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The state of medical education and practice in the UK: 2017 report

Our seventh annual report on the state of medical education and practice in the UK sets out an overview of issues that feature prominently in healthcare.

It examines the GMC data relating to the changing medical register and explores  the patterns of complaints about different groups of doctors.

In our 2016 report we highlighted the ‘state of unease’ gripping the UK’s medical profession. This was the first time we had expressed such a serious concern about the pressure on doctors and the effect this was having on their morale and wellbeing.

From what doctors tell us – through their feedback, behaviour and choices – it is clear that this ‘unease’ has continued through 2017.

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Chapter one: Our data on doctors working in the UK

Chapter one provides an overview of the UK medical register in 2017. We consider how the make-up of the medical workforce continues to change in terms of age, gender and ethnicity. We look at how the number of licensed doctors has increased in 2017 after a period of remaining steady, and possible reasons for this.

We examine how the profiles of particular specialties have changed since 2011 – some are growing while others are shrinking, and some have a greater reliance on older doctors and non-UK graduates. We also look at how there has been a fall in doctors coming to the UK from many regions of the world.

Chapter two: Our data on medical students and doctors in training in the UK

This chapter presents data on medical students and doctors in training in the UK. We examine how the population of medical students has changed between 2012 and 2016, and how the population of doctors in training has changed between 2012 and 2017. There is a particular focus on gender in individual specialty training programmes, and on the number of doctors in full-time and less than full-time training.

There was a 116.6% increase in doctors on the emergency medicine training programme between 2012 and 2017 and an 8.8% increase in GP trainees. Several training programmes have seen a reduction in the number of doctors in training, including psychiatry (-8.8%), pathology (-8.4%) and core training (-8.1%).

Chapter three: Complaints about doctors

We examine the number of complaints that we received in 2016 and how these complaints were resolved. In 2016 the number of complaints was similar to 2015, falling by just 1%. This is 10% higher than in 2011, but shows that the annual fall in complaints each year since 2013 is continuing.

The proportion of complaints which are fully investigated has fallen from 33% in 2013 to 18% in 2016. We look at how changes in our complaint handling processes might have contributed to this fall.

Chapter four: Groups of doctors with higher rates of complaints and investigations

While only a relatively small number of doctors receive complaints each year – the equivalent of 3% of doctors each year between 2012 and 2016 were the subject of a complaint – we know some groups of doctors have a higher rate of complaints and investigations from particular sources and about particular allegations.

Our data in this chapter tells us that GPs are more likely to be complained about than other types of doctor (17% received a complaint between 2012 and 2016). We looked at specialty groups and saw that occupational medicine (19%) and psychiatry (18%) were the specialists most likely to be complained about. Doctors on neither the GP nor the Specialist Registers and not in training are considerably more likely to reach the threshold for a GMC investigation.

We looked at which groups of doctors are more likely to receive a sanction or a warning – male doctors and doctors who graduated outside of the UK – and we also looked at who is making complaints and what these complaints are about.

Chapter five: Regional and country differences in our data about doctors

In this chapter we look at how the medical workforce is deployed and distributed across the UK, and at changes from 2012 to 2017 at a regional level. We found that most differences between the countries of the UK were relatively small, and that there were far more similarities than differences, but there were some variations.

We look at Scotland, where there are more GPs per head of population than any other country; at Wales, where the population of doctors is older than the rest of the country; at Northern Ireland, which has the lowest proportion of non-UK graduate and BME doctors; at England, which is very close to the UK average in all areas due to its size (84% of UK licensed doctors are in England). In England’s case we look at some variations between English regions where significant.

Reference tables

These tables cover GMC data relating to the register and medical education from 2012 to 2017 and fitness to practise for 2011 to 2016. They provide the source information used to develop many parts of this year’s report.

Register of medical practitioners

Register of medical practitioners, by country and region

Medical students and doctors in training

Fitness to practise