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10 July 2013, 09:32
Research carried out at hospitals including the Royal Bournemouth has found high workloads are putting doctors off training for emergency medicine.
The study by the General Medical Council (GMC) found that the next generation of senior doctors are not being given the help and support they need to develop in emergency medicine.
It said "too much reliance'' on locum doctors providing supervision was a cause for concern, as they can lack experience in the speciality and the hospital.
The review also came across supervisors working too far away from doctors in training or preoccupied with managing high-risk patients and unable to provide support.
The GMC noted that of the 177 doctors in training in England and Wales who applied to train in emergency medicine last year, 115 were offered a place and only 61 accepted.
The research was carried out from December to February into training at University Hospital of North Tees in Stockton-on-Tees, James Cook University Hospital in Middlesbrough, Leeds General Infirmary, King's Mill Hospital near Mansfield, Queen's Medical Centre in Nottingham, Royal Bournemouth Hospital and Jersey General Hospital.
Niall Dickson, GMC chief executive, said:
"The evidence from this admittedly limited review is serious and underlines what others have found. Emergency departments are under very significant pressure - with limited resources, they are coping with huge demand, staff shortages and heavy workload.
"Training the next generation of senior doctors in this area of medicine is absolutely vital and we need to make sure they are given the supervision and support they need to develop.
"It is crucial that they are valued and continue to pursue a career in this specialty. If we do not get this right we will not attract the doctors we need to work in emergency medicine.''
Ben Molyneux, chairman of the British Medical Association's junior doctors committee, said:
"We have to ask what has gone so wrong when we see burgeoning demand by patients for emergency care while simultaneously facing a workforce crisis.
"With senior emergency medicine consultants describing working conditions akin to that of a war zone it can hardly be surprising that doctors are reluctant to opt for a career in emergency medicine.
"The Government and employers should look closely at the culture that pervades many departments as poor training experiences and later poor support for consultants is making the specialty increasingly unpopular.''
The GMC also highlighted areas of good practice, such as at the University Hospital of North Tees and University Hospital of Hartlepool where the emergency medicine departments were combined after it was clear they could not achieve adequate staffing levels.
This allowed consultants to cover from 8am to 10pm seven days a week, which doctors in training found helpful and led to a higher retention rate.
Leeds General Infirmary was also praised as the workload of its emergency department was reduced after GPs were able to admit patients directly on to the relevant specialty ward.
The GMC said it has set a number of requirements for each NHS trust and has pledged to ensure training standards are met in the future.