BACKGROUND: In the course of national studies of doctors' career choices and progression, we received spontaneous comments from respondents about job satisfaction and the National Health Service reforms. To assess whether such comments were representative, or whether they reflected minority views, we added questions to subsequent questionnaires to gauge systematically how doctors view their own professional position and the wider NHS. METHOD: Self-administered questionnaire were sent to all 10,504 qualifiers of 1977, 1988 and 1993 from UK medical schools. RESULTS: A total of 7391 responded (70 per cent). Most doctors in UK medicine were positive about the career opportunities they have had (66 per cent of relevant respondents), their future prospects (68 per cent) and their present position (80 per cent). Few were positive about the NHS reforms (9 per cent) and the effects of the reforms on their own professional work (9 per cent). Only 0.2 per cent of the 1993 qualifiers scored their impression of the internal market as 'strongly favourable'. CONCLUSIONS: In recent years the NHS shifted from a collaborative to a competitive model of management of health care with the establishment of an internal market. The great majority of respondents viewed recent changes and the internal market unfavourably. This is not, however, a reflection of more widespread discontent with their work. The majority viewed their own professional opportunities and present position favourably.
BACKGROUND: In the course of national studies of doctors' career choices and progression, we received spontaneous comments from respondents about job satisfaction and the National Health Service reforms. To assess whether such comments were representative, or whether they reflected minority views, we added questions to subsequent questionnaires to gauge systematically how doctors view their own professional position and the wider NHS. METHOD: Self-administered questionnaire were sent to all 10,504 qualifiers of 1977, 1988 and 1993 from UK medical schools. RESULTS: A total of 7391 responded (70 per cent). Most doctors in UK medicine were positive about the career opportunities they have had (66 per cent of relevant respondents), their future prospects (68 per cent) and their present position (80 per cent). Few were positive about the NHS reforms (9 per cent) and the effects of the reforms on their own professional work (9 per cent). Only 0.2 per cent of the 1993 qualifiers scored their impression of the internal market as 'strongly favourable'. CONCLUSIONS: In recent years the NHS shifted from a collaborative to a competitive model of management of health care with the establishment of an internal market. The great majority of respondents viewed recent changes and the internal market unfavourably. This is not, however, a reflection of more widespread discontent with their work. The majority viewed their own professional opportunities and present position favourably.