The findings of a new study based on in-depth interviews with individuals about to leave for work in other countries have concerned doctors’ leaders, who warn that Scotland’s NHS cannot afford to lose more expertise.
In one of the first studies of its kind, 17 Scottish-based foundation year two doctors were asked about their reasons for leaving.
Staff shortages, a feeling that it was difficult to raise concerns about their jobs, the financial implications of Brexit and the threat of Scottish independence were among the reasons mentioned.
The perception that Australia and New Zealand were more attractive places to work contrasted with complaints about the lack of work-life balance in Scotland.
Loneliness at work, in particular a lack of contact with other doctors, was an issue for some, as was bullying.
One interviewee described breaking down when shouted at by a consultant.
“I was sitting flicking through a massive set of notes and then the consultant walks round the corner and goes: ‘What are you doing?’ and shouts at me in front of all the nurses, everyone on the ward,” the interviewee said.“Then when you get a bit tearful, tells you to grow up in front of everyone, very publicly. Numerous occasions like that, particularly in surgical jobs.”
The study said: “Loneliness at work, a lack of support from seniors, dysfunctional relationships and bullying at work were all cited as reasons for lack of enjoyment in their foundation jobs.”
Research author Dr Samantha Smith said negative reasons for leaving such as bullying were “very concerning”. “Even if just one person is experiencing bullying in the workplace that is a bad sign and my own experience in the NHS suggests that bullying does exist there,” she said.
“I wanted to find if there were ways we can discourage people from going and we conclude – at the end of the research – probably not. But there are ways to encourage people to come back by making the NHS a really attractive place.”
The study has been published amid concern over consultant and GP shortages in Scotland. Last year a study suggested Scotland had a record 470 consultant vacancies. The shortage of family doctors was outlined in a survey which this month suggested a quarter of GP surgeries were at least one short.
Chair of BMA Scotland’s Junior Doctors Committee, Dr Adam Collins, said: “The reasons cited for leaving should concern and dismay all those who supervise Foundation Doctors in Scotland. Lack of senior support, bullying, lack of support to resolve work-life conflict, the undervaluing of health care professionals, a negative working atmosphere, lack of formal teaching, and difficulty raising concerns all speak of an NHS under pressure that is not adequately supporting the next generation of doctors.”
Health Secretary Shona Robison said: “Brexit – and the UK Government’s determination to end free movement of workers – threatens our ability to continue to secure skilled staff for our health service. We recognise the importance of recruiting and maintaining medical talent in Scotland and are listening to the views of trainees so we can keep offering high quality, supportive training posts while we continue to fill the vast majority of junior trainee posts at 100 per cent.”