This is the first in a series of reports exploring how doctors progress through training. We are at an early stage with our research in this area and this report uses the national training survey census* (2012-2017) and responses to career intentions questions (2015- 2017). A subsequent report will include findings from qualitative research including focus groups and structured interviews with trainees and trainers.
At a high level, the UK medical training population appears to have been stable since 2012. Each year there have been around 60,000 doctors in training programmes, around 7,500 doctors have joined the Foundation Programme† and we have issued around 6,000 certificates of completion of training (which allow doctors who have completed postgraduate training in the UK to apply to join the specialist or GP register).
Taking time out of training is common; around a third of the current training population have taken a break in the past five years and breaks immediately after completing the Foundation Programme are increasing, from 30% after 2012 to 54% after 2016. A small number of doctors complete the Foundation Programme and have not returned to UK training after five years (525 or 7% of the 2012 F2 cohort). However nearly 90% of doctors who complete the Foundation Programme go on to enter specialty or core training in the UK within three years.
The average time taken to move through training doesn’t appear to be changing. It takes an average of 5½ years to complete the five years to the end of ST3 and 9 years to complete the seven years to the end of ST5. However, there are now 30% more doctors who have been in training between five and ten years than there were in 2012.
A four-nation view of this data reveals that Wales and Scotland have a much lower rate of doctors passing from their foundation programmes to their core and specialty training programmes. Data from the 2017 NTS shows that only 29% of F2s completing foundation training in Wales in 2016 progressed to core or specialty training in Wales, compared to 46% in England. A contributory factor to this lower rate of throughput could be a ‘domicile’* effect: only 35% of F2s in Wales are Welsh and many of their non-Welsh F2s return to their home country in the UK to continue training. In Scotland only 52% of the F2s in 2016 were Scottish and only 35% of Scotland’s 2016 F2s progressed to core or specialty training in Scotland in the following year.
Responses to our career intentions questions have found that the proportion of F2s aiming to take an immediate break from training in 2017 (17%) was lower than in 2016 (26%), returning to a similar level as 2015. Of those who intend to take a break, the most frequently chosen reasons for doing so are consistently:
- ‘work/life balance’ (86% in 2017).
- ‘wanting to gain further experience before making a decision’ (60%).
- ‘working in foundation programme placements has led to burnout’ (51%).
Additional research is underway to explore this in greater detail and we hope to publish further in early 2018.