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JUL 02/2014

Encouraging medical trainees to take up undersubscribed specialisms

Given the increased emphasis on proper staffing levels within UK hospitals, it is likely that there will be a greater number of NHS jobs for trainees available in the coming months and years than ever.

However, there are a number of fields in particular that are currently crying out for an influx of new blood. While it is inevitably the case that certain specialisms will be more popular than others, in recent times there has been an oversupply of staff in certain areas, while others go underserved.

Organisations representing the medical sector seem to be in agreement that the NHS needs to do more to encourage trainees to take up the relatively undersubscribed professions, though the exact form these actions might take remains a matter for debate.

Which sectors are most in need of new staff?
This issue of imbalance within the NHS workforce was recently highlighted in a report compiled by BMJ Careers, which suggested that emergency medicine, paediatrics and psychiatry are all experiencing a relative lack of trainees at the moment.

Meanwhile, the Royal College of Physicians has warned that the acute and geriatric medicine fields require additional manpower, with more posts being advertised in these sectors than any other. However, due to the lack of applicants, around half of the consultant appointments advertised in acute and geriatric medicine in 2012 were either cancelled or left unfilled.

These trends could lead to the possibility of staffing shortfalls in key areas, which would be unacceptable to NHS leaders at a time when efforts are being made to offer expanded seven-day services.

It is particularly important that the gap affecting the emergency medicine sector is filled, as A&E staff are responsible for providing care for those in greatest need. Moreover, emergency departments are typically among the busiest parts of any hospital.

Indeed, the College of Emergency Medicine (CEM) has been campaigning for some time for efforts to be made to address the lack of available A&E doctors, working with Health Education England to devise new ways of addressing the issue.

What can be done to remedy this?
Potential methods of bolstering interest in less well-subscribed sectors of the NHS take many different forms. For example, in Wales, organisations such as Plaid Cymru and the British Medical Association's (BMA's) general practitioners committee have suggested offering financial incentives to those going into fields where demand for staff is high.

One of the key strategies pursued by the CEM is to improve the attractiveness of the specialties themselves, ensuring clearer career progression and better work-life balances by offering more guidance and more generous allocations of paid leave. This would help to prevent UK-trained staff from being tempted abroad.

Clifford Mann, president of the CEM, said: "We must make sure that we are not undoing the good work by failing to retain the expertise we have recruited and developed."

However, many of the issues could be solved if the NHS's training and career progression infrastructure could be made more flexible. This method - as recommended by the BMA - would make it easier for workers to switch between various specialisms over the course of their career, allowing the workforce to react more fluidly to changing demands, while providing more varied options to the staff themselves. 

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