Abstract
In a year dominated politically in the UK by Brexit, and in health by ongoing disquiet among medical professionals about service delivery in the NHS and its sustainability, it seems fitting, although not deliberate, that this month’s research paper explores doctors’ intentions of remaining in the UK. 1 A cynic might dismiss this study as merely a questionnaire survey, but this is the latest study from probably the leading research group in this field. Indeed, the work of the UK Medical Careers Research Group encompasses surveys of multiple cohorts of doctors over many decades.
Unsurprisingly, a greater proportion of doctors from UK family homes intend to remain working in the UK than those defined as non-UK residents. However, a closer look at intentions of doctors from UK family homes reveals a worrying trend. Surveys from the 1980s gave a range of 49.7–57.8% of doctors definitely intending to stay in the UK. For the next two decades, that percentage was lower but stable, in the range of 37.5–49.6%. The latest survey, based on a questionnaire distributed in 2015, finds that only 25.8% of doctors from UK family homes definitely intend to practise in the UK. Things are unlikely to get better.
These surveys are of doctors who are three years post-graduation, which means that younger doctors are increasingly looking to establish their careers overseas. This is a bad outcome for medical schools who train doctors, and the health service which creates the environment for on-the-job training. It is a damning indictment of the state of the NHS, a globally renowned and nationally loved service entering its 70th year, and adds to doubts about its sustainability.
The political dimensions of medicine raise their heads elsewhere in this issue. One of the more bizarre entanglements of Donald Trump’s US regime was a complaint against the Cuban government that an illness outbreak among staff at the US embassy in Havana was caused by an acoustical attack. Robert Bartholomew investigates the plausibility of these claims. 2
After Christmas in 1941, Winston Churchill developed chest pain while opening a window during a stay at the White House. He soldiered on, of course, but Allister Vale’s and John Scadding’s detailed review examines whether this illness was indeed caused by a myocardial infarction. 3
Returning to 2017, Stephen Hawking created more history in a brief amount of time with a remarkable talk at the Royal Society of Medicine about the NHS and the misuse of statistics by politicians. 4 You can read the full transcript of Hawking’s talk in this month’s JRSM, an issue that reminds us that although 2017 may be remembered as the year of fake news, genuine news was often more worrying than fiction.