There are not enough training jobs available for resident doctors, according to the GMC’s annual report on the medical workforce.
It suggested that while there was an increase in the number of doctors overall, that the UK risks wasting their skills to the ‘detriment of patient care’.
The report referenced the number of locally employed doctors (LEDs), which grew by 75% between 2019 and 2023 in England and Wales, compared to only a 9% growth in doctors on the GP register and 13% growth of doctors on the specialist register over the same period.
These doctors are in roles which are ‘too often poorly defined with limited opportunities for career progression and training’, the GMC argued.
Last year, NHS England’s long-term workforce strategy confirmed plans for ‘doctors other than GPs’ to be able to work in primary care ‘more easily’.
The strategy said that LEDs are a ‘rapidly growing group’ and that NHSE will work with partners to ‘identify ways to better support postgraduate career progression’ for this group.
Charlie Massey, chief executive of the GMC said of the challenges faced by LE doctors: ‘Locally employed doctors have a lot to offer our health services. But too often they find themselves in roles without proper access to the education and training they need to develop their skills.
‘Without changing the way we think about training, the UK risks sleepwalking into a situation where these doctors are overlooked and undervalued, to the detriment of good patient care.’
Dr Emma Runswick, deputy chair of council at BMA added: ‘Today’s report rightly points out that there are not enough training jobs available for the current cohorts of resident doctors. The result is unprecedented competition for posts and stymied careers, with both UK and internationally-trained medics left to wonder if their vocation is still worth it. Doctors are joining locally employed roles without plans for progression out of necessity, lest they join the ranks of under- and un-employed doctors.
‘This report reminds us that while increasing the numbers of medical students is a laudable aim, it is worth little if training and career support is not increased along with it.’
Suzie Bailey, director of leadership and organisational development at The King’s Fund, added that though it was encouraging to see the number of doctors on the register growing, that this was ‘not enough’.
‘There needs to be adequate training and support in place, all of which can be in short supply in a stretched healthcare system,’ she said.
‘The reasons why the number of locally employed (LE) doctors in particular are increasing should be examined to understand why individuals may be choosing this career path. Reasons may include flexible working, potentially better choices around work-life balance, as well as avoiding yearly transfers between different hospitals that may involve moving to different areas.
‘However, we know these doctors also experience racism, inadequate inductions, lack of recognition, poor access to training and career development.’
Ethnic diversity of doctors
The report also showed that the UK now has more doctors from ethnic minority backgrounds than white doctors, with the number of non-UK graduate doctors in training increasing across all specialties, but ‘especially’ in general practice.
The percentage of international medical graduates (IMGs) in GP training rose from 34% in 2019 to 52% in 2023, making it the highest proportion of all specialty training programmes.
Since the demographics of the training cohort is a good predictor of the fully qualified GP workforce, the GMC forecasted that ‘general practice will have higher proportion of non-UK graduates in future’.
The regulator emphasised the importance of IMGs in general practice being ‘integrated to supportive teams’ and having access to ‘the same opportunities for career progression as other doctors’.
‘Doing so will aid retention and ensure the UK’s general practice systems operate at their best,’ the GMC report said.
Last year, in the same report for 2023, the GMC argued that the NHS must address why general practice is less attractive to UK graduates.
It comes as the Labour government has committed to developing a new long-term workforce plan for the NHS that will be published next summer.
