Abstract

Objectives: To assess the nature and number of unexpected withdrawal by senior house officers (SHOs) after acceptance of a hospital post at interview, and to investigate the reasons and possible solutions.

Design: Postal questionnaire based study.

Subjects: Medical staffing departments, accident and emergency (A&E) consultants, and withdrawing SHOs in England.

Main outcome measures: Unexpected withdrawals by hospital specialty, three year trend in A&E departments, notice and reasons given, and action taken.

Results: 39% of medical staffing departments reported unexpected withdrawals in a broad spectrum of specialties for February 1998. In the specialty of A&E medicine this occurred in 34% of departments. Overall 72% of A&E departments had experienced this problem over a three year period, and the trend is increasing. The majority of A&E consultants (70%) took no action, and there was a lack of consensus among all respondents on the appropriate course of action to prevent this escalating problem.

Conclusions: Unexpected SHO withdrawal is a substantial issue in hospital medicine and has been increasing in A&E medicine. Measures to prevent this national problem are urgently needed.