Junior Doctors’ Proposals for Healthcare Workforce Retention

Junior Doctors’ Proposals for Healthcare Workforce Retention

Authors: Patrick Pihelgas, David Alves Berhanu, Alvaro Cerame, Miglė Trumpickaitė, Anna Klesmite-Bluma

Context
The European region is grappling with an increasing shortage of healthcare professionals, driven by a surge in service demand, even as the overall number of healthcare specialists continues to grow steadily. The European Junior Doctors’ Association conducted a qualitative study to determine factors influencing healthcare workforce attrition all over Europe. The results indicated the need to focus on workforce retention in lieu of recruitment. A series of proposals were collected from participating junior doctors that would apply to the entire health care system and have a positive impact both for junior doctors as well as other professional groups.

Methods 
A qualitative study based on semi structured interviews with representatives from 24 national medical associations was conducted by the European Junior Doctors’ Association. The interviews aimed to delve into the experiences of junior doctors across nine categories: job satisfaction, wellbeing, job resignations, working experiences, quality of training, personal lives, gender inequalities, proposals, and specific issues. A thematic analysis followed with the focus on finding common experiences and suggestions that would have a wide positive impact across Europe.

Results
Suggestions to improve healthcare workforce retention were divided into five main categories:

General:
•    Medical workforce as a priority issue in health policy agendas.
•    The need for workforce planning and forecasting systems.
•    Increased investment in the health workforce.
•    Considering junior doctors’ changing values around work.*

Working conditions and work-life balance:
•    Increased flexibility in work.
•    Strategies to improve the working environment.
•    Monitoring and reducing workloads.
•    Monitoring compliance with EWTD.
•    Adequate remuneration.
•    Enhancing job stability.

Wellbeing and mental health:
•    Need for indicators on wellbeing.
•    Promotion of professional networking.
•    Monitoring and increasing professional satisfaction.
•    Developing strategies and protocols to prevent institutional violence.

Training:
•    Protecting training of residents.
•    Reducing variability in training.
•    Ensuring time for training and supervision.
•    Increasing accountability during residency.
•    Supporting academic activities.

Inequalities:
•    Reducing the gender gap in active professional careers.
•    Achieving gender representation in positions of responsibility.
•    Narrowing the pay gap.
•    Increasing recruitment of women in underrepresented specialities.
•    Educating health workers on inequalities.

Discussion
Suggestions for workforce retention focused heavily on the promotion of better working conditions, mental health and work-life balance. Although raising healthcare workforce recruitment is important, especially in certain fields like family medicine and psychiatry, our findings clearly showed the need to switch the focus from recruitment to policies promoting workforce retention. Junior doctors are in an especially vulnerable position due to having expectations from both training and rising demand for healthcare services. The new generation of doctors seem to have different expectations for work, seeing it as one more part of their lives, and valuing a good work-life balance. Flexibility and a supportive working environment, where equal opportunities are available for everyone and no one needs to be afraid of institutional violence, are also key components valued by junior doctors. Overall, there is a need for indicators to evaluate the actual state of the workforce, as without measurable data, administrative decisions will be lacking in evidence and ineffective. Finally, even though our study concentrates on junior doctors’ experiences, presumably these proposals would have a positive impact on all professional groups in healthcare.

Associated links: 
European Health Management Association Official Website

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