Almost a quarter of aspiring GPs plan to turn to locum work after completing their training, a small new poll suggests.
A survey of trainee general practitioners approaching the end of their three-year GP vocational training in the West Midlands found that 23.2% plan to be doing locum work six months after they complete training.
The poll of 178 trainee GPs - which represents 57% of those training in the region - found that six months after training, a third plan to be salaried GPs.
Overall, six in 10 (61%) doctors who are completing their training to become GPs plan to work in NHS general practice after six months, the authors found.
This rises to 64% three years after training ends but falls to 59% after five years.
The researchers, from the University of Warwick, found that most participants planned to work as salaried GPs or locums rather than entering a GP partnership for at least the first five years after training.
Others failed to express a career plan or planned to leave general practice completely or work overseas, according to the study published in BMJ Open.
The study suggested that perceptions of work-life balance and low morale during training affect trainee GPs' career choices.
Lead author, Professor Jeremy Dale, from the University's Warwick Medical School, said: "The study highlighted a number of potentially modifiable factors related to GP training programmes that are detrimentally influencing the career plans of newly trained GPs.
"Many of these relate to how general practice had been experienced across undergraduate, foundation and vocational training, and in particular perceptions about workload pressure and morale within practice placements.
"The negative portrayal of general practice by politicians and the media was experienced as having had a detrimental effect on personal career intentions.
"A sizeable proportion of individuals did not describe their future career plans, perhaps expressing ambiguity about career direction."
Commenting on the study Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: "Unfortunately, these findings are a clear indication that trainees are being put off from a career in general practice because they are seeing first-hand the intense resource and workload pressures GPs and our teams are facing across the country.
"Workload in general practice has risen 16% over the last seven years, but resources for our profession has declined, and our workforce has not risen at pace.
"It's a massive shame because if properly resourced - with adequate investment and workforce - being a GP can be the best job in the world, with lots of variety and numerous career opportunities.
"We urgently need to turn general practice around and make it the attractive career option that it once was - not just as a profession that trainees want to enter, but as a profession that they want to work in for years to come.
"The GP Forward View launched by NHS England could be the lifeline that general practice needs - but our annual assessment of its progress shows that things are not moving as quickly as they could in certain areas.
"We need the pledges made in the GP Forward View, including £2.4bn extra a year for general practice, 5,000 more full-time equivalent GPs, and 5,000 more members of the wider practice team, to be delivered in full and as a matter of urgency, so that we can deliver the care our patients need and deserve, now and in the future."
Dr Richard Vautrey, chairman of the GP committee of the British Medical Association, said: "There are already widespread GP shortages in England, with areas like the West Midlands particularly badly affected.
"Without enough GPs, the NHS cannot deliver enough appointments to patients, especially the growing number of older people who require intensive and specialist care in the community.
"We need the Government to act urgently to implement the recommendations of the GP Forward View and provide general practice with the resources, including the right staffing levels, that the public deserves."
A spokeswoman for Health Education England said: "This is a very small sample representing less than 2% of all doctors in GP training.
"We do, however, recognise some of the issues raised and are working to address some of the negative perceptions and to promote the great attractions of a career in general practice, both now and in the future.
"Last year we recruited the highest number of GP trainees the NHS has ever seen at that level."