A collaboration between Health Education England (Wessex) and the University of Southampton
The GMC has published “The state of medical education and practice in the UK 2020”

The GMC has published “The state of medical education and practice in the UK 2020”

The report is split into 4 sections:

  1. The state of medical practice
  2. The state of medical education
  3. The changing medical workforce
  4. Learning from 2020


  1. The state of medical practice

This section uses data from the online “Barometer Survey” collected in June and July 2020 through purposeful sampling; completed by 3,693 doctors. The results have been weighted to reflect the UK doctor population on the basis of age, registration status, ethnicity and place in which primary medical qualification was gained. It covers redeployment statistics and other changes to work and whether changes in practice were positive or negative.

A striking difference between the proportion of white and BME doctors who reported positive change is reported, with BME doctors reporting significantly less positive impact. Work-load, work-satisfaction and burnout were reported as reduced compared to 2019, but this was of course when we were in a full-lockdown in June and July. Only 52% of doctors agreed they felt supported by non-clinical management, and 43% reported experiencing a situation whether their own or a colleague’s safety was put at risk. In General Practice 34% reported seeing patient safety and care compromised.

  1. The state of medical education

Not the usual National Training Survey, but a shorter survey (n=27488), which ran from 22 July to 12 August 2020 informs this section. Trainees reported change in their day to day work, with change being reported most in General Practice, Anaesthetics and Occupational Medicine where it was heavier and Ophthalmology and Surgery, where it was lighter. Understandably, training was reported as disrupted most in ophthalmology and surgery. Burnout risk remained the same among trainees and trainers compared to 2019, but it was significantly worse in those redeployed. Again only 52% thought there was a culture of senior leaders in their trust/board listening to trainers.

Foundation Interim Year 1 (FiY1) doctors are focused on in this chapter with data from Newcastle University on 1,448 graduates, 73% of which reported working as (FiY1); 23% of the 4,662 doctors who took up an FiY1 posts. The majority of FiY1 doctors reported they took the posts to learn and gain experience and worked on medical and surgical wards.

  1. The changing medical workforce

This section is based on Medical and Temporary Registers and Postgraduate training data from Health Education England. Licensed doctors are now reported as 48% female and 54% of doctors joining the register in 2020 identified as BME. More International Medical Graduates mainly from South Asia and the Middle Eastern region were licensed to practice than UK and EEA graduates combined in 2020. International Medical Graduates make up 28% of the total number of licensed doctors in 2020. This is of particular interest as the Mutual Recognition of Professional Qualifications Directive will no longer apply to the UK, so EEA graduate doctors may find their UK qualifications are not recognised in their home countries and may no longer chose to train here. This will lower the 9% of doctors licensed with an EEA primary medical qualification. The number of Speciality and Associate Specialist and Locally Employed licensed doctors has grown by four times the rate of trainees from 2019 to 2020.

Only 35% of F2 Trainees continued their training with no pause in 2019 and 10% of the respondents to the Barometer survey were considering leaving the profession, with the most common reason for leaving being their current role adversely impacting their wellbeing. An adverse impact on wellbeing was also sited as the most common reason for moving to a role with less clinical workload.

  1. Learning from 2020

There is acknowledgement in this section of the challenges that have occurred as a result of Covid through redeployment, working patterns, medical school processes, postponed rotations and how clinical duties are carried out. The corporate strategy 2021-25 has a focus on improving the continued lack of visible, inclusive leadership. The lower reporting of positive change from BME doctors is acknowledged and the GMC has written to the profession setting out its commitment to reduce inequalities.

The results are reframed in this section against the backdrop of the core needs of doctors identified in “Caring for doctors caring for patients”: Autonomy, Belonging and Competence, with quotes from commissioned, independent one-to-one interviews with 13 doctors in July and August 2020. To attract and retain the workforce it is acknowledged that workload pressures need to be addressed through increasing the supply of doctors, through the creation of other roles such as Physicians Associates and through encouraging and improving flexible training, but there is a missed opportunity to commit to flexible working.

Click on the link below for the full report:

The state of medical education and practice 2020, GMC.

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