That was the message to a board meeting of Lancashire Teaching Hospitals NHS Foundation Trust (LTH) which heard that fewer trainees are choosing traditional medical career paths - something which can cause problems for those who do.
The trust currently has a vacancy rate of 13 percent on its foundation training programme for doctors straight out of medical school.
After two years, foundation doctors can then opt to specialise in their chosen branch of medicine - a process which can last up to eight years. LTH has a vacancy rate of 15 percent across all of its specialist training posts.
The trust’s Workforce Director, Karen Swindley, told board members that, in an average room of foundation trainees, as many as half might not intend to begin specialising.
“Trainees aren’t naturally going through to specialist training as they once were - and that’s causing gaps,” Ms. Swindley explained.
“The current generation doesn’t necessarily want what my generation did - a guaranteed salary at the end of the month and the ability to pay the mortgage. Many are more interested in a flexible career - perhaps working two months on and two months off.
“It’s difficult [for the trust], because patients have to be looked after 24 hours a day, 7 days a week. But it’s a balance - we need to start to think about offering flexibility.
“So could we have three people filling one role, for instance?” she asked.
A report presented to the board revealed that vacancies amongst speciality trainees have led to some having to cover night shifts without other junior support. Meanwhile, consultants have regularly been “acting down” to fill rota gaps - causing a knock-on effect on their own clinical activity.
Agency cover to rectify the problem has now been secured until the end of the year, the report notes.
The meeting heard that some trainees are also unable to attend planned teaching sessions because they are scheduled on the rota to work at that time. Plans are in place to enable them to catch-up, with a longer-term aim of ensuring they can access training in real time.
Ms. Swindley told board members that the challenges are “not unique” to the trust - and are experienced across the country.
The workforce report added that there is now “more awareness amongst senior clinicians [of] the need for their junior team members to comply with scheduled rota times” since the new junior doctors’ contract came into force almost two years ago.