Doctors are struggling to get a job, with BMA Scotland warning that the deepening unemployment crisis caused by chronic underinvestment in training posts requires urgent action.  

Despite rising patient need and demands on NHS Scotland, the number of training posts available has led to an increasingly small fraction of  qualified resident doctors – previously ‘junior doctors’ – applying. 

This shortage means graduates from Scottish medical schools feel forced to leave Scotland in search of jobs while others move into locum work or find roles to ‘fill the gaps’ for their local health board. 

It comes amidst concerns over the ability of clinicians to deliver extra appointments pledged by the government over the next year, with health leaders pointing to ‘unsustainable’ levels of agency and bank use to keep NHS Scotland staffed. 

Dr Chris Smith, chair of BMA Scotland’s Resident Doctor Committee, told healthandcare.scot that politicians must work with health leaders to address this crisis:

“The prospect of growing medical unemployment is a sobering one and is undoubtedly a fact that the profession and politicians will need to tackle imminently. 

“This is an issue which has been building and worsening over the past few years and leaving an increasing number of resident doctors facing unemployment at a time when the NHS is struggling with a workforce crisis and needs more doctors to keep up with the demands of an ageing, frailer population. 

“While some patients are struggling to get the appointments they need, there will be doctors who want to work but can’t.” 

Launching the Scottish government’s programme for government this week, the First Minister promised it would deliver “more capacity and more opportunity for people to access health services”. 

John Swinney said he and health leaders will explore the challenges raised by the doctors’ union next week.

Speaking on BBC Radio Scotland after his pledge to eradicate long waits, he said he has been assured by NHS leaders that recruitment is going well – advice that appears to “completely contradict” what doctors on the ground are experiencing:  

“I want to ensure we've got opportunities for trained doctors to make their contribution to the health service, and we need them, because we need that capacity.” 

“I had my weekly health service meeting yesterday and I was pressing the NHS leadership in front of me about recruitment and was being assured it was going well and contributing to the improvements we’re seeing in performance and capacity we’re seeing in the health service. 

“This is a one-week warning to my health service leadership who’ll be in front of me next Tuesday that this is an issue we’ll be talking about.”

BMA Scotland’s Dr Smith said the union shared ‘stark information’ around the issues facing resident doctors with Scotland’s health secretary during engagement back in December.

In a blog post published this April, he said the scarcity of training posts for qualified resident doctors is a prospect that he wouldn’t have believed when applying to medical school. 

Dr Smith told healthandcare.scot that urgent action is needed to return medicine to a secure profession – for current and incoming doctors, the wider NHS workforce and patients: 

“Some resident doctors may even face having to move to another country to reach their full potential, or seek alternative careers altogether, with the risk they may never return to Scotland. 

“We are concerned that without urgent action, the problem of medical unemployment will rapidly escalate into a crisis for not just for resident doctors, but by extension, our NHS and patients in Scotland.”

Read more: Corridor care ‘the norm’ in struggling hospitals; Scottish doctors happier but still at risk of burnout; Current metrics fail to capture NHS activity; NHS Scotland: waiting lists and beyond; Shocking levels of violence towards NHS staff; Watchdog criticises homelessness health service cuts; Report spotlights burnout and discrimination; Racism in NHS Scotland still rampant; First Minister unveils NHS renewal plans;  NHS Chair: “I'm sorry”

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