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Last Updated: Wednesday, 21 July, 2004, 00:21 GMT 01:21 UK
Doctors opt for general practice
Doctors want flexible working patterns
More newly trained doctors are opting for a career in general practice rather than hospital medicine, a survey suggests.

The British Medical Association says general practice offers more opportunity for flexible working.

It says more rigid working patterns in hospitals do not appeal to many doctors seeking a better work-life balance.

The research also highlights concerns that new limits on junior doctors' hours may damage patient care.

Hospitals are going to have significant staffing problems if they don't extend opportunities to work flexibly.
Dr Jo Hilborne
The BMA has been monitoring the progress of 490 doctors who graduated in 1995 on a yearly basis.

Almost three quarters are now either working part-time (25%) or would like to in future (45%).

The figures show the flexibility of general practice is the main reason for a sharp rise in the numbers choosing to become family doctors.

Almost half (46%) of the GPs surveyed were working less than full-time, compared to less than 10% of the hospital doctors.

The proportion of the cohort already working as GPs has increased from less than a quarter in 2001 to more than a third in 2003, and the proportion planning to enter general practice has risen from less than a fifth (18%) at graduation, to more than a third (34%) in 2003.

Changing perception

The growing popularity of general practice marks a major shift in doctors' perceptions.

Over recent decades it has been seen as a less glamorous alternative to hospital medicine.

However, reform of the out-of-hours component of the job has helped to make it more attractive, and it is the one branch of medicine which has been swift to recognise the importance of offering flexible and part-time working patterns.

These options are often particularly attractive to female doctors, who want to combine a career with having a family.

Dr Jo Hilborne, deputy chairman of the BMA's Junior Doctors Committee, said the results highlight the need for better work-life balance for all doctors.

"Working in a hospital is often very demanding, and balancing responsibility to patients with the needs of a family can be stressful.

"Given the changing expectations of doctors, hospitals are going to have significant staffing problems if they don't extend opportunities to work flexibly."

Long hours

The survey shows long hours are still a problem. As of August 2003 - when the survey was distributed - more than a half of senior house officers were still working above their contracted hours.

And for many junior doctors, the European Working Time Directive, which will introduce a maximum 58 hour working week from August, has actually meant a more intense working life.

As a result of the legislation, trusts are replacing traditional on-call rotas with shift systems that require long stretches of continuous work of up to 13 hours.

Where these approaches have been adopted, only two in five doctors (44 out of 110) believe they have been effective.

Many complain that although their hours have gone down, quality of training and patient care has suffered.

Mr Simon Eccles, chairman of the BMA's Junior Doctors Committee said: "Reducing doctors' hours to safe levels is long overdue.

"However, many trusts have suddenly realised the deadline is coming, panicked, and arbitrarily introduced working patterns that are bad for both doctors and patients.

"Managers need to work with junior doctors to develop ways of meeting the limits that ensure neither training or quality of care suffer."

Alastair Henderson, policy manager at the NHS Confederation, which represents NHS trusts, said the increased popularity of general practice proved that the new GP contract had been a success.

"We do recognise that greater flexibility in working hours for hospital doctors is important, but Improving Working Lives initiatives and the new consultant contract should make progress in this respect."

NHS 'facing new staffing crisis'
08 Apr 04  |  Health
EU law 'threatens NHS care'
06 Apr 04  |  Health
GP shortage 'worsens'
28 Jan 03  |  Health

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