Should junior doctors do 5 years of NHS service after they qualify?
‘Education is not the filling of a pail, but the lighting of a fire’ – WB Yeats.
Medical school is an academic greenhouse where the seeds of enthusiasm and academic scholarship in tomorrow’s doctors are planted.
It should produce a plentiful harvest of frontline doctors who will provide cutting-edge care, research scientists who will find solutions to diseases we cannot currently cure, and leaders who will design new paradigms to improve care pathways.
But the reality is that in 2023, many junior doctors (JDs) cannot wait to leave the NHS and work in Australia or New Zealand – where the pay and working conditions are better. And the weather is better.
This is despite the fact that their education in the UK has cost the taxpayer a considerable amount of money; accepting they also have had to pay alot to get through university for one or more degrees. They can easily leave university with £100,000 of debt.
In March 2017, the then Department of Health (DH) proposed that graduates would need to undertake ‘mandatory NHS service’ for a period following graduation or incur a significant financial penalty. If this system was instituted, it would have to be paid if they ever wanted to return to NHS work.
So. Would mandatory service uproot the optimism, enthusiasm and the good will of future doctors? The Royal Colleges have opposed such mandatory service when it has been suggested in the past, saying it would not improve patient care and would be detrimental to trainee morale.
Or what about a financial reward?
Rather than a financial punishment for leaving the NHS, what about a financial reward for staying? For example, we could pay off 10% of a JDs student debt (up to say, £10k a year) for each year completed in the NHS, so long as they are taken in the first 15 years after qualification.
This leeway would allow them to work abroad in their younger years. Despite the title of this article, we think it is good for a JD (and their patients) to gain experience of medicine in other healthcare systems. It is also good for doctors who have trained abroad – and the NHS’s patients they treat – to work in the NHS; passing on medical ideas and practices from their country of origin.
Conclusion
MyHSN would like to hear your view? Would mandatory NHS service (or paying off debt) be a way of improving retention in the NHS (making us less reliant on doctors from abroad), and be better use of public money? Or would NHS service drive even more JDs to abandon the NHS, and work somewhere where they are better paid, more appreciated .. and warmer?
This is a good video on Tik Tok from a JD in the UK, with the counter view and an explanation of why
many JDs want to work abroad (you need to click in the lower area, ie ‘why are doctors leaving .. etc):
@lbc Why are doctors leaving the UK to work in Australia? Caller Liv explains. #LBC #uk #nhs #doctor #australia #doctorsoftiktok #news #ukpolitics
