To resent doctors who leave the profession?

[Prrambulate]

IN PARTICULAR, to take up lucrative management consultancy roles at the likes of McKinsey. I know three doctors among my uni cohort who have left the profession in the early-mid 30s, very close to or having trained at consultancy level for specialisms like ophthalmology, orthopaedics. It seems to be happening more often but that could just be my perception.

It’s frustrating because medical places are significantly capped in the UK, getting a place on a course is difficult, and training these doctors is costly. And then just to lose these qualified doctors at a time of dire need in the NHS is kind of maddening.

What salary are these consultants on and what working conditions need to be changed?

I'm not asking about the working conditions for lower level NHS staff. I'm talking about the problems that these top consultants face that is making them leave in droves.

I love (not) how the very first post here is blaming women.

If I were a consultant and carrying out operations I'd be frustrated at the fact that the NHS waiting lists mean I am generally operating at an incredibly late stage when the outcomes of my hard work are likely to be less good. I'd also be frustrated that I don't get to see people when I need to, or that I am being told not to follow up on operations (in the south Devon area, women who've had gynaelogical procedures do not have follow ups unless they ask for them).

That would make me leave because I'd wonder what the point was.

It's not blaming women. It's a fact. It means we need to amend the number of doctors being trained to reflect the increased percentage of women who work part time. Basic workforce planning.

But that same trust says fuck you, if you won’t do it for X, we’ll put it out to an agency for double the price, when staff want somewhere in the middle? Why shouldn’t you know what your worth is and not work for less? No where else in real life would you be expected to do overtime for less than you should be paid.

They’re going above the rate card so I think they are unreasonable. No agency for those roles so the trust has to pay despite impact on other services. We’re not near a city so it’s not a popular Trust for agency.

I am a FT female GP.I have worked FT apart from (short when I have my kids) maternity leaves. I am dropping to PT soon. I'm exhausted, burnt out and beyond frustrated at he mess this government has driven out health service too. Its not ALL he government's fault there is also a totally unrealistic societal expectation that every want for things as diverse and 'coffee allergy' and 'sunscreen' and every test under the sun with no medical value should be funded without question by the NHS, today. However the chronic an increasing underfunding of medical provision and social care leave hundreds of thousands of people unable to get the care they need.
If I were younger I would 100% leave the UK, conditions are shit, pay, for the level of risk and decision making we are expect to 'just do' is shit, and the workload is uncontainable.
Don't blame those doctors for leaving, look at why they are going .... ( and I've done 30 years + solely in the NHS)

@Prrambulate who exactly do you want to take up theses non-clin roles that require a med degree and clinical experience?

When I started out, insurance companies were a large employer of doctors, who used to be the first line in assessing medical claims. That’s all changed now of course, but point being there have always been other areas that have employed doctors. I have a few friends who went into government jobs involving evaluation of medicines (places like MHRA) and to pharma companies. Another who went into an advisory role in government, for medical policy. Another who took up a role in the countries Medical Association (then went on to become a politician 🤣). Lots of different jobs outside clinical facing in the health system require doctors. In your model, who would do this?

There's going to be a lot of resentment soon as doctors will be leaving. Because they can't get a job. Coming this August. Hundreds of F2 & ST3 with no jobs to go to. Because apparently we don't need doctors.

Resent them all you want. Imagine how they feel not being able to work in this country doing the job they've trained for, got into massive debt for, given up their young lives for.

I think you're being unreasonable OP, I'm sorry but I do. We know the NHS is underfunded, and that medical healthcare professionals are working in shitty conditions - I think placing them on some kind of saintly pedestal is unhelpful. 1) because it means that the organisation itself is often too slow to pick up on and resolve poor behaviour or clinical practices (which can have the most serious outcomes imaginable) and 2) because they're human beings like all of us, fallible but also shouldn't be obligated to put up with intolerable working conditions at the cost of their health, mental or physical, relationships, general life etc. also when you factor in at what point in time a consultant today first decided they wanted to be a doctor, chose their A'levels and degree accordingly and spent all those years working towards that goal - the NHS and as a result doctor's working conditions were very different when they first made that choice. Things have gone seriously downhill and they're obviously entitled to decide to get out as a result.

We are being flooded with UK doctors in the ME lately, mainly in the energy sector clinics. We avoid them.like the plague, they are so used to rationing care that they are useless and never prescribe anything. They have a lively quiet life, the only thing people use them for is mental health which is weaker here. After a few months they calm.down and you can see them for non life and death issues and get anti bionics and the Panadol which I think may be legally binding in all GP visits here, I have never seen one without taking home a pack. You can't blame them though, if I was an NHS doctor I wouldn't be able to look at myself in the mirror or sleep at night. I would be ashamed to be actively doing harm, both mental and physical.

Hmm I see your point. I highlighted management consultancy specifically because it’s just largely about increasing the wealth of corporate leadership, saving companies money, making executives richer. Cost effectiveness and profitability are king, and most of their clients are Fortune 500 companies. I don’t even see the spirit of the medical profession in that career switch. I’d be more sympathetic to other decisions. Not that any of this matters, of course people can do as they like!

@Prrambulate what do you suggest the unemployed doctors do ? Stay here on benefits or move abroad ?

Thoroughly agree - when the system treats trainee doctors like shit and can't progress after f2 or imt3 because of a lack of training places either initial or specialist.
Even once the consultant standard is reached there are not enough permanent posts.
Trainees are expected to move all over the country because the posts are allocated by a points system (points are allocated and weighted in a bizarre way) the trainees know they are needed locally as they are currently working as locums covering gaps in the hospital they would like to be at and the consultants would like to have them as proper trainees.
Perhaps things will improve once this shitshow of a government is thrown out

YABVU

It’s a career, not a life sentence. People have to have the right to leave a job it they want to.

Capped numbers is not the fault of individual doctors, it’s a systemic problem. As are the issues with pay and conditions which are driving the ever rising attrition rates- at all levels. Record numbers of juniors and consultants are leaving the profession or the country or retiring early, and the numbers of doctors going from foundation training into specialist training are falling. Most are doing so for a reason, not on a whim. And if it is for a better life elsewhere or a more lucrative job- who can blame them? I’m an nhs doctor and things are the worst I’ve ever known it and a LOT of it is due to chronic and systemic failures. I don’t blame those who are burnt out or just don’t want to do it any more.

If at any point a person wants to change career or move into alternative roles or leave the country they have to be free to do so. Anything else is immoral but also unlikely to lead to better patient care- burnt out doctors makes mistakes. People who hate their jobs don’t tend to do their best work.

But she is also completely entitled to do that. She's a human being, and is entitled to make her own life decisions. If her degree was law, science, or business, the government would still have subsidised her qualification, but she wouldn't be subject to this moralising.

People generally go into medicine with high expectations of giving back, but I honestly don't blame them when they choose a path out of the NHS that uses their skills that they have spent years acquiring.

@LameBorzoi of course she entitled to do it, but it does make me think less of her.
Also, I wasn't aware that government funding was used to subsidise law, science and business degrees, in the manner of medicine.
Why would the government fund a degree in business?

The government doesn't subside law etc.
The government sets the fees at £9250 - some degrees cost more than that to run ie medicine, dentistry, sciences and engineering because of all the practical teaching using equipment and higher teacher numbers required.
Law, history, English are cheap for the universities to run - can have huge numbers at lectures can do a lot online, and infrequent seminars and tutorials.
A broad entry university can cross subsidise and some universities have now dropped their science courses as costing too much.
Medicine courses get government funding (fees paid for final one or two years and NHS bursaries for students)

Medical students will pay over £250,000 for their training. That's what they'll repay. How is there training subsidised by anyone ? It's a story told to the public to make them believe doctors owe then their time. I believe slavery was abolished sone time ago.

Again. We have enough doctors, but they don't have jobs. Why ? Because the government prefers less trainee staff. Who cost more money.

I've just qualified as a GP. My training practice can't afford to employ me even for a day a week. They're advertising for an Advanced Nurse Practitioner because they get funding from the Government for the nurses.

@Tincancat it's so so sad. Within 12 months the job of a doctor has been eroded. I am so sorry, we need all the GPs we can get. ARRS funding has been v well named !!!

I really hope the scandal of so many unemployed doctors this August makes the news. But doubt it.

In case anyone is interested, 4,000 GPs will qualify this year. But there are 928 jobs. Loads of PA positions available though.

Resent doctors for leaving ? Know the facts first as they are leaving the NHS by force.

1,000 first year doctors currently don't know where they are going as they have no job. Start in August, could be the other side of the country with no friends, family or a room to sleep in. They've been at Uni for 5 years so the NHS has had 5 years to plan.

Many other doctors have no job from August. Must mean people like the long waiting times in A&E, or to see a GP or for a knee replacement. We have enough doctors. The NHS refuses to employ them - PAs cost more so it's not about money 🤷‍♀️

I'm convinced the transition to PAs is all about lowering the substantive staffing establishment so any insurers or businesses coming in to take over trusts can fire or renegotiate contracts to reduce the staffing costs or worsen conditions...

@FixTheBone or the 2 tier health service that makes Tory MPs lots of money. Doctors for private, PAs for state.

The shortage of higher training places is shocking. There are plenty of qualified doctors who are available to work and plenty of plenty of gaps in rotas. Rather than employing these doctors properly where they can gain experience, learn the required skills and gain the sign offs towards their completion of clinical training qualification and become consultants they are getting clinical fellowship posts where they can do a good job but struggle to get the required skills or going through the agency which costs a fortune.
These doctors are often in their early thirties where many of their peers would be in the process of setting up a home and family rather than having to move around the country