For a number of years, recruitment and retention of staff in the NHS has been challenging: 10.7% of nursing posts and 6.6% of medical posts are vacant. How might the covid-19 pandemic affect staffing in the long term? Covid-19 has introduced considerations that many UK-based healthcare professionals have not had to think of for decades such as the degree of self-sacrifice required to be a doctor and the emotional burden associated with treating those in a pandemic. This may alter the number of prospective medical students and international medical graduates, and the number of doctors retiring or leaving the profession.
We have recently applied to medical school ourselves. We wonder whether the risk that the pandemic presents will deter medical school applicants. How much occupational risk will potential applicants feel is acceptable for a doctor to undertake, in order to look after patients? Although many doctors begin their careers aware of some risks such as blood-borne diseases or equipment-related injuries, the potential of death due to working in a pandemic likely did not cross their mind. Family members, too, may have new reservations about their children exposing themselves to such risks and influence their decision to apply to medicine even if young adults tend to think of themselves as invincible. As we both enter the wards for the first time since the pandemic, the risk of contracting and spreading covid-19 is certainly a worry for us although (somewhat thankfully) our personal risk of severe disease is low enough not to keep us away.
Regardless of the magnitude of risk to doctors, we can also appreciate that the importance of healthcare staff has been highlighted during this time and may serve to increase interest in the profession. As essential workers during the lockdown, doctors’ contribution to society has been acknowledged through “clap for carers” events and a multitude of shop discounts. Being a key part of this fast-moving situation may inspire the next generation. The Association of American Medical Colleges saw a large increase in MCAT registration on their opening day this year and Norway had 16.7% more medical school applicants compared to last year which may show the influence of the pandemic on application rates already, although other contributing factors need to be taken into account.
The UK also relies on a supply of international doctors immigrating to support the NHS. How our government responds to the pandemic compared to other countries may influence foreign doctors in their decision to move to the UK. The lack of personal protective equipment (PPE) and the troubled coronavirus testing programme do not serve as a strong advertisement for doctors considering moving to the UK, and this is even before Brexit has happened.
The last consideration is the effect on the existing workforce: while we have quickly bolstered staffing with final year medical students and recently retired staff, these are only temporary. How many doctors will decide to leave the profession during and after the pandemic due to burnout or psychological distress? The BMA says doctors are at considerable levels of risk at work, which could lead to them moving careers or to other countries. Conversely, doctors who have returned from other jobs may find themselves invigorated and enjoy the heightened sense of camaraderie during these difficult times, inspiring them to continue in medicine once again.
The pandemic has simultaneously stretched medical staff to the limit and brought together the NHS, with the country rallying around its healthcare system. Whilst existing doctors struggle with exceptional circumstances, new medical students will enter into the new normal still excited by their prospects. We too, start our new roles with enthusiasm albeit more cautiously than we would have before. Although the full impact of covid-19 on medical recruitment will only become apparent with time, it is crucial that efforts are made to understand the concerns of our doctors, both prospective and existing, to maintain the quality and quantity of the NHS workforce that our country needs.
Rebecca Lam is starting graduate entry medicine at King’s College London this year.
Jonathan CM Wan is an Academic Foundation Programme (Oncology) doctor at Guy’s and St Thomas’ Hospitals.
Competing interests: none declared