UK trainee doctors spurn obstetrics and gynaecology

The specialty of obstetrics and gynaecology is facing a recruitment crisis, the Royal College of Obstetricians and Gynaecologists said last week. It said that the number of medical students opting for a career in the specialty has fallen dramatically over the past 10 years.

A thousand new consultants were needed to plug the gap, which has resulted from poor workforce planning and a lack of enthusiasm for the specialty among medical students, said a panel headed by the college's president, Allan Templeton.

Only about two in every 100 medical graduates were now opting for the specialty, a figure that needed to be trebled if hospitals were to keep pace with increasing expectations from patients and an expanding NHS, the panel said.

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Obstetrics and gynaecology suffered a dramatic cut in training posts in the late 1990s, and this—coupled with poor experiences of the specialty among undergraduates—meant that many medical students saw it as a difficult career path, the panel's research indicated.

“People want a work-life balance these days, and on the maternity suite there's no escaping night work,” said Professor Templeton. “Also, because of cuts in the past, there is a perception that there won't be a job for you when you graduate. This hasn't been true for some time.”

Difficulties with undergraduate attachments, including students (particularly men) being excluded from the delivery room, were also to blame, the authors said.

“There is more of a `I have my rights' culture among patients,” said Richard Warren, honorary secretary of the college. “They are more likely to say, `I don't want a student here.'” The percentage of male graduates opting for obstetrics and gynaecology fell to 0.8% in 2002.

The result was that students were being deprived of vital experience, the panel said. “It's difficult to get enthusiastic about a career if you're kept on the other side of a closed door,” said Jenny Higham, a senior lecturer at Imperial College.

The full implementation of the European Working Time Directive in 2009 and the college's plans to increase the presence of senior consultants on maternity wards mean that the need for new consultants was urgent, the panel argued.

“In the meantime we'll have to be reliant on overseas doctors,” said Mr Warren. “But there are ethical questions about taking people who are often the best and brightest from countries that are desperately in need of them.”