A study just published on bmj.com informs that in Britain, most graduates in medical studies work in the National Health Service (NHS) for many years. The report contradicts the alleged growing trend of displeased doctors leaving the NHS. Another study also available today reports that women´s career progression in the NHS is no longer slowed down by direct discrimination.
Regular surveys of doctors trained in UK medical schools over the last thirty years are the basis for these observations.
The first research included 32,013 graduates (94 percent were UK resident, 6 percent were from overseas) who were monitored on a regular basis for up to twenty five years after qualification.
Two years after graduation, 88 percent of the students with family homes in Britain were working in the NHS. The study shows a steady slow decline over the years: 86 percent after five and ten years, 85 percent after fifteen years, 82 percent after twenty years, and eighty one percent after twenty five years. Most of the doctors who left the NHS remained in medical practice in Britain or abroad.
For the doctors with family homes overseas, 76 percent were working in the NHS for two years after qualifying. Ten years later, two thirds were still working in the NHS.
Contrary to the claim that women are much less likely than men to practice, there was the same percentage of women and men working in the NHS. A much higher percentage of women than men worked part time. The authors remark this fact should be carefully considered in workforce planning.
In the second study, 7,012 doctors were surveyed on career progression. They all had qualified from UK medical schools in 1977, 1988 and 1993.
Data showed that men progressed faster than women to senior posts, and that fewer women reached those positions. However, the career path of men and full-time working women was almost identical.
Women and men working part-time also had roughly the same trajectories, which were more delayed than those of full-time doctors.
For women who always worked-full time, there was no indication that having children stalled their career progress in reach or speed.
The striking differences between men and women and between full-time and part-time women were noted in their specialty destinations.
The researchers explain that while the evidence shows that there is no systematic direct discrimination against women in the NHS, there are still signs of indirect discrimination. They are noticeable in the working conditions conflicting with family life and the lack of suitable role models in some specialties.
“There can be no doubt that there were real barriers to women in medicine in the past”, they note.
However, women currently comprise 60 percent of the medical school intake. For that reason, the authors conclude it is essential to guarantee an obstacle-free career progression for women wishing to work part-time.
A Royal College of Physicians report published this week confirms these findings (“Women and medicine: the future”). It states that “the main challenge ahead is no longer barriers to entry or delays to the career progression of women….” Instead, it considers the new challenge as being “to ensure that the increasing proportion of women is effectively, economically, and fairly incorporated into the workforce for the benefit of patients.” An additional editorial further discusses the report.
“Retention in the British National Health Service of medical graduates trained in Britain: cohort studies”
Michael J Goldacre, professor of public health, Jean M Davidson, research officer, Trevor W Lambert, statistician
Written by Stephanie Brunner (B.A.)