The state of medical education and practice in the UK report: 2016

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we will all need to think creatively about retaining new graduates, re-integrating those who have had time out, dissuading older doctors from retiring early, and recognising that 35% of doctors currently working in the UK qualified in the EEA or further abroad. The strong contribution of EEA and international medical graduate doctors to UK healthcare should not be underestimated.

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The risk of receiving a sanction or a warning was higher for older and male doctors. Doctors aged 50 years and over were consistently complained about more than younger doctors – and this was true of women and men alike for doctors on the GP, Specialist and neither register. A higher percentage of investigations about younger doctors led to sanctions or warnings.

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Wales has very slightly older GPs The age profile of doctors varied relatively little between the four countries of the UK. Wales had the oldest profile of GPs, though the difference was small: 43% of GPs in Wales were aged 50 years and over compared with a UK average of 39%.

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The number of licensed doctors has remained fairly constant since 2011 To maintain a licence to practise, doctors have to be revalidated as being fit to continue practising every five years. The process of revalidation, which was introduced in 2012, encourages doctors to decide whether they need to retain the licence for the work that they do. The number of non-licensed doctors was expected to grow as a result, mainly from older doctors who were no longer practising, but also from those involved in teaching or research who were no longer using the licence.

Many doctors who have given up their licence to practise have maintained their registration – this means that they do not have to take part in revalidation, but still have a connection to the medical profession. We provide further data on revalidation at the end of this chapter. Although the register continues to grow, with an 11% increase in the period 2011-1515, the trebling of the number of unlicensed doctors, largely following revalidation, means that the number of doctors licensed to practise in the UK has remained steady, increasing by only 1% over the period (figure 5). The growth in the number of non-licensed doctors has now slowed slightly, but still increased by 29% in 2015, which was expected.

As figure 6 shows, between 2011 and 2015 there has been more than a three-fold increase in the number of non-licensed GPs and specialists and a slightly lower (two-and-a-half fold) rise in the number of doctors on neither the GP or specialist register (excluding doctors in training).

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The number of older doctors is increasing at nearly one-and-a-half times the rate of younger ones

The number of older doctors (aged 50 and over) on the register increased by 15% compared with an increase of only 10% in those aged 30–50.

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The ageing of the doctor population may also be a cause for concern in the future as demand and expectations continue to rise.

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In some specialties, older women are increasingly present

The specialties that have the highest proportion of older doctors have growing numbers of women.

Pathology, overall, has decreased in size by 4% between 2011 and 2015, but the number of male pathologists has decreased by 12% and the number of women has increased by 6%. Obstetrics and gynaecology shows the same pattern, with a decrease of 9% in men and an increase of 29% in women. In those aged 50 years and over, men have not increased at all between 2011 and 2015, but women have increased by 41%.

The number of specialists in emergency medicine has increased by 22% overall between 2011 and 2015, but the number of female specialists aged 50 years and over has increased by 75%. Despite this, female doctors overall still make up only 32% of this specialty.

This trend – a relative increase in older female doctors – may be because older male specialist doctors are retiring or giving up their licence to practise.

Certain specialties are getting older

a41% of specialists and 39% of GPs are aged 50 years and over. As mentioned above, pathology is the specialty with the highest percentage of specialists aged 50 years and over (50%). Other specialties with high proportions of older doctors include obstetrics and gynaecology (47%) and surgery (44%).

Anaesthetics and intensive care medicine is becoming an older specialty, with 38% of doctors aged 50 years and over compared with 35% in 2011.

By contrast, emergency medicine has the youngest age profile, and has become younger since 2011. Only 27% of doctors were aged 50 years and over in 2015, compared with 28% in 2011.

The trend for some specialties to have an older workforce is not necessarily negative and may reflect people living and working longer. It does not automatically follow that an ageing workforce means an increased risk of doctors retiring. But in some specialties it does appear that, as the number of doctors in the specialty declines, the remaining doctors tend to be older.

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Doctors’ age affects the likelihood of deferring revalidation

In 2015, doctors aged 20–39 years old and those over 70 years old were more likely to have their revalidation deferred than other age groups (figure 25).

Doctors aged 39 years old and under are more likely to be in training and therefore are more likely to have their revalidation date deferred to bring it in line with their expected CCT award date.

Doctors aged 70 years old and over are less likely to have revalidated. These doctors also show a higher rate of deferral than other age groups, which was largely because of insufficient evidence. 92 doctors over 80 years old had a revalidation decision, of whom 57 were revalidated, 28 were deferred and seven did not engage with the process.

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Doctors aged 50 years and over and male doctors are at increased risk of receiving a sanction or a warning

Table 2 confirms that the risk of receiving a sanction or a warning is higher for older and male doctors. This finding is largely driven by:

■ female doctors receiving far fewer complaints than male doctors – particularly in the case of GPs under 50 years old.

■ doctors aged 50 years and over being consistently complained about more than younger doctors – this is true of both female and male doctors, across all types of doctors.

But the probability of a complaint leading to a sanction or a warning is also higher for older and male doctors – again consistently across all types of doctors.

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The age profile varies little across the UK

There is relatively little variation in the age profile of licensed doctors not in training across the UK countries and regions of England. Slightly more of the doctors in Wales are aged 50 years or older – 28% of the licensed doctors in Wales not in training are aged 50–59 years, compared with a UK average of 25%.

http://www.gmc-uk.org/SOMEP_2016_Full_Report_Lo_Res.pdf_68139324.pdf