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within professional occupational groups. It is alsothe case that the health service is heavily reliant on migrant professional workers to
deliver its services (Bach, 2004b). Our study provides an insight into the experienceof structured forms of career constraint resulting from grade rigidities. This studyis made all the more important as it particularly compares the experience of
UK-qualified (UKQ) and overseas-qualified (OVQ) doctors and considers the HR andequality implications. Specifically, the article aims to provide an insight into theimpact of a medical career structure on employment conditions by comparing the
experience of UKQ and OVQ1 doctors in the Staff and Associate Specialist Group(SASG) with regard to their reward, workload, autonomy and morale.
Our focus is on the SASG, which is the fastest growing medical career group andis made up of a number of grades (SASC, 2003). The structural conditions for this
group are spelt out by the Department of Health (DH): (1) there is no consistentframework for progress through the grades, (2) no external review and lack of aproper career development, (3) ad hoc local arrangements compound the lack ofclarity, (4) little or no access to formal, skilled career counselling and frequently alack of a perspective on career options, (5) few opportunities to move out of the
grades, for example, back into the training system and to complete training and (6)the existing pay system militates against movement back into training (DH, 2003).
Therefore, this is a group perceived to have inherent structural disadvantages andone that is currently the centre of the proposed reform. This group’s interests arevoiced within the British Medical Association (BMA) by the Staff and Associate
Specialist Committee (SASC). This committee is concerned to see proper recognitionand reward and career progression within the grade and ‘resists the grade beingused as any kind of dumping ground’ (BMA, 2003). The DH (2003: 5) recognises theperception that doctors in this group, rather than making a positive career choice,
have failed elsewhere.

 

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Impact of a career structure on the employment conditions of overseas- and UK-qualified doctors
148 HUMAN RESOURCE MANAGEMENT JOURNAL, VOL 17 NO 2, 2007
© 2007 The Authors.
Journal compilation © 2007 Blackwell Publishing Ltd.
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