Need a better balance between service commitment and education.

The exodus of young doctors from the NHS has been exaggerated,1 but British medicine has nothing to be complacent about. Disillusionment and discontent among doctors seems widespread and, as shown in this week's journal, is by no means confined to the juniors. Growing concern about the service's inability to care adequately for patients is causing frustration and even despair among senior doctors. This is perhaps reflected in early retirement, which is becoming common among both hospital consultants (especially those without merit awards) and general practitioners. Surveys of junior doctors who have left or are contemplating leaving medicine now rank the unattractive lifestyle of consultants as a major factor in their decision. In general practice the same concern about lifestyle is adversely affecting recruitment to general practitioner training schemes.

Objective measurement of the misery index may be lacking and anecdote more evident than hard data, but recent discussions at the Royal Society of Medicine made it clear that there is an iceberg of discontent that cannot be ignored. Over the past year there have been 3300 calls to the BMA's helpline, mostly from doctors between the ages of 21 and 25 years, and although less than 100 have left their jobs many were experiencing difficulties. The causes of discontent are familiar. Despite the New Deal, long …