One in three UK doctors feel unable to progress their careers as they would like, the General Medical Council (GMC) has warned, revealing a growing risk to NHS workforce retention.
The regulator’s annual survey, published this week, reveals a marginal improvement in doctors’ wellbeing for the second year running. But progress is overshadowed by frustration with career progression, lack of support from senior colleagues and systemic barriers such as training bottlenecks and intense competition for posts.
In its first detailed look at doctors’ perceptions of career advancement, the GMC found a strong correlation between progression and wellbeing. More than 80% of doctors who felt they could advance their careers were satisfied in their roles, and most were at very low risk of burnout. Among those who lacked career control, satisfaction dropped to 33%, and only 18% were at low risk of burnout.
Charlie Massey, Chief Executive of the GMC, said there was an urgent need to modernise the training system. “Doctors need to be satisfied, supported and see a hopeful future for themselves, or we may risk losing their talent and expertise altogether.”
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The report identifies five actions for healthcare leaders and policymakers, including reforming the training system, tackling disparities in workplace experiences and making general practice more attractive.
Growing exit intentions
The findings come amid wider concerns about doctors leaving the NHS, as nearly one in five doctors surveyed by the GMC are considering quitting UK medicine altogether. Among those, a significant number have already applied for roles abroad or contacted recruiters, with countries such as Australia and Canada seen as offering better pay and conditions.
Two-thirds of those considering emigration said they were motivated by pay, but the GMC’s data indicates that career stagnation may be an even deeper frustration, and one that cannot be resolved by pay alone.
The British Medical Association (BMA) has repeatedly warned of chronic underinvestment in training places and staff development. In July, junior doctors held a five-day strike over pay and met with Health Secretary Wes Streeting this week for negotiations. A pause in industrial action has been agreed for August while talks continue.
BMA: ‘We face a bizarre contradiction’
Responding to the report, BMA council chair Dr Tom Dolphin said the findings demonstrated the consequences of a system that failed to support its staff.
“This report shows the very real impact of what happens when a service does not value and support its staff: they will continue to choose to leave.
“We face a bizarre contradiction: we still have near record-high waiting lists and patients are desperate to be seen by doctors, but at the same time able and enthusiastic doctors are forced to consider moving abroad because they see no future in the UK.”
Dr Dolphin said the current shortage of training places was “absurd” given widespread NHS workforce gaps. “Just last week, we revealed that thousands of doctors are facing employment limbo due to a shortage of training places. This is absurd given workforce shortages across the NHS and the growing needs of patients. We need to be training more specialists in the UK to provide the care NHS patients need and deserve, not fewer.”
He added: “The GMC’s findings echo these concerns about career progression and show the effect this has on doctors’ wellbeing and the NHS’s ability to keep doctors working here.
“The solutions to this problem are clear: ensure there are enough roles to keep doctors who have put such time and effort into their training here, while ensuring these jobs are supportive and paid well enough to stop the haemorrhaging of UK doctors overseas when patients and the NHS need them most.”
Knock-on effects for employers
The GMC has emphasised the impact that doctor satisfaction and retention have on patient care. “Improving the experiences of doctors and their environments correlates with enhanced patient care,” Massey said, adding that health systems must capitalise on small wellbeing gains by addressing structural issues.
Workforce experts say employers must now prioritise job guarantees, protected training time and better rota design. Billy Palmer, a senior fellow at healthcare think tank the Nuffield Trust, told The Times that the GMC’s findings “[put] a spotlight on the wider difficulties facing the medical profession. Job guarantees, better rotas and placements and protection of training time need to be on the table”.
GMC’s five calls to action
The GMC’s report recommends the following steps to improve doctor retention and workplace satisfaction:
- Support safe, high-quality care: Employers and governments must ensure working environments enable doctors to deliver effectively.
- Revitalise general practice: Additional support is needed to make general practice more appealing and sustainable.
- Reform training systems: More posts and better support for trainers and trainees are essential.
- Tackle inequalities: Disparities in workplace experience, particularly among minority ethnic doctors and international medical graduates, must be addressed.
- Use data to drive improvements: Health leaders should actively monitor and respond to insights that can shape better working environments.
While the Department of Health acknowledged that career progression and training are major concerns, it said it remained committed to “bringing in ways to recognise and reward talent” and to cutting red tape to free up clinicians’ time.
