Correspondence

Too far, too long, too few: workforce planning indermatology

doi: 10.1111/j.1365-2230.2012.04391.x

The 2010 British Association of Dermatologists (BAD)annual workforce survey identified 73 vacant consultantposts in the UK, with 52 consultant posts occupied bylocums.1 The UK government agency, the Centre forWorkforce Intelligence (CfWI), consults with stakeholdersto mathematically model future workforce demands, andhas allocated six new dermatology trainees between 2011and 2013.2 However, workforce calculations are limited bylack of data about trainees� current career plans relating topart-time work, academic careers and work abroad. Ananecdotal perception exists that many trainees are

unwilling to move away from the region in which theyhave trained, making it difficult to fill consultant posts inregions with lower trainee numbers.

We conducted a study to explore the plans of UKdermatology trainees completing training for part-timework, work abroad and academic work, and to investigatetheir likely future geographical mobility.

All 201 current UK dermatology trainees1 [traineespecialty registrar (StR) grade 3 and higher] were con-tacted by e-mail, and asked to complete an anonymousweb-based workforce questionnaire between 28 March and10 April 2011.

In total, 62 surveys from all regions were returned (31%response) from 19 male (31%) and 43 (69%) femaledoctors. Of the 62 questionnaires, 1 was excluded becauseit was incomplete, and 3 were excluded because they were

7 (12%)

25 (43%)17 (29%)

9 (16%)I would go to any region in the UK

I would go to the neighbouring regions to the one where I am currently training

I would only stay in the region whereI am currently training

Other

Local medical political situation is favourable

Availability of option to work less than full-time

Likelihood of availability of permanent consultant posts

Proximity to where my partner/spouse/family liveDon’tknow

Not at allimportant

House prices

Patient mix

Opportunity to set up new services or facilities

Where I had studied/worked in the past

Good academic research facilities

Good countryside, or local sporting and leisure opportunitiesNot veryimportant

Neutral

Slightly important

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Availability of private practice

Number of dermatologists per 1000 population servedVeryimportant

(a)

(b)

Figure 1 (a) How far the trainees are

prepared to move to secure a consultant

post; (b) factors considered by trainees

when deciding on the location of a

consultant post.

Viewpoints in dermatology • Correspondence

� The Author(s)

CED � 2012 British Association of Dermatologists • Clinical and Experimental Dermatology 1

from clinical fellows, leaving 58 questionnaires for furtheranalysis.

Response rate per region varied between 10% (South-west) and 45% (Northern and Yorkshire). Response num-bers for StR years 3, 4, 5, 6 and 6+ were 15, 16, 14, 9 and4, respectively, with 45 (77.6%) working full-time and 13(22.4%) working less than fulltime.

Of the 58 respondents, 15 (26%) planned to work part-time (average 6.6 sessions) as consultants, with 13 (22%)undecided, in the 10 years after completing training, thuson average, each trainee would contribute 0.88 whole-time equivalent (WTE).

With regard to working outside the UK, 22 (38%)planned to do so, for an average of 2.7 years, with 10(17%) undecided, thus the trainees on average will spend8.7 years (0.87 WTE) contributing in the UK during the10 years after training.

The combined effect of part-time work and work abroadis that each trainee will contribute approximately 7.7 yearsas a UK consultant dermatologist in the 10 years aftercompleting training (ignoring maternity and sick leave,and stopping work for other reasons).

With regard to the type of work, 13 trainees (22%)planned to work in a mixed academic and clinical environ-ment, 37 planned to undertake clinical work withoutfixed academic sessions, and 8 were still undecided. Mosttrainees (72%) planned to take a consultant post in the sameor neighbouring region (29% in the same region only)indicating that most trainees will not move to distantgeographical areas (Fig. 1a), mainly owing to the perceivedimportance of family life (Table 1, Fig. 1b).

Demand for dermatology consultants has increased3

over the past two decades. Estimates for future numbers ofdermatology consultants have sometimes been ignored,possibly because of a false belief that general practitionerspractising dermatology and telemedicine would result in a

decreased demand for dermatologists. Consequently, thereare many vacant consultant posts in the UK. Estimatingtrainee numbers requires prediction of future demand forconsultants over a period of 5–40 years. Our new datashould enable accurate increased CfWI allocation oftraining posts to allow the shortage of British consultantdermatologists to be corrected.

In conclusion, the choice of part-time work and workabroad will result in a loss of 2.3 years per consultant inthe first 10 years after completing training. The limitedmobility of dermatology trainees indicates that traineenumbers in each region should match projected localdemand.

E. Galinskaya and N. J. Levell*

Department of Dermatology, Broomfield Hospital, Court Road,

Chelmsford, Essex, UK; and *Department of Dermatology, Norfolk and

Norwich University Hospital, Colney Lane, Norwich, Norfolk, UK

E-mail: evguenia@doctors.net.uk

Conflict of interest: none declared.

Accepted for publication 8 February 2012

References

1 2010 British Association of Dermatologists Workforce

Survey (personal communication with Dr Nick Levell BAD.

Honorary Secretary), 23 February 2011.

2 Centre for Workforce Intelligence. Medical Specialty Workforce

Summary Sheet, 2011. Available at: http://www.cfwi.org.

uk/intelligence/shape-of-the-medical-workforce-informing-

medical-specialty-training-numbers/dermatology (accessed

5 February 2012).

3 Levell NJ, Jones SK, Archer CB. Consultant Physicians Working

with Patients, 5th edn. Available at: http://www.bad.org.

uk//site/1440/default.aspx (accessed on 5 February

2012).

Table 1 Factors considered by trainees when deciding on the location of a consultant post.

Factor

Answer options

Very

important

Slightly

important Neutral

Not very

important

Not at all

important

Don�tknow

Responses,

n

Availability of private practice 8 22 16 7 5 0 58

Number of dermatologists per 1000 population served 9 26 19 4 0 0 58

House prices 11 21 21 4 1 0 58

Patient mix 11 26 16 3 2 0 58

Opportunity to set up new services or facilities 14 32 10 1 1 0 58

Where I had studied ⁄ worked in the past and know

first-hand about working conditions there

16 18 15 7 2 0 58

Good academic research facilities 16 26 12 3 1 0 58

Good countryside, or local sporting and leisure

opportunities

19 14 18 5 2 0 58

Local medical political situation is favourable 19 25 10 3 1 0 58

Availability of option to work less than full-time 24 14 9 5 5 1 58

Likelihood of availability of permanent consultant posts 42 14 2 0 0 0 58

Proximity to where my partner ⁄ spouse ⁄ family live 50 5 2 0 1 0 58

Correspondence

� The Author(s)

2 CED � 2012 British Association of Dermatologists • Clinical and Experimental Dermatology