Factors driving thousands of doctors to consider leaving the UK have been revealed in new research published today by the General Medical Council (GMC). The GMC commissioned independent research into the reasons doctors may be considering, or have already made, a move abroad. The report, Identifying groups of migrating doctors, also makes recommendations for interventions that may persuade more of them to stay.

Feeling undervalued, a lack of progression opportunities and disillusionment with the UK’s healthcare systems, are just some of the motivations researchers identified that make doctors want to leave.

A survey of doctors asked how likely they were to move abroad to practise medicine in the next 12 months, to which over 13% of those practising in the UK answered ‘very likely’. A further 17% said they were ‘fairly likely’. "This is a stark reminder of the challenges we face in the UK, but it also presents valuable insight into how healthcare leaders, employers and workforce planners can target interventions to improve conditions."

Charlie Massey - GMC Chief Executive.

More than 3,000 doctors – including those who have left the UK to practise abroad, had left and since returned, or are currently still working in the UK – answered questions on how satisfied they felt day-to-day, their experiences of working in the UK and their attitudes towards migration.

Following analysis of the data, researchers split doctors into six distinct groups based on shared attitudes and experiences towards work and life as a doctor in the UK:

-1). Deep discontent: the most negative and most likely to say they will leave in the next year. These are doctors who are dissatisfied on multiple fronts with the political environment, UK healthcare systems and its effects on their wellbeing.

-2). System sceptics: concerned about the direction of the health systems and dissatisfied with their own working conditions, these doctors feel undervalued and unsupported. Most likely to be attracted to English speaking countries where they feel there are better conditions.

-3). Burnt-out: working in the UK has left this group exhausted and unsatisfied with a low level of personal wellbeing and work-life balance.

-4). Mobile career developers: neutral about working in the UK but obstacles to career progression could tempt this group to leave. A high proportion qualified overseas.

-5). Open to opportunity: a relatively happy group of doctors, who may consider working abroad for a new challenge.

-6). Happy in the UK: the most positive, this group has a high proportion of doctors who qualified overseas and who are happy working in the UK but may return to their home country at some point due to those connections.

The report recommends targeting the top three categories of ‘deep discontent’, ‘system sceptics’ and ‘burnt-out’ as a priority, viewing these as having the greatest chance of significant impact to the workforce. The report highlighted general improvements to workplace conditions could have the biggest impact on retention. Doctors in the largest three groups reported feeling overworked and under-supported.

A negative view of UK practice was also a key factor estimated to impact the three largest groups of doctors. The report showed a widespread perception that the UK’s health systems are ill equipped to provide patients with the care they need.

Over 75% of doctors reported feeling under-valued professionally, demonstrating a concern with pay. The research said increasing pay would reduce its importance as a reason to move abroad.

Charlie Massey, Chief Executive of the GMC said:

‘This is a stark reminder of the challenges we face in the UK, but it also presents valuable insight into how healthcare leaders, employers and workforce planners can target interventions to improve conditions. Though the number of doctors actually leaving to practise abroad in 2023 was comparably low, these findings are a warning to all should conditions fail to improve.’

According to the latest GMC data, approximately 4,000 doctors who gave up their licence to practise or left the medical register in 2023 gave ‘going to practise abroad’ as one of their reasons for leaving.

The report showed that some migration is inevitable and natural, for example a third of leavers were returning to a home country, 9% to carry out caring responsibilities, and that numbers migrating into the UK are high.

The new research builds on the GMC’s 2022 project Understanding doctors’ decisions to migrate from the UK which looked in more detail into the journeys and decisions made by doctors leaving UK practice.

Mr Massey added:
"It’s much easier to dissuade someone from leaving by acting upon concerns, than to persuade them to return. There are no easy fixes, but these findings highlight the urgency with which we must act. We must work together as a system to make informed changes so the talented professionals keeping our nation well feel supported to continue working in the UK.’

https://www.youtube.com/watch?v=xIw5_XMP3So?si=Adl4IdzvVYywJKAD
"If I was in charge.....I Farage RAGES at Doctors pocketing £400k from NHS who then abandon Britain

Nigel Farage says NHS trained doctors should be required to work for the health service for a number of years after completion of their training, to stop doctors trained at our expense from going abroad.

My position on the Bill to make it mandatory for Medical and Dental practitioners not to be given full practising license until five years after graduation to stem brain drain. As the Chairman Senate Committee on Health, a stakeholder in Nigeria's Health Sector, and a health system specialist, I am of the view that the legislative proposal sponsored by Hon. Ganiyu is not enough as a strategy to address the challenge of brain drain in the health sector.

This is because the factors responsible for brain drain are multifaceted and the mere denial of full practice license to medical practitioners as contained in the proposal will never resolve and may even aggravate them.

Besides, it is not only medical doctors that are leaving the country for greener pastures abroad, there are other health workers, as well as professionals in other fields of human endeavour, trained but leaving the country on daily basis for similar purposes, consequently, focusing attention only on the medical doctors is like curing one of many ailments that are threatening the life of a dying patient without finding solutions to the others.

In addition, with all due respect, the issues and facts related to granting of practising license are not understood by the sponsor of the bill, thus, it becomes imperative for me as a stakeholder in the health sector to offer my perspective, this time as a medical practitioner of many years and not particularly as a senator with the privilege of heading the Senate Committee on Health.

2. The piece of the proposed legislation at a minimum violates the right to the "Freedom of Movement" (Sec. 41) and "The right to freedom from discrimination" under (Sec. 42) as guaranteed by the Constitution of the Federal Republic of Nigeria (CFRN) 1999, as amended. These rights cannot be ordinarily denied by any person or government. Thus, we can't be seeking legal redress through an illegal procedure.

3. A person who is "qualified as a Medical Doctor" cannot be denied a license to practise having been certified qualified, except if he is found wanting in the ethics of the profession. Labour laws will come into place here. Furthermore, before the bill can be considered for legislative passage and executives' approval, the following fundamental issues are important to scrutinise:

a) When does the 5-year period start, before or after the housemanship?
b) What sort of license will be awarded to a fully trained doctor instead of a full license to practise under the proposal?
c) Is there going to be a limit in the doctor’s scope of practice, and to what extent are the limits during the five years waiting period? And we need to establish why we are putting such limits; is it for lack of skills, or political expediency?
d) What happens after the five years of denial of rights to practise?
e) Consequently, how will this law advance the quality of clinical services, education, and research in any system, let alone, a crippled one like ours?

Given the above reasons, it is my considered opinion that resolving the challenge of brain drain in the country's health sector cannot be achieved through this bill. Rather, we need to address the various factors that make skilled health workers desire to migrate out of Nigeria.

I, therefore recommend that rather than enacting laws that will curtail the rights of the citizens to free movement and seek better opportunities through legal means, we should advocate for an improved system that will be very attractive and make medical practitioners unwilling to travel abroad to seek better living conditions. That is, we have to make our pastures to be greener so that other people's pastures won't be tempting to them.

We can achieve this through the following recommendations:

i. Medical students could be obliged to choose between paying the standard market rate for their training or opting for government-subsidized training. Quality education in its real sense can't be free. Those who however opted for subsidized training after their qualification would in return be compelled to work in Nigeria for a certain time or refund the subsidies. This is a practice obtainable even in advanced countries such as the UK.

ii. To achieve the goal of a mandatory work scheme, we can enable a system that will guarantee employment opportunities for medical professionals after their qualification and provide inflation-adjusted living earnings for a few years after graduation on the condition that they stay in Nigeria to practice. Apart from providing attractive remunerations, their work environment and career expectations should also be prioritized. Incorporating both measures should give us satisfactory results.

iii. Lastly and importantly, we need to improve our health system with sustainable investments to make it conducive for the various health workers to work. We can be assured of better outputs only if what we input is in good condition.

Doctors in the largest three groups reported feeling overworked and under-supported.

Maryannana:
What could be the problem

Gboom:

Are you referring Nigeria to agbado country?
Your understanding about life is shallow.

Johnholmes:
In the rat race of life, the winner is still a rat

chopnaira:

Doctors wage for 1 are low in the UK.

Nahunger:

They should come to
Agbado Republic!!
They will be handsomely rewarded with items like,
1. Cassava
2. Corn
3. Cassava and
4. Corn 🌽