Innovative Recruitment and Clinical Orientation Programme to Manage NHS Junior Doctor Shortfall: A District Hospital Experience

Future Healthc J. 2020 Jun;7(2):131-136. doi: 10.7861/fhj.2019-0047.


Background: International medical graduates (IMGs) contribute significantly towards the NHS care provision. No standardised clinical orientation programme (COP) for IMGs new to the NHS exists.

Objective: Our objective was to describe recruitment and retention strategies for junior doctors (JDs) in general medicine and develop a framework to anticipate outcomes of these interventions using the realist evaluation methodology.

Methods: We performed quality improvement interventions of recruitment and COP for new entrant IMGs in our organisation employed between December 2017 and April 2019.

Results: Twenty-three IMGs were recruited, 96% successfully completed the COP with a mean contract duration of 13±5 months. From the academic year 2017/18 to 2018/19, mean JD post occupancy increased from 54±3 to 73±4 JDs (p<0.001) and JD locum spend fell by £1.9 million.

Conclusion: Our structured COP provides a stable, trained and financially sustainable JD workforce. Application in broader NHS settings is recommended.

Keywords: Health service research; clinical orientation programme; medical education; quality improvement; realist theory.