Stop the Brain Drain: Ways to Improve Recruitment and Retention to Scottish Consultant Posts

Abstract

NHS Scotland loses approximately one-third of Specialist Registrars (SpRs) it trains to consultant posts elsewhere. This has considerable resource and service implications and is the cause of intense political frustration. This study sought to gather data about the career intentions of SpRs and to discover what factors influence their career decisions. All SpRs in Scotland due to gain their Certificate of Completion of Specialist Training (CCST) between April 2005 and March 2006 were approached to take part in an interview about their career aspirations. Interviews, using a structured interview schedule, took place in spring 2005. 198 SpRs were interviewed--75% of the target population. Almost three-quarters would prefer to stay in Scotland if possible, but when asked to realistically predict where they would take up a consultant post, this proportion had dropped to 64%. Perceived barriers to working in Scotland included the large number of District General Hospital (DGH) posts (often with onerous on-call rotas). A further problem concerned poor information flow between NHS Boards and trainees, with trainees being lost to Scotland who might have stayed if a job had been advertised in time. The majority of SpRs would prefer to stay in Scotland for their consultant career. There is a need to improve information flow between NHS Boards and trainees. NHS Boards need to know more about the career intentions of trainees and training committees and trainees need to be informed as to when and where posts will be advertised. Posts in DGHs might be made more appealing by having some sessions in larger teaching hospitals (although split-site working is not always popular). Flexibility and part-time options need to be promoted.