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Rapid response to:


Seven days in medicine: 4-10 January 2023

BMJ 2023; 380 doi: (Published 12 January 2023) Cite this as: BMJ 2023;380:p47

Rapid Response:

Re: Seven days in medicine: 4-10 January 2023

Dear Editor,

You've done it again!

The news piece claiming that junior doctors 'plan to leave NHS en masse' appears to have accepted without thought or critical enquiry the output of a survey of junior doctors conducted by the BMA at the end of last year. They (the BMA) reported that four in ten respondents said they planned to work in another country in the next 12 months. All very alarming, until you note that there were only 4500 respondents to the survey (see, out of a total of over 70,000 junior doctors in the country, of whom approximately 45,000 are BMA members and who therefore will have been invited to participate. This makes the response rate for the survey about 10%. We know the respondents are atypical of all junior doctors (because they responded, whilst 90% didn't), we know nothing about the career intentions of the other 90%, but we may reasonably suspect that there was an element of response bias among the minority who did do so. (If you are disaffected, you are more likely to respond.)

So the facts are that when 45,000 junior doctors were asked for their views, approximately 1,800 (40% of 4,500) said they were planning to work abroad. That is 4%. Hardly 'junior doctors planning to leave the NHS en masse'.

Unfortunately the BMA has form in this, (increasingly so). They have in the past presented the results of a survey of discrimination against our BAME colleagues, with a very low response rate, as being a valid reporting of all BAME colleagues' experiences, when that was in no way justified. Unfortunately the BMJ has form too, because I wrote to you on that last occasion pointing out the failings of that survey, and you were good enough to reproduce my letter as a 'letter of the week', which suggests you had some sympathy with my argument!

Please, next time the BMA pushes the results of one of their surveys with a dramatic headline, before you publish anything ask what the response rate was, and whether there may have been response bias. And then consider whether the dramatic conclusions being pushed are justified. This kind of reporting does neither you, nor the BMA, nor perhaps most importantly the profession, any credit.

Competing interests: No competing interests

24 January 2023
Jeremy P Wight
Retired public health physician