Jessica O'ConnorMore than half of Northern Ireland’s final and penultimate year medical students are planning to leave the region’s health system after graduation, with most looking to Australia for better pay, working conditions, and training opportunities.
The findings come from a new survey conducted by BMA Northern Ireland, which painted a concerning picture of a looming workforce crisis in the health service.
The survey asked students at Northern Ireland’s two medical schools about their career intentions post-graduation, including whether they plan to stay in Northern Ireland and what factors are influencing their decisions.
According to the results, 54% of respondents said they were either planning to leave or were currently undecided about where they would work after completing their foundation training.
Of those who reported plans to leave, more than 66% said they intended to work in Australia.
Among students planning to either leave Northern Ireland or exit the medical profession entirely after foundation training, over 81% cited pay and workplace conditions as their primary motivation.
This was followed by dissatisfaction with the current state of the health service, and more than half of these respondents pointed to poor experiences during medical education or training as a key reason for their decision.
Only 3.92% of students surveyed considered doctors’ pay in Northern Ireland to be fair or adequately rewarding.
However, over 83% said that improved pay would encourage them to remain in the region, while nearly 77% said better working conditions would influence them to stay.
Students who are choosing to remain in Northern Ireland overwhelmingly pointed to the presence of family and support networks as the main reason behind their decision.
One student remarked: “[Doctors] Not treated with the value that is deserved. Underpaid compared to other counties. Too competitive for training programmes.”
Another wrote: “I have no intentions of working long term in the NHS. I plan to move to Australia or New Zealand, either to train or upon achieving CCT. Better lifestyle, better remuneration. UK is a race to the bottom – doctors no longer valued; disrespected and vilified.”
Others expressed sadness and anxiety about the prospect of starting work in the current system.
“I honestly dread the thought of working as an F1 in NI with current conditions. Extremely sad after five years you should be excited to graduate and work,” one respondent said.
Milan Kapoor, chair of the BMA’s Northern Ireland medical students committee, described the findings as deeply troubling.
Kapoor added: “It should be deeply concerning to all of us that a significant number of medical students on the verge of graduating are already planning for careers elsewhere after they complete foundation training.
“Northern Ireland medical students graduate with high levels of debt. They also have first-hand experience of workplace pressures in the health service and this has a huge impact on the quality of education and training while on clinical placements.
“It should therefore come as no surprise that they are looking elsewhere for better pay and training quality in health systems outside of Northern Ireland.”
Kapoor added: “Over 90% of those surveyed said they still wanted to pursue a career in medicine so it is imperative that the government do all they can to encourage these newly qualified doctors to stay here for the duration of their careers.
“Aside from addressing doctors’ pay and workplace conditions, one area they can tackle to help this is fixing the unfair and complicated student finance system.
“It saddles students with a large amount of debt as soon as they start work and penalises those from lower-socio economic backgrounds from studying medicine. These debts are another factor in resident doctors seeking work in better paid health systems in other countries.”
Dr Alan Stout, chair of the BMA’s Northern Ireland Council, echoed Kapoor’s call for urgent action.
He said: “This sounds an alarm for an increasing workforce crisis with worrying implications for a health service system that is already operating with unsafe staffing levels.
“We owe it to the patient population to encourage these doctors of the future to stay and work in Northern Ireland. That means valuing doctors with timely and adequate pay uplifts alongside targeted workforce planning.
“Long-term, we need to see urgent roll-out of HSC transformation as outlined in countless transformation reports, and transformation that is properly funded by ring-fenced, multi-year budgets.”
