Physicians' exodus: why medical graduates leave Austria or do not work in clinical practice.

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<p><b>BACKGROUND: </b>Austria has the highest number of medical graduates of all Organisation for Economic Co-operation and Development (OECD) countries in relation to its population size, but over 30% choose not to pursue a career as physicians in the country.</p><p><b>OBJECTIVE AND RESEARCH DESIGN: </b>This article describes under- and postgraduate medical education in Austria and analyses reasons for the exodus of physicians.</p><p><b>MEDICAL EDUCATION: </b>In Austria, medicine is a 5- or 6-year degree offered at four public and two private medical schools. Medical graduates have to complete training in general medicine or a speciality to attain a licence to practice. While not compulsory for speciality training, board certification in general medicine has often been regarded as a prerequisite for access to speciality training posts.</p><p><b>ANALYSIS: </b>Unstructured postgraduate training curricula, large amounts of administrative tasks, low basic salaries and long working hours present for incentives for medical graduates to move abroad or to work in a non-clinical setting. The scope of current reforms, such as the establishment of a new medical faculty and the implementation of a common trunk, is possibly insufficient in addressing the issue.</p><p><b>CONCLUSION: </b>Extensive reforms regarding occupational conditions and the structure of postgraduate medical education are necessary to avoid a further exodus of junior doctors.</p>