Universities told *not* to train extra doctors

ronib

Cuba has an excess of trained medics so a hospital based training system is viable. Also salaries for doctors are kept at a low level so more numbers are viable.

This is not meant to be a hostile remark but I have noticed that bright, academically gifted females are often encouraged by their parents to go to medical school. I wonder if there’s a problem with retention amongst young mothers who are unable to combine motherhood with medicine? What steps could be taken to bring about a change of approach? It might be that three small children is the number which stops a medical career? All I know is that I met a young doctor who was living in Holland and there it’s common practice for mothers to go back to work after 3 months maternity leave. She said everyone does this!

I don’t think that’s the issue ronib, female doctors in the UK don’t tend to leave the profession when they have children. They have part time roles, many are GPs or in non surgical clinical specialties, or academia. This is a good government report into gender pay inequality in Medicine which covers the points you raised quite well.
assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/944246/Gender_pay_gap_in_medicine_review.pdf

Casdon it’s a very long report! 384 pages! I was speaking from personal observation but I might wade through it tomorrow.

It is really, really hard to get into medical courses at the universities here but same as the UK we are very short of doctors. Some of the doctors they are shipping in from overseas( I have experienced this personally ) have very poor English language skills which is a worry, even if they are superb doctors. My grandson is a medical student but he says none of the people he is studying with want to be GPs because they get small reward for the stress and expenses of running a practice. They all want to work in a hospital setting. Scary for the future.

ronib

Casdon it’s a very long report! 384 pages! I was speaking from personal observation but I might wade through it tomorrow.

Sorry, just read the executive summary at the front.

Casdon something interesting is that the young obstetrician I met from Holland is now working as a full consultant obstetrician in the Uk. She had taken only 3 months maternity leave for each of her two daughters.

However the other exceptionally high flying academically gifted female , first, top student etc in the Uk on full maternity leave has not returned to work as a gp after the birth of her third child. Although she had worked as a locum which had helped juggle family responsibilities.

It's common practice in the Netherlands for mothers to work, but most of them work part-time and never return to full-time work.

www.dutchnews.nl/news/2022/09/most-mothers-never-go-back-to-full-time-work-survey-shows/

I wonder if there’s a problem with retention amongst young mothers who are unable to combine motherhood with medicine? What steps could be taken to bring about a change of approach?

Make childcare more affordable, for all families, not just medics. There’s a report today on the BBC about women not being able to afford to return to work after having children.

On training for student medics, there is such a shortage of qualified doctors to do the training that my Foundation Years dd was training students! She was barely qualified herself.

Anyone would think the current government want to leave the country in as big a mess as possible for Labour to sort out….

SueDonim the two families I know both have very high earning non medical partners so combined family income can easily accommodate child care costs. One family can combine working full time as a consultant and the other family can’t combine gp work with three small children.

That sounds a personal choice, then, Ronib. There isn’t much to be done about that, I guess.

SueDonim to some extent personal but also culturally influenced.

ronib

SueDonim to some extent personal but also culturally influenced.

Maybe she's been reading the GN posts which refer to nurseries as baby farms and criticise working mothers for wanting it all.

Good on her for wanting a few years with her children when they're young - and she can afford it. Who knows what she'll do in the future? I doubt if her training will be wasted.

The alternative, of course, would be for the father to take a career break or for society not to invest in women's education.

Growstuff I think we have established that a place at medical school costs the taxpayer £160k or maybe more. There’s a limit on the numbers going through currently 8,500? England has a shortage of doctors and excess deaths are rising.

The consultant obstetrician from Holland is able to hold down a senior role and combine motherhood. Her daughters are thriving presumably with the help of her partner plus good childcare.

I don’t think it’s that fair if female medics drop out for a long time. Yes if it’s any other profession. I don’t mind if lawyers, accountants or anyone else takes an extensive career break . Surely you can see that medics are in short supply and it does impact on the health of the nation?

I recall the Chinese introduced 'barefoot' doctors to alleviate a shortage there.

They did indeed, but these people were not doctors. They were sent into inhospitable regions, with no training or equipment and meant to get on with it. Sounds a bit familiar actually.

Not quite so, Antonia. They did receive training.

The Harvard Public Health Magazine reported in 2018

'Fifty years ago, during the Cultural Revolution in China, a cadre of “barefoot doctors”—some 1.5 million peasants who received intensive three- to six-month training in anatomy, bacteriology, birth control, maternal and infant care, and other topics—were dispatched to provide basic health care for their rural communities. Even in the midst of the revolution’s social upheaval, this low-tech medical corps (named for the fact that many worked in their own rice paddy fields when they weren’t tending to their neighbors) was highly successful, significantly reducing infectious disease and boosting life expectancy. '

It was a low cost strategy that paid off in high health outcomes.

ronib

Growstuff I think we have established that a place at medical school costs the taxpayer £160k or maybe more. There’s a limit on the numbers going through currently 8,500? England has a shortage of doctors and excess deaths are rising.

The consultant obstetrician from Holland is able to hold down a senior role and combine motherhood. Her daughters are thriving presumably with the help of her partner plus good childcare.

I don’t think it’s that fair if female medics drop out for a long time. Yes if it’s any other profession. I don’t mind if lawyers, accountants or anyone else takes an extensive career break . Surely you can see that medics are in short supply and it does impact on the health of the nation?

I don’t know where you have got the impression from that there are high levels of women leaving medicine when they become mothers ronib, as it’s not the case. Far more serious in terms of impact on the medical workforce in the UK is the number of doctors leaving to work overseas, particularly to Australia and New Zealand.

Casdon BMJ 17 November 2021 David Oliver

Only 1 in 20 GP trainees told a King’s Fund survey that they intended to work full time.

Is there any evidence that female doctors leave the profession for ‘a long time’? Do you begrudge them having a family, simply because they are doctors?

I absolutely agree about the comments such as baby farms. For goodness sake. All six of my GC have parents who work FT and all six children seem happy and healthy and in fact have probably had a wider experience of life in nursery than their parents alone could provide. None of them have a double decker bus to play in or a donkey to ride or chickens and rabbits to look after.

BMA has always made sure one way or another that there is a shortage of doctors...

SueDonim what I begrudge most is a Nhs which is not working as it should. I think some hard questions need to be asked about a workable way forward.

If only 1 in 20 trainee gps intend to work full time, then okay but a numerical adjustment needs to be made so that 100 per cent availability is guaranteed.

As we have just heard medical places at university have been capped.

I might not have a string of A stars at gcse (I did o levels) but even I can see a problem here!

I agree, Ronib - we need more doctors, not work the doctors we already have now to death! My dd is currently doing what’s called part-time work, having almost been broken both mentally and physically by working through Covid. That still involves 35+ hours a week, which for most people would be a full time job.

ronib

Casdon BMJ 17 November 2021 David Oliver

Only 1 in 20 GP trainees told a King’s Fund survey that they intended to work full time.

Working part time isn’t the same thing as leaving the profession though, is it? A high proportion of women work part time when their children are young in all professions, and doctors are no different.

SueDonim oh dear that’s hard for you. I know of one young gp who works three days as a gp and two days as an illustrator! This is to maintain mental health.

Seems the health service is a busted flush.
Hope your dd finds her equilibrium again.

The male GPs in my practice only work part-time. I don't know what they do with the rest of their time - maybe they help look after their children or maybe they put their feet up and come into work feeling refreshed.

Casdon I started looking at a gmc report on this and gave up. True that young mothers work part time in all professions but I think that it’s relatively possible, if not easy, to be a full time secondary school teacher as a young mother for example. I really don’t believe that medics in Greece and Germany are working under the extreme conditions that we have here. I have relatives in both countries.

The bottom line is that it’s up to senior Nhs management to find solutions and make adjustments if working part time impacts safe provision in the Nhs. Safe working conditions for staff also need to be a consideration.

Whilst my personal observation tends to say that some mothers do retire early, I do agree that this is not an empirical fact. But facts are in short supply these days.