Why do doctors migrate and how can we keep them in NHS? Research investigates

An average of around 2.1% of doctors leave the UK medical workforce annually to go overseas.
In addition, overseas-qualified doctors are an integral part of the UK medical workforce, with more than a third of those licensed and on the GMC register having trained abroad.
But what factors influence medical professionals’ decisions to move to, and from, the UK?
New research, commissioned by the General Medical Council and led by the University of Plymouth, investigated the drivers and barriers behind migration, to better anticipate and respond to emerging trends affecting recruitment and retention.
The report was based on analysis of secondary data of the migration patterns of doctors to and from the UK between 2009 and 2019; a systematic review of the literature on the drivers of, and barriers to, the migration of doctors; and 18 in-depth interviews with organisations involved in workforce planning in the UK and internationally.

Key findings were:

  • Reasons for overseas qualified doctors coming to work in the UK include perceived better employment opportunities and working conditions, more training and development opportunities, and a better overall quality of life.
  • The barriers to migration to the UK include stricter immigration policies, the complexities of the registration process, and perceiving the healthcare system as difficult to enter. Professional and personal concerns include worries about a new working environment, lack of support and language difficulties.
  • Despite career progression being one of the key drivers for joining the UK workforce, migrating doctors report finding it difficult to progress within the UK healthcare system.
  • Many of the key drivers of migration to the UK, for example better working conditions, were also factors driving migration from the UK and into other countries.
  • Reasons for doctors leaving the UK include poor working conditions in the NHS, feeling professionally undervalued, and the desire for a better quality of life.
The authors grouped the migration drivers and barriers into macro-level (global and national), meso-level (professional) and micro-level (personal) factors – acknowledging that the decision for a doctor to migrate is multi-layered and is often a complex balance of all of these different considerations.
Dr Nicola Brennan, the report’s lead author from the University’s Collaboration for the Advancement of Medical Education Research (CAMERa), said:

“Through our research, it was clear that there’s no magic answer to why doctors choose to come to or leave the UK. But we found a number of really interesting themes – particularly in relation to ‘working conditions’ – that we hope will inform conversations around recruitment and retention. The fact that overseas trained doctors find it difficult to progress in their careers in the UK is concerning and an area for future research in order to provide better support for these doctors.

“We were pleased to compile the report in CAMERa and the ‘Future Ready Workforce’ theme within the University’s Plymouth Institute of health and Care research (PIHR) as part of our commitment to advancing the development and sustainability of the healthcare workforce. Our NHS is so diverse and hugely valuable, and it’s vital that we look after the people delivering the services.”

The Collaboration for the Advancement of Medical Education Research and Assessment (CAMERa) researchers aim to improve the development and sustainability of the healthcare workforce by focusing on three research themes, namely workforce development, continuum of education, and professional regulation.

CAMERa’s research programme, carried out by a multi-professional group and employing a mix of qualitative and quantitative methods, impacts directly on national and international literature, educational theory, practice and policy.

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