Goddard Andrew F
Medical Workforce Unit, Royal College of Physicians, London, UK.
Frontline Gastroenterol. 2013 Jul;4(3):166-170. doi: 10.1136/flgastro-2012-100203. Epub 2012 Aug 18.
There are over 1100 gastroenterology consultants and approximately 600 higher specialist trainees in the UK in 2012. The speciality has expanded considerably over the past 20 years but will need to expand further over the next 10 years to accommodate those completing training. There is an undoubted need for expansion due to increased demand from an ageing population, cancer screening and an increasing burden of liver disease. However, the UK economy and changes in the way that workforce planning will be made over the next few years will determine whether such expansion occurs. There is accumulating evidence that getting a substantive post in gastroenterology is getting harder and that some trainees are taking up new types of post-training posts. Gastroenterology has historically been a male-dominated speciality but this is changing as more female trainees come through the system. Current trainees have defined expectations about how and where they will want to work as consultants and these expectations are different according to their gender. Trainees are also aware that the way of consultant working is likely to change considerably in the next decade with increased need for acute medicine in hospitals and 7-day working. Medical workforce planning has always been very difficult. There are major changes planned in how training will be controlled in the NHS over the next few years, both locally and nationally. The future for gastroenterology is unclear but almost certainly trainees will have to be more flexible in how and where they work.
2012年,英国有超过1100名胃肠病学顾问以及约600名高级专科培训学员。在过去20年里,该专业已有显著扩张,但在未来10年还需进一步扩张,以容纳完成培训的人员。鉴于老年人口需求增加、癌症筛查以及肝病负担加重,扩张无疑是必要的。然而,英国经济以及未来几年劳动力规划方式的变化将决定是否会出现这种扩张。越来越多的证据表明,获得胃肠病学的实质性职位正变得愈发困难,一些学员开始从事新型的培训后岗位。胃肠病学在历史上一直是男性主导的专业,但随着越来越多的女性学员进入该体系,这种情况正在改变。当前的学员对成为顾问后如何工作以及在哪里工作有明确的期望,而且这些期望因性别而异。学员们也意识到,随着医院对急症医学的需求增加以及实行一周7天工作制,未来十年顾问的工作方式可能会发生很大变化。医疗劳动力规划一直都非常困难。未来几年,英国国家医疗服务体系(NHS)在培训管理方面将在地方和全国层面进行重大变革。胃肠病学的未来尚不明朗,但几乎可以肯定的是,学员们在工作方式和工作地点上将不得不更加灵活。