Research into why some areas of the country lack enough doctors has revealed the reasons why medical professionals prefer certain locations over others.
The paper entitled "Medical training pathways and underdoctored areas: a qualitative study of doctors working in areas that struggle to recruit and retain" is by Liz Brewster, Michael Lambert, Choon Key Chekar, Clare Mumford, Tasneem Patel, Nicola Rennie and Cliff Shelton from Lancaster Medical School.
Interviews were conducted with a hundred doctors working in three "undoctored" areas between December 2022 and March 2024, across a range of doctors working in primary and secondary care, at different career stages, and with a range of demographic characteristics such as age, gender and ethnicity.
Lead author Dr Brewster said: "Undoctored areas are, by definition, those with ongoing issues in recruitment and retention of medical workforce and understanding the motivations for working in these locations is crucial for leveraging access to care in these locations.
"By examining routes into a location and the impact of different life stages, we have described some of the rationales for working in these areas and reflected on how these decisions were often driven by compromises."
Doctors presented complex, intertwined accounts of their rationale for working in these areas, which encompassed elements of family life, career satisfaction and place-characteristics.
Prioritising people
For many participants, the driving factor in where they lived and worked was guided by those around them (e.g. family, partners, friends).
A medical consultant in the Northwest, Tegan, said: "I can't imagine me leaving. Personally, because I'm from this area, live in this area, my family are in this area, I wouldn't be planning to move anywhere else."
Prioritising place
A smaller number expressed their decision-making as being driven by the place itself, sometimes based on the attractions of scenery or outdoor opportunities.
Northern GP Yasmin said: "We both wanted to be somewhere more rural. And I took a locum job in Cumbria, and we ended up staying here. West Cumbria is an environment all of its own, so a lot of poverty, a lot of needs. It was challenging but on the doorstep of some of the world's most stunning scenery."
Prioritising career
However, a more common explanation for ending up working in an underdoctored area was because of career opportunities or other work-related attractions.
Another consultant in the Northwest, Xavier, said: "I deliberately picked [deprived town in northern England], because I could tell that it would allow me to do as much as possible of what I had trained to do to as high a level as I possibly could."
Any choice based on one of these factors had potential consequences for the others. For some participants, these intertwined factors were aligned, which enabled them to settle in place, but for others, the factors were in conflict, and compromises had to be made.
Dr Brewster said: "Our research highlights some of the patterns where particular types of choices are made, which may be useful for considering future workforce planning.
"We found that for the doctors in our study, these expectations of mobility in early training often led to a desire to settle down in a place longer term. Location of medical school did not seem to be a deciding factor unless there were other affordances offered by the place.
"These findings raise questions about what might shift perceptions of places, what meaningful work looks like alongside a good quality of life, and what might be altered to encourage more doctors to work in particular areas."
