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Independents' Day

5,000 doctors a year considering leaving the UK to emigrate abroad

Exclusive: The number of GPs applying to the GMC for certificates that enable them to work abroad shows no sign of abating, Pulse has learnt, with many escaping to Australia for the shorter working hours and higher wage.

The number of doctors applying to the GMC for Certificates of Good Standing (CGSs), a document which enables them to register with an overseas regulatory body or employer, has remained at a constant of more than 4,700 per year for the past two years, according to new figures obtained by Pulse.

GP leaders have said it is ‘alarming’ that taxpayers’ money is being invested in training graduates to become GPs, only for them to leave the NHS and have warned that the numbers could be higher, with many coming to train in the UK and returning to their country of origin to practice.

Last year Pulse reported that the number of CGS applications had risen by over 12% since 2008. The latest GMC figures show that the numbers are still increasing, although at a slower rate, with a a total of 4,741 UK-trained doctors obtained CGSs in 2013 - up from 4,726 in 2012.

Pulse has also found that a further 2,485 doctors have received CGSs in the first six months of 2014 alone, compared with 2,479 for the same period in 2013.

Figures from overseas medical regulators also indicate that the level of migration of British doctors to other countries has remained constant. Australia is one of the most popular destinations for UK doctors, with 729 granted the certificates of Advanced Standing that allow them to practice in Australia in 2013, and 945 in 2012.

The Australian Medical Council has awarded certificates of Advanced Standing to over 5,500 UK doctors since 2006, 40% of whom have gone on to complete the 12-month supervised performance assessments needed for general registration.

New Zealand is also an increasingly popular destination for UK-trained doctors, with 469 doctors added to the New Zealand medical register in 2013 and 511 in 2012, according to the Medical Council of New Zealand. Specialist medical recruitment consultants have told Pulse that other sought-after destinations include Canada, the USA and the UAE.

Guy Hazel, managing director of the Austmedic recruitment agency, told Pulse that there are fewer GP vacancies available in Australia compared to three years ago, particulary in the cities where UK GPs want to work. However the interest is still there and he sees a spike in ‘serious’ enquiries every year in August as MRCGP trainees receive their CCTs.

He said: ‘Most GP trainees who apply this August will be practicing in Australia by February next year. Most of them graduate and then spend three or four month locuming before moving over. But it’s not just newly-qualified GPs - I’m helping a 40-year-old GP partner from Northern Ireland to move over this week. I see a lot of partners looking to move because they’re attracted to the lifestyle.

‘GPs might work a 65 hour week in the UK. In Australia, they’ll work 40 and probably earn more. Once they’ve settled and gotten to grips with the Australian system, which takes about three months, a UK-trained GP could easily be earning $260,000-300,000 (£143,000-165,000)’

Paul Brooks, the managing director of the EU Health Staff agency told Pulse that many of the 100 or so UK doctors he has helped emigrate in the last year have sought to escape the ‘overwhelming bureacracy, paperwork and rationing of healthcare’ they associate with the NHS.

‘Two years ago, we’d have found a job for any GP that applied. Now there aren’t as many jobs, and not everyone will get one - but the interest has stayed pretty much the same.’

Pulse reported last year that Australia has seen a ‘sharp increase’ in the number of overseas GPs entering the country since 2006. Mr Brooks added: ‘Money clearly plays a part in it as well. Most GPs aren’t earning the figures they Daily Mail thinks they are, and they can earn quite well in both Australia and Canada.’

GPC negotiator Dr Beth McCarron-Nash said that the ‘deterioration’ of primary care in the UK was likely to prompt GPs, especially those who are newly-qualified, to consider careers abroad.

She said: ‘Trainees want their work/life balance to be healthy. They see the excessive demands and workloads placed on general practice here, and decide that this isn’t what they want long term.’

She added: ‘It’s very alarming for taxpayers to know that all that money has been invested in young doctors who are considering not working in the NHS. We need to ensure that the best and the brightest remain here.’

Dr Krishna Kasaraneni, chair of the GPC’s training committee, said that GPs of all ages and levels of experience are being lost to the healthcare systems of foreign countries. He concedes that the true number of GPs emigrating may be much higher, as the CGS figures do not include doctors from other countries who train in the UK and then return to their countries of origin to practice.

He said: ‘It’s not that one particular age group, gender or location are feeling hard-done by - it’s the fact that general practice is getting more and more stressful. It’s about self-preservation. I don’t blame any of my colleagues for wanting to leave. The workload in general practice is getting more and more every day without the resources to try and cope with it.

‘UK GPs are a great resource for any health system, but if we don’t respect them, we will lose them. It’s already happening.’

In the absence of any official data, the number of CGSs issued each year is the most reliable indicator of how many doctors are considering moving abroad. However, not all doctors who hold a CGS leave the country, and many of those who do remain on or return to the medical register.

The RCGP is proposing allowing GPs to have their annual appraisal whilst in another country,possibly via Skype, in a bid to remove barriers for GPs wanting to return to practise in the UK.

Number of doctors issued with Certificates of Good Standing (CGS)

2013 4,741

2012                     4,726

2011                     4,462

2010                     4,084

2009                     3,913

2008                     4,222

Source: GMC



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Readers' comments (34)

  • No surprises here then. With F2 drs seeing more of the realities of general practice these days, before they have to make their specialist training choice, I can't see a flood of applicants for GP. My current F2 is keen to do GP. In Australia. She is booked to leave in 6 months.

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  • I've been in this wonderful system for 10 years and just received my registration back home wherever it is.....pity UK politicians bragged to the world about their gem - the NHS- and then set to bury it alive. UK Pailiament needs it's own Mental Health review

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  • Unless the government steps in curb NHS restrictions on GPs the brain drain will continue.
    Julkien Given of newcastle grup had sted with facts and figures that if gPs are alllowed to prescribe slightly more expensive but cost effective medication immidite and long term costs would be reduced.Prof Tony Barnet's statement backed by EBM also confirms this
    NHS and GMC are supoosed to protect the public which they do not seem to be doing as noted below.
    However also, in interest of preserving Public Confidence in the Profession, quite often regularity bodies address partic Particulars ignoring very important Public Health Issues., which can affect Doctors careers and the public. I produce three illustrating case scenarios which are a common occurrence in General Practice.
    NICE guidelines say if we fear hypoglycaemia we should not prescribe Sulphonylureas, which endocrinologists say often occurs with them
    Picture 3 cases of GPs.
    1) A GP forced by the cost-cutting NHS PCT to prescribe cheaper Sulphonylureas as second line treatment in Diabetes Mellitus, His patient drops his blood sugar detected by Traffic officers to 2.2mmol/litre. His GP because of cost-cutting could not provide him Blood Sugar testing strips.
    The GP is hauled before GMC for allowing his patient to meet with an accident, and to preserve public confidence is struck off the GMC List
    2) A conscientious GP REFUSES TO PRESCRIBE Sulphonylureas as second line treatment. His PCT trumps up charges against him and hauls him before GMC.GMCFTPP releases GP places him back on GP specialist List. The PCT trumps up further charges, steps up impractical unproven goals and sends him before GMC. The demoralised conscientious GP suffers physically and mentally from this torture. His defence bodies, because of the three years GMCFTPP took to clear the doctor, refuse to continue their indemnity. The GMC takes PCT’s claims seriously, ignoring Public health issues involved which the GP brings up. To preserve’ public confidence’ this GP is also struck off.
    3) A third scenario is an NHS accommodating GP prescribes Hypoglycaemia inducing Sulphonylureas and his patient dies of it. The death is labelled as a Prinzmetal Variant MI or cardiac arrhythmia, which have no post mortem evidence. The GP has got off scot free and will live with his biting conscience for the rest of his life. In such circumstances being a GP in the UK is a curse

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  • it can be fixed! Return pension contributions to what they were rather than having partners pay over 30% of their income. The state should pay for medical indemnity as this is another 10% of pay. Remove CQC as a complete waste of time. Stop pointless revalidation. Remove useless ratings of practices and the ability to rant officially online on NHS choices. Then allow doctors to manage health needs over health wants. Also allow GPs to get on with the job of seeing patients. Oh and of course, increase pay and practices income, at least in line with inflation!! Simple as that!!! Funny thing is - when you read this back, you realise why their is a brain drain and a recruitment crisis!

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  • Anonymous | GP Partner | 28 July 2014 11:53am

    Do you see where you've made a grave error?

    Thinking the political-media axis have the best interests of people in mind and want a solution.

    They don't care.

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  • Took Early Retirement

    Who cares about those "considering" it. What you need to do, dear colleagues, is to "Action" it. Either emigrate, or leave early as I did. It is an effective form of industrial action which will help those who remain, and HMG can do NOTHING to stop you. Another bonus.

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  • @ john glasspool -
    With all due respect simply asking the older doctors to leave and the young ones to emigrate does not solve the problem...yes, you and the various people above who consistently blame politicians for not caring isn't going to help either....GPs themselves are partially responsible for the mess that they are's GPs who agreed to CCGs, it's GPs that over medicalise creating an unsustainable workload, it's GPs that encourage nanny statist 'cradle to grave' dependency amongst patients not willing to take even the slightest reasonable responsibility for their Health...we got ourselves into this mess

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  • to 12:51 You couldn't have been more wrong. Gps dont grab patients from their necks to the consultation rooms . Patients want medical term for every tiny problem . The reason for more work load is simply because the nation is getting older and there aren't enough GPs . UK has one of the lowest doctor per 1000 patient in the western world if not the lowest . As for me I made up my mind I am leaving too. Best of the luck to you all.

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  • I agree with John Glasspool.

    Since the GPC are spineless in this matter, passive resistance or leaving the profession in this country is the only way of sorting out the problem.

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  • Took Early Retirement

    "it's GPs who agreed to CCGs,"

    ER.... nope, we didn't!

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