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Motivations of medical students and doctors leaving the NHS explored in a residency training application webinar series
  1. Setthasorn Zhi Yang Ooi,
  2. Rucira Ooi,
  3. Amanda Godoi,
  4. Eu Fang Foo,
  5. Timothy Woo,
  6. Chunhei Li,
  7. Sashiananthan Ganesananthan
  8. Cardiff Healthcare International Perspectives Society (CHIPS)
    1. Cardiff University School of Medicine, Cardiff, UK
    1. Correspondence to Setthasorn Zhi Yang Ooi, Cardiff University School of Medicine, Cardiff, UK; ooisz{at}


    Background Recent reports show that about 10% of UK-graduate doctors leave the country to pursue specialty training elsewhere. Our article aims to evaluate the motivating factors for UK graduates to leave the National Health Service (NHS), especially during the COVID-19 pandemic and Brexit.

    Study design Cross-sectional study.

    Method A novel 22-item questionnaire was disseminated at a webinar series regarding the application process to pursue residency training in six different countries/regions from 2 August 2020 to 13 September 2020. The data was analysed using Kruskal-Wallis rank-sum with post-hoc Wilcoxon test to compare the difference in significance among the motivating factors.

    Results 1118 responses from the UK medical students and doctors were collected; of which, 1001 (89.5%) were medical students, and 88 (7.9%) were junior doctors. There was a higher propensity for leaving after the Foundation Programme compared with other periods (p<0.0001 for all comparisons). There was no difference between desire for leaving after core surgical/medical training and specialty training (p=0.549). However, both were significantly higher than leaving the NHS after medical school (p<0.0001). Quality of life and financial prospects (both p<0.0001) were the most agreed reasons to leave the NHS, followed by clinical and academic opportunities and, subsequently, family reasons.

    Conclusion Future work on the quality of life for doctors in the UK should be explored, especially among those considering leaving the NHS. Policymakers should focus on assessing the difference in working hours, on-call hours and wages that may differ among healthcare systems.

    • health policy
    • medical education & training
    • human resource management

    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.

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    • CL and SG are joint senior authors.

    • Collaborators Cardiff Healthcare International Perspectives Society (CHIPS): Vin Shen Ban, Moses Chidowe, Ka Ho Oscar Chiu, Elizabeth Fong, Mitchell Goldenberg, Kuhanesh Janardanan, Tze Hao Leow, Ka Ting Ng, Krisada Shen Yang Ooi, Lucinda Raudaschl, Usama Syed, Johnson Pok Him Tam, Kimberly Tan, Nicholas Tan, Qi Jun Tan, Yi Chuen Tan, Joash Tan-Loh, David Yung.

    • Contributors SZYO (conception, design, methodology, writing, reviewing and editing, project administration, organisation of webinar), RO (writing, design, reviewing and editing, visualisation), AG (methodology, writing, organisation of webinar), EFF (methodology, writing, organisation of webinar), TW (data curation, formal analysis, writing, reviewing and editing), CL (conception, data curation, formal analysis, writing, reviewing, methodology, supervision), SG (conception, data curation, formal analysis, writing, reviewing, methodology, supervision). All authors contributed to the article and approved the submitted version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.