Review of job advertisements in BMJ careers (February to May 2005)
June 2005
Introduction
A study [Go to note 1] in 2003 showed that non standard grade posts were being created by trusts to meet service requirements. This paper summarises an analysis of advertisements in BMJ Careers in early 2005 to determine if the use of non standard grade posts by trusts has increased in the period since the earlier study.
Methods
Four issues of BMJ Careers (12 February 2005, 12 March 2005, 02 April 2005, 21 May 2005) were selected at random and the non-consultant job advertisements in the UK Hospital Appointments section (excluding locum agencies) were reviewed and the job titles of the posts offered recorded. The job titles were then compared with the list of standard grades (Table 1), the job titles for non standard grade posts advertised are in Table 2.
The results were also broken down into posts recognised for training (Table 3) and posts not recognised for training. It should be noted that where training rotations were advertised and the number of posts available on the rotation were not specified an assumption was made that 2 posts were available, this assumption will undoubtedly mean that the number of posts in the training grades are under reported.
Table 1 - Standard NHS hospital grades for non consultant doctors (excluding locum appointments)
- House Officer
- Senior House Officer
- Specialist Registrar
- Staff grade doctor
- Associate Specialist
- Clinical Assistant
- Hospital Practitioner
- 3 Yr Fellowship
- Junior Clinical Fellow
- Clinical Fellow
- Senior Clinical Fellow
- Junior Fellow
- Fellow
- Fellow/Research Registrar
- Fellowship in Advanced Laproscopic Surgery
- Fellowship in Gynaecological Oncology
- Fellowship in Ophthalmic Plastic and Reconstructive Surgery
- Oculoplastic and Adnexal Surgery Fellowship
- Part Funded Anterior Segment Fellowship
- Research Fellow
- Clinical Research Fellow
- Clinical Research Medical
- Clinical Vitreoretinal Fellow
- Clinical Teaching Fellow
- Surgical Fellow
- Spinal Fellow
- Trauma Fellow
- Neonatal Neuro-Imaging Fellow
- Surgical Research Fellow
- Retinal Fellowship
- Senior Clinical Medical Officer
- SHO and Clinical Demonstrator
- Subspecialty Registrar in Hepatology
- Clinical Practitioner
- Medical Registrar
- Middle Grade
- Surgical Officer
- Ward Medical Officer
- Clinical Lecturer
- Staff Doctor
- Staff Grade Equivalent
- Registrar
- Research Registrar
- Relief Clinical Assistants
- Resident Medical Officer
- Resuscitation Team Leader
- SHO Trust Grade Doctor
- Senior Trust Doctor
- Trust (Senior 3)
- Trust Clinician
- Junior Trust Grade
- Trust Doctor
- Trust Fellow
- Trust Grade
- Trust Grade (SHO Level)
- Trust Grade Fellow
- Trust Grade Registrar
- Trust Grade Specialist Registrar
- Trust Medical Officer
- Trust Middle Grade
- Trust Registrar
- Trust Senior House Officer
- Trust Staff Obstetrician and Gynaecologist
- Trust Surgeon
- House Officer
- Senior House Officer
- Specialist Registrar
- Foundation year 2 pilot
- Pilot Run Through Grade
- Basic General Medical Training Programme
- Basic Specialist Training Scheme
- Basic Surgical Training Scheme
- Fixed Term Training Appointment
- Locum Appointment for Training
Results
Of the 2,160 non-consultant, hospital appointments advertised in the four issues of BMJ Careers selected, 22 per cent ((316+159)/2,160) did not conform to the standard NHS grades or other training grades as set out in Tables 1 and 3.
When posts that are recognised for training are excluded from the analysis, of the 651 non training posts advertised, only 27 per cent (176/651) are for standard career grade, non locum appointments. Over 50 per cent of advertisements are for non standard posts ((316+10)/651) and 23 per cent (149/651) are for locum appointments to recognised posts.
Table 4 provides a summary of the results.
Table 4 - Summary of the results
|
Number |
% of total |
|
Total |
2,160 |
100.00 |
|
Total posts recognised for training* |
1,484 |
68.70 |
|
Total (excluding posts recognised for training) |
651 |
30.14 |
100.00 |
Total standard career grade posts |
176 |
8.15 |
27.04 |
Total non standard posts (not locum) |
316 |
14.63 |
48.54 |
Total locum** |
159 |
7.36 |
24.42 |
total locum standard posts |
149 |
6.90 |
22.89 |
total locum non standard posts |
10 |
0.46 |
1.54 |
* Including locum appointments for training
** Excluding locum appointments for training
Discussion
The previous study referred to in the introduction, examined advertisements in BMJ Careers over two different study periods. They found that just under a quarter of non-consultant posts advertised in the two different study periods were for non standard grade posts (21 per cent in the four weeks to January 2003 and 23 per cent over a sample taken from the 12 months to September 2002).
The analysis outlined above shows in early 2005 approximately 22 percent of posts advertised were for non standard posts, indicating that trusts continue to use non standard posts at the same level despite recommendations to the contrary.
The earlier study did not provide an analysis of the non training grade posts, and as such it is not possible to provide a comparison. It is particularly worrying that there are so few standard grade posts available for this group of doctors and that so many trusts are choosing to implement alternative terms and conditions of service.
It should be noted the vast majority of advertisements for standard grade non training posts were for Staff Grade appointments and included only 16 Associate Specialist posts (2 per cent of non training posts and 0.7 per cent of all posts advertised), 6 Clinical Assistant posts (1 per cent of non training posts and 0.3 per cent of all posts advertised), and 3 Hospital Practitioner posts (0.5 per cent of non training posts and 0.14 per cent of all posts advertised).
It was also noted during the review that a number of the advertisements could be misleading and the job titles chosen for non standard grade posts are often very similar to equivalent standard posts. This is particularly worrying as it is believed that a large proportion of applicants for these posts are overseas doctors who may not appreciate the difference between these posts. These doctors may mistakenly apply for/accept posts that are not recognised for training or for posts that have less advantageous terms and conditions than standard grade posts.
References
1 Recruitment of doctors to non-standard grades in the NHS: analysis of job advertisements and survey of advertisers; S Dosani et al; BMJ 2003;
327:961-4.
2 This list excludes any locum posts advertised.