Written evidence submitted by The University of Plymouth (RTR0081)


Introduction to organisation

The Collaboration for the Advancement of Medical Education Research (CAMERa) exists to improve the development and sustainability of the healthcare workforce through high-quality research. Our research programme is supported by external funding bodies including NIHR, Erasmus Plus, GMC, GDC, HEE, Health Foundation, Medical Council of Ireland, Advance HE, and the Department for International Development. The CAMERa research team sits within the Plymouth Institute of Health and Care Research group, where researchers within the Faculty of Health focus on research related to the Future Ready Workforce. The team come from a range of disciplinary backgrounds and use a mix of qualitative and quantitative research methods.

Our world-leading research investigates workforce sustainability, seeking to address the critical questions and develop tangible solutions that have local, national and international impact. Our work focuses on three main themes:

    1. Workforce development
    2. Continuum of education in healthcare careers
    3. Professional regulation

The areas of research we specialise in are capability, preparedness for practice, recruitment, selection, remediation, revalidation, resilience, fitness to practise, and migration of healthcare professionals.

Areas of evidence we can contribute to

Our work on the migration of doctors answers an aspect of this question specifically why doctors are choosing to migrate overseas.

Migration from the UK:

Our systematic review of the literature identified the following drivers as being most important:

  1. Macro-level: poor working conditions in the UK, attractive working conditions overseas, and employment opportunities
  2. Meso-level: pushed/desire to leave the NHS, better training and development opportunities, feeling undervalued professionally
  3. Micro-level: better quality of life, family reasons, desire for a life change, financial gain for self.

The qualitative interviews with stakeholders confirmed that many of the reasons associated with attracting doctors to the UK, also constituted push factors for UK doctors to decide to leave the UK and practise abroad, typically in Australia, New Zealand or mainland Europe. Two factors that aid migration are the extent to which the destination health system is comparable to the UK, and the ease of the registration process within the destination country. Doctors in the UK are attracted to emigrate by the general notion of a better balance between work and one’s personal life, and overall a better quality of life. There is a perception of a better work-life balance, a better work rota, the ability to take breaks during working hours, and have days off and protected annual leave, as well as a greater appreciation of well-being. These factors are extremely significant because altogether they contribute to better employee well-being, but also a sense of appreciation, of being valued professionally, and of being able to provide better patient care. Finally, UK-PMQ doctors may also be drawn overseas by the desire to experience a new healthcare system. Stakeholder interviewees described this migration trend as a rite of passage that will make them a more competitive and well-rounded candidate with a more interesting CV.



Our work on the migration of doctors, which involved an analysis of secondary data, showed that the vast majority of doctors migrating to the UK do not join the GP or specialist register at the time of initial entry and relatively few go on to gain specialist or GP registration. Looking at the cohort of doctors that registered in 2009, within 5 years only 448/3,860 doctors (11.6%) had joined the specialty register, but for those that have been on the register for 10 years (2019) the percentage rises to 27.2% (2009 cohort). Training opportunities and support provided to these doctors need to be examined to understand why this is happening, and to make changes to ensure that more of these doctors gain appropriate accreditation to join the specialist and GP registers.  



Our work mapping basic dental training across the UK and EU member states illustrates the challenges of recruiting healthcare staff from outside the UK. Establishing what constitutes a ‘trusted training programme’ is complex, and our research found:



Brennan N, Langdon N, Bryce M, et al. Drivers of international migration of doctors to and from the UK, 2021.  https://www.gmc-uk.org/-/media/documents/drivers-of-international-migration-research-final-report_pdf-88769526.pdf. Accessed 14th January 2022.



Gale T, Bryce M, Burns L, Hanks S, Zahra D. Review and mapping of basic dental training in EU member states: final report, 2020. https://www.gdc-uk.org/docs/default-source/research/review-and-mapping-of-basic-dental-training-in-eu-member-states6453cb89-113a-4197-85bf-52564a644da8.pdf?sfvrsn=29396567_3



Professor Tom Gale, Dr Nicola Brennan, Dr Marie Bryce

Collaboration for Medical Education Research,

Plymouth Institute of Health and Care Research,

University of Plymouth


Jan 2022