As part of our research for our State of medical education and practice in the UK (SoMEP): Workplace experiences 2023 report, we conducted interviews with high-level senior healthcare sector stakeholders, from across the four nations. These are the insights taken from their responses, which the interviewees raised themselves as part of their answers (we did not specifically ask about this topic). We are not able to determine the reason for their responses and we did not focus further on these issues in our interviews. The insights shared are: • Belief that rural issues, such as recruitment, retention and health inequalities, are much more pronounced in some of the devolved nations than they are in most of England. • Rural/remote geographies are generally unappealing to trainees, so these locations have fewer trainees, reduced quality of care, and a higher dependency on international doctors who are likely to be new to the UK, where they’re then isolated with poor social networks, leading to issues with long term retention. Promotion of the value of rural life, incentivising packages, and awareness of local benefits such as good schools etc are seen as beginning to address these issues on a localised scale. • Development of CESR (Certificate of Eligibility for Specialist Registration) training pathways in metropolitan areas to support doctors’ progress into specialist registration and minimise doctors having to continuously move around different hospitals are generally seen as beneficial, but can result in unintended consequences for particular specialties that are already hard to recruit in more remote/unpopular geographies.
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