The GMCs State of medical education and practice 2019 (SoMEP) report shows that 18% of GPs were considering leaving medicine entirely in 2020.

Nearly a quarter of GPs polled by the regulator 'gave responses that suggested they were at high risk of burnout' - and nearly one in 10 had taken a 'leave of absence due to stress' within the past 12 months. Around one in six GPs said they were unable to cope 'every day'.

GPs were significantly more likely to be dissatisfied than doctors as a whole - with 45% of GPs dissatisfied compared with 30% of all doctors.Increasing workload, long hours, difficulty dealing with patient expectation and bureaucracy were among key factors cited by GPs.

The report, which gathered responses from 1,079 GPs, found a growing shift towards part-time working in general practice; a trend theGMC said reflected deliberate choices by GPs to manage their wellbeing and protect against burnout.

A total of69% of full-time GPs said they were likely to reduce the amount of time they worked in clinical practice next year, and 36% of GPs had done so in 2019. Nearly half (45%) of GPs said they were already contracted to work less than full-time (LTFT).

The GMC highlighted an increasing number of doctors in GP training which grew by 6% in 2019, but warned it may not directly translate into reduced pressure on GP services because of the continuing trend towards LTFT working.

The regulator called for legislative change to allow a more streamlined process for registering overseas-trained doctors and innovative models of education to attract more doctors to general practice.

The GMC found that GPs working LTFT were more likely to be satisfied at work (6% higher) and less likely to be planning to leave the profession compared with full-time colleagues. Meanwhile, the analysis showed doctors who paused before starting their specialty training were, on average, at lower risk of burnout.

GMC chief executive Charlie Massey said: The challenge our health services are facing is no secret. We need more flexible training and career options if high levels of patient care and safety are to be sustained.

Doctors say they are no longer prepared to stick with the traditional career paths to meet that demand. We are seeing what looks like a permanent shift in the way newer doctors plan their careers.

That doctors are making choices for a better work-life balance and career development is a new reality which health services cannot ignore. Establishing a sustainable workforce and encouraging supply, particularly of expert generalists who can spread the burden in primary care, is vital.

RCGP chair Professor Martin Marshall said: It's not surprising to see more GPs reducing or planning to reduce the number of clinical hours they work. They shouldnt be criticised for this - its this flexibility in working patterns that general practice offers that makes the job sustainable, so that GPs and our teams can continue to deliver safe care to a million patients a day across the country.

Working "full-time" in general practice is simply not doable for many, and this is causing GPs to burn out, or leave the profession earlier than they planned to because they feel they cannot guarantee safe standards of care for their patients. It makes sense that GPs are making choices about their career to safeguard against this.'

BMA chair Dr Chaand Nagpaul said: 'Exhausted and burnt out doctors, overwhelmed by demand, are struggling to provide the level of care that patients deserve. This is affecting quality and safety of the care thats being delivered. Its clear that the impact of the state of the NHS is being felt across the whole profession from juniors beginning their careers, to experienced hospital doctors and GPs.

'The government and employers need to do more to retain the existing workforce. This means recognising the flexible working patterns that doctors are increasingly opting for, and as the BMA has consistently called for, a learning rather than a blame culture in the health service.'

GPonline reported last month that the full-time equivalent (FTE) fully-qualified GP workforce fell by 340 over the year to September 2019.

GP practices delivered a record 30.8m appointments in October 2019 - by far the highest figure recorded in a single month since NHS Digital began collecting data 18 months ago.

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One in six GPs could quit medicine within a year, GMC report finds - GP online