Recruitment to UK cardiothoracic surgery in the era of public outcome reporting
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Stephen Westaby1, Kamran Baig2, Ravi De Silva3
1John Radcliffe Hospital, Oxford, UK stephen.westaby@ouh.nhs.uk.
Insights
UK cardiothoracic surgery faces a recruitment crisis, with fewer UK graduates and a rise in overseas doctors. Negative publicity has impacted morale and interest in this vital surgical field.
Area of Science:
- Medical Workforce Analysis
- Surgical Recruitment Trends
- Healthcare Policy Impact
Background:
- UK cardiothoracic (CT) surgery has experienced significant morale issues since 1999 due to widely publicized events.
- A growing need for more surgeons highlights potential challenges in maintaining the workforce.
Purpose of the Study:
- To investigate the impact of negative publicity on recruitment and demographic changes in UK CT surgery.
- To analyze trends in the specialty between 1999 and 2014.
Main Methods:
- Data collected from the SCTS public portal, GMC Specialist Register, and NHS Annual Workforce Census.
- Demographic analysis of UK consultant CT surgeons focusing on country of primary medical qualification and ethnicity.
- Comparative analysis with other surgical specialties, cardiology, and respiratory medicine.
Main Results:
- A significant decline in UK medical graduates entering CT surgery.
- A 4-fold increase in consultant appointments from Europe, with a high percentage of overseas graduates in various CT subspecialties.
- Low female representation (5%) in the current CT surgeon workforce, with only 32% of trainees being UK graduates.
Conclusions:
- Negative publicity has detrimentally affected recruitment in cardiothoracic surgery.
- The low proportion of female surgeons and declining UK graduate interest may exacerbate recruitment challenges.
- Urgent action is required to revitalize interest and improve recruitment in the specialty.
Objectives:
Since 1999 important widely publicized issues have affected morale in UK cardiothoracic (CT) surgery. Because more surgeons are needed, we sought to investigate whether these events have affected recruitment and demographic change in the specialty between 1999 and 2014.
Methods:
We collected information on UK consultant CT surgeons using the SCTS public portal, the GMC Specialist Register and the NHS Annual Workforce Census via the Health & Social Care Information Centre. We analysed the demographics of UK CT surgeons with regard to country of primary medical qualification and ethnicity between 1999 and 2014. We compared the changes with other surgical specialties, cardiology and respiratory medicine.
Results:
There has been a worrying decline in UK medical graduates entering the specialty and a 4-fold increase (282%) in consultant appointments from Europe. Whilst consultant numbers expanded by 83% overall, 59% of congenital heart surgeons, 46% of thoracic surgeons and 36% of adult cardiac surgeons are overseas graduates. It is found that 5% are female. Currently, only 32% of trainee surgeons are UK graduates. Of those receiving UK Certificate of Completion of Training in 2013, only 18% were UK graduates compared with 68% in 2000. Comparison with other specialties shows fewer UK graduates in CT surgery with the exception of Obstetrics and Gynaecology (52%). In cardiology, 77% are UK graduates with only 8% from Europe.
Conclusions:
Repeated negative messages have had a detrimental influence on recruitment. Because 55% of UK medical graduates, but less than 5% of CT surgeons are female, recruitment problems may worsen. Action is needed to restore interest in the specialty.
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