UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
J R Soc Med. 2018 Jan;111(1):18-30. doi: 10.1177/0141076817738502. Epub 2017 Oct 16.
Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address these concerns by introducing real improvements to resources, staffing and working conditions.
报告医生考虑离开医学或英国的原因。
问卷调查。
英国。
向 2008 年和 2012 年毕业的所有英国医学毕业生发送了三年后的问卷。
医生对离开医学或英国（或两者兼而有之）的主要原因的评论。
回复率为 46.2%（5291/11461）。在不打算肯定留在英国医学领域的 60%的受访者中，50%的人考虑在英国以外的地方从事医学工作，10%的人考虑离开医学。在考虑在英国以外从事医学工作的人中，最常提到的原因是获得更广泛的经验、认为其他地方会“更好”，以及对国民保健制度及其文化、国家和政治的负面看法。其他原因包括更好的培训或工作机会、更好的薪酬和条件、家庭原因以及更高的期望。在毕业后的三年里，2015 年接受调查的医生比 2011 年接受调查的医生更有可能提到与国民保健制度、薪酬和条件、他们的期望以及对工作-生活平衡和患者护理的影响有关的因素。在考虑离开医学的人中，离开医学的主要原因是对国民保健制度的负面看法（提到这一原因的人占该组评论者的一半）。在毕业后的三年里，2015 年接受调查的医生比 2011 年接受调查的医生更有可能提到这一原因，以及工作时间过长和工作量过大，以及经济原因。
许多医生对国民保健制度中初级医生经历的许多方面以及许多人认为在资金不足的系统中提供高质量患者护理的困难持越来越负面的看法。旨在鼓励更多医生留下来的政策变化应该是出于通过引入对资源、人员配备和工作条件的真正改善来解决这些问题的愿望。
