Equal opportunity for all? Trends in flexible training 1995-2001

This paper describes current patterns and trends in flexible training in the UK. It is a descriptive study based on (1) survey data on the number of flexible trainees from the annual survey of UK deaneries from 1995 to 2001; (2) Department of Health workforce figures on numbers of consultants and specialist registrars in England; (3) survey data from UK deaneries on the destination of those leaving flexible training schemes from 1999 to 2001. The absolute number and percentage of flexible SpRs in England increased from 389 (3.5%) in 1995 to 1067 (8.4%) in 2001. There is substantial variation by region, with only 4% of SpRs in Mersey being flexible compared with 11% in South Western and Oxford in 2000, and by specialty, with 2% in general surgery compared with 22% in psychiatry and 19% in paediatrics. There was a continued increase in the number and percentage of flexible SpRs over the period 1995-2001. The rate slowed in 2001 and fell in three regions, suggesting a possible adverse effect of the New Pay Deal for junior doctors. Substantial geographical and specialty inequities in access to flexible training appear to exist. If skills and talents of female doctors required to achieve the medical workforce needed in the future are to be retained, these issues need to be urgently addressed.