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Maternity medics threaten mass exodus

New contract would lead to loss of two-thirds of junior obstetrics and gynaecology doctors

Mark Gould

Monday, 30 November 2015

Imposing a new contract could lead to a huge exodus of junior doctors from obstetrics and gynaecology (O&G) and put pressure on hospitals' ability to provide vital out-of-hours care for women and their babies, according to a new survey.

As junior doctors representatives meet NHS managers at the arbitration service ACAS today in a bid to head off the first of a series of strikes starting tomorrow, the survey reveals that nearly two thirds of junior O&G doctors may look for alternative work abroad or leave the profession altogether due to unhappiness about the government's contract offer.

The survey of a third (521) of the UK's junior O&G doctors, carried out by the Royal College of Obstetricians and Gynaecologists (RCOG) National Trainees Committee found that:

  • 97% of O&G trainees are unhappy with the proposed contract
  • Only 34% of trainees plan to complete their training if a new contract is imposed (compared with 90% if no changes are made)
  • A third (34%) of trainees would look abroad for work
  • 21% would leave the profession altogether

Obstetrics and gynaecology are high intensity emergency specialties and junior doctors already provide seven-day care. There are currently 1,600 O&G junior doctors in the UK whose responsibilities include caring for women throughout pregnancy and childbirth as well as treating many women's health conditions.

In a reflection of the recent BMA ballot, 97% of O&G trainees answered that they are unhappy with the current contract proposal.

If there was to be no change to current working conditions, 90% of junior doctors indicated that they intend to complete their training in Obstetrics and Gynaecology. Worryingly, this drops to just 34% intending to complete their training if the new contract is forced through. Unsurprisingly, the senior registrars (ST5-6) are much more likely to keep going (50%) than those earlier in their training.

Only 25% of doctors in their second year of specialist O&G training plan to continue training if the new contract comes in at the start of August 2016. The drain from the speciality is highlighted by the fact that many people would remain in O&G but look to work abroad (34%) and just over one in five intend to leave medicine for an alternate career (21%).

Commenting on the survey results, Dr Matthew Prior, a junior doctor at Nottingham University Hospitals NHS Trust and Chair of the RCOG Trainees' Committee, said such a loss of junior doctors would have a huge impact on the care received by women both the short and long term.

"The majority of out-of-hours care in the UK is led by junior doctors and the survey confirmed this, with most units relying on junior doctors (41%) or a combined tier of junior and senior registrars (34%) to provide emergency care. Only 9% of units have a resident consultant at all times.

"When taken in the context of one in five training posts going unfilled and a ‘drop-out’ rate of 18% this new contract may seriously compromise the vital around the clock care needed by women in this country as well as create a recruitment and retention crisis of a worrying scale.

"We are glad that the Department of Health has agreed to conciliatory talks with the BMA via mediation but we continue to urge to Secretary of State to drop the threat of imposition of contract changes, firstly to avert the impending industrial action, but also to find a solution to the contract changes which does not risk jeopardising the future of our workforce," he said.

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