Health services across the UK must adapt to rapid changes in how doctors are choosing to progress their careers, according to a new GMC report published today.

In the GMC’s The state of medical education and practice: workforce report 2023, the regulator says rising numbers of doctors are moving away from the traditional postgraduate training model and instead choosing increased flexibility and less linear career pathways. These can include training breaks, working part-time or as locums, undertaking research or choosing to work as specialty and associate specialist (SAS) or locally employed (LE) doctors.

The report adds that instead of viewing this changing landscape as a threat to workforce stability, it could in fact help to reduce burnout and dissatisfaction, improve work-life balance, support informed career decisions and increase the likelihood of doctors remaining in UK practice.

The GMC is already working with partners in all four UK countries to consider solutions to support greater flexibility in career and training pathways, saying that this will ultimately benefit both the wellbeing of individual doctors and the wider healthcare system over the long-term, leading to better patient care.

The GMC report also says the UK must remain an attractive option to doctors who qualified overseas for the foreseeable future. The regulator says the impact of policies and commitments to increase UK medical school places, including the welcome doubling of places outlined in the NHS England Long Term Workforce Plan, would not be felt for a number of years.

The report reveals that doctors who qualified outside the UK made up just under two thirds (63 per cent) of the 23,838 new additions to the register in 2022. International medical graduates (IMGs) made up over half (52 per cent) of new joiners, while doctors who graduated from within the European Economic Area were a smaller component, at 10 per cent.

The report says that, even with current and upcoming increases to medical school places, the length of time it takes to train a doctor means the UK must remain an attractive option for doctors who qualify abroad for some time to come. It projects that, 14 years from now, 39 per cent of UK doctors are likely to have qualified overseas.

The report also reveals that:

  • The number of doctors joining the UK medical register is rising. In 2022 there were 296,182 doctors with a licence to practice, an increase of 18 per cent since 2018.
  • Since 2019, for every doctor who leaves, on average more than two join the workforce.
  • While the number of doctors leaving the profession increased last year, from 9,825 in 2021 to 11,319 in 2022, the proportion of the workforce leaving (4 per cent) is still only returning to pre-pandemic levels. However, the GMC is aware of increasing numbers of doctors taking hard steps towards leaving UK practice.

Charlie Massey, Chief Executive, said: “Many of these changes will have long-term benefits. We know, for example, that post-foundation training breaks can reduce the risk of burnout and help young doctors build confidence in their next steps. For some, they help provide certainty over their choice of specialty.

“Workforce thinking needs to keep pace with these changes. The ability to provide good patient care, now and for the foreseeable future, depends on the ability to respond quickly to changing career pathways, and to think clearly about making the most of the resources available.”

In the last year, the numbers of SAS and LE doctors, who are not on the traditional training pathway, have also increased dramatically – at four times the rate of the rest of the workforce. Between them, SAS and LE doctors now make up almost a quarter (24%) of licensed UK practitioners.

“Patients benefit hugely from their knowledge and experience, and their flexibility is vital,” Mr Massey added.

“Too often these doctors are treated as a single homogenous group, which does not help our health services get the most out of their skills. More needs to be done to ensure these professionals are recognised for their skills, feel valued and are supported to progress their careers.”

“Doctors from overseas bring skills and experience, and are vital to the UK’s health services. There is already a lot of good work going on around induction and support, but the more we and our health services can collectively do to support doctors arriving in the UK, the better the chance of retaining their services for longer. They need to be welcomed, valued and supported, and their expertise must be properly recognised,” Mr Massey added.

The GMC’s ‘The State of medical education and practice: workforce report 2023’ is available online.