Medical workforce planning of the future: trends from Junior Doctor’s eyes after the pandemic

  Authors: Dr Alvaro Cerame del Campo, Dr Francisco Ribeiro Mourao, Dr Mathias Korner, Dr Antanas Montvila, Dr Ellen McCourt

Context
For decades, medical workforce planning (MWFP) has been a central item in the healthcare management agenda due to the shortcomings caused by MWFP absence - namely lack of personnel and underemployment. The future projections point towards a physician deficit in the upcoming years. However, COVID-19 pandemic and the challenge it has posed towards healthcare systems and professionals may have changed those projections and created emerging problems.
Methods
The European Junior Doctors Association (EJD) held a meeting during its November 2021 General Assembly which aimed at elucidating the way in which the pandemic had affected MWFP and understanding the evolution of physician unemployment, underemployment and other emerging trends such as physician resignations.
Results
Every member organisation stated that traditionally MWFP had been mainly controlled in their countries through numerus clauses (increasing or decreasing the number of graduates) and the overall trend had been an increase in graduates because of the prediction that there was going to be a lack of doctors from 2010 onwards. Some countries reported an overall lack of specialists (Sweden, Norway, Finland, Denmark, Germany, Spain) which was not evenly distributed through all specialties and regions. Many countries reported medical unemployment in the form of a bottleneck between graduation and the access to Postgraduate Training (PGT) systems (Spain, Portugal, Sweden, Latvia, Greece, Italy) and a mismatch between the number of medical graduates and the PGT positions. Nearly all countries were dissatisfied with MWFP systems in their countries. Many countries described the proliferation of private medical schools, with Spain being the most notable example with 20 schools opened in the last two decades. Some countries manifested an increase in physicians’ resignations due to the worsening of working conditions and personal and patient safety during the pandemic.
Discussion
Last decade’s forecast predicted a decline in the workforce after the retirement of many physicians from the baby boom generation. However, an increase in the number of graduates has created a mismatch between graduates and PGT positions in many countries, creating bottlenecks and medical unemployment / underemployment - especially with a rising number of non-specialised and non-differentiated healthcare professionals working in an increasingly differentiated environment. The pandemic, as an unforeseeable event, has altered MWFP and needs to be taken into account when accurately predicting future workforce needs. Working conditions must be improved across Europe to prevent junior doctors' absence due to stress and burnout and to ultimately retain doctors in the medical workforce. All in all, more data needs to be gathered at the European and national levels to analyse how the pandemic has impacted MWFP and to be the basis for a MWFP which can allow for a better and effective distribution of the health workforce, while creating positive environments which allow for an increase on professionals satisfaction and the retention of doctors in the healthcare systems.