South Asian GPs to work in the NHS, I was struck that I kept returning to parts of the UK that for the first four decades of the NHS were predominantly industrial and working class. The people I was interviewing had mostly had careers in inner cities and industrial areas. I met them at their homes and practices in the former coalfields of South Wales, Fife, and Yorkshire, and in the urban areas that made up Britain’s industrial heartlands: Glasgow, the Midlands, Manchester, and the East End of London.

This was no coincidence. Medical migration from the former British empire in South Asia was a fundamental aspect of the working class experience of healthcare in Britain in the period I researched (from the 1940s to the 1980s) and beyond. By the end of the 1980s, although about 16% of GPs in England and Wales were from South Asia, their distribution was hugely uneven.

In fact, there was a stark divide. Few South Asian doctors practised in areas that were generally more middle class and rural. In Somerset or Cornwall or the Isles of Scilly, for instance, less than 1% of doctors in 1992 had qualified in South Asia. GPs from the Indian subcontinent were largely catering to the residents of generally working class and industrial areas. In some parts of England, such as Walsall in the Midlands and Barking and Havering in Greater London, they …

Image result for doctors emigrating cartoon

 

 

This entry was posted in A Personal View, Professionals, Stories in the Media, Uncategorized on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s