Factors driving thousands of doctors to consider leaving the UK have been revealed in new research published by the General Medical Council (GMC).
The GMC commissioned independent research into the reasons doctors may be considering, or have already made, a move abroad. The report, Identifying groups of migrating doctors, also makes recommendations for interventions that may persuade more of them to stay.
Feeling undervalued, a lack of progression opportunities and disillusionment with the UK’s healthcare systems, are just some of the motivations researchers identified that make doctors want to leave.
A survey of doctors asked how likely they were to move abroad to practise medicine in the next 12 months, to which over 13% of those practising in the UK answered ‘very likely’. A further 17% said they were ‘fairly likely’.
More than 3,000 doctors – including those who have left the UK to practise abroad, had left and since returned, or are currently still working in the UK – answered questions on how satisfied they felt day-to-day, their experiences of working in the UK and their attitudes towards migration.
Following analysis of the data, researchers split doctors into six distinct groups based on shared attitudes and experiences towards work and life as a doctor in the UK:
- Deep discontent: the most negative and most likely to say they will leave in the next year. These are doctors who are dissatisfied on multiple fronts with the political environment, UK healthcare systems and its effects on their wellbeing.
- System sceptics: concerned about the direction of the health systems and dissatisfied with their own working conditions, these doctors feel undervalued and unsupported. Most likely to be attracted to English speaking countries where they feel there are better conditions.
- Burnt-out: working in the UK has left this group exhausted and unsatisfied with a low level of personal wellbeing and work-life balance.
- Mobile career developers: neutral about working in the UK but obstacles to career progression could tempt this group to leave. A high proportion qualified overseas.
- Open to opportunity: a relatively happy group of doctors, who may consider working abroad for a new challenge.
- Happy in the UK: the most positive, this group has a high proportion of doctors who qualified overseas and who are happy working in the UK but may return to their home country at some point due to those connections.
The report recommends targeting the top three categories of ‘deep discontent’, ‘system sceptics’ and ‘burnt-out’ as a priority, viewing these as having the greatest chance of significant impact to the workforce.
The report highlighted general improvements to workplace conditions could have the biggest impact on retention. Doctors in the largest three groups reported feeling overworked and under-supported.
A negative view of UK practice was also a key factor estimated to impact the three largest groups of doctors. The report showed a widespread perception that the UK’s health systems are ill equipped to provide patients with the care they need.
Over 75% of doctors reported feeling under-valued professionally, demonstrating a concern with pay. The research said increasing pay would reduce its importance as a reason to move abroad.
Charlie Massey, Chief Executive of the GMC said: "This is a stark reminder of the challenges we face in the UK, but it also presents valuable insight into how healthcare leaders, employers and workforce planners can target interventions to improve conditions. Though the number of doctors actually leaving to practise abroad in 2023 was comparably low, these findings are a warning to all should conditions fail to improve."
According to the latest GMC data, approximately 4,000 doctors who gave up their licence to practise or left the medical register in 2023 gave ‘going to practise abroad’ as one of their reasons for leaving.
The report showed that some migration is inevitable and natural, for example a third of leavers were returning to a home country, 9% to carry out caring responsibilities, and that numbers migrating into the UK are high. The new research builds on the GMC’s 2022 project Understanding doctors’ decisions to migrate from the UK which looked in more detail into the journeys and decisions made by doctors leaving UK practice.
Mr Massey added: "It’s much easier to dissuade someone from leaving by acting upon concerns, than to persuade them to return. There are no easy fixes, but these findings highlight the urgency with which we must act. We must work together as a system to make informed changes so the talented professionals keeping our nation well feel supported to continue working in the UK."
