doctors working hours have found either a beneficial or neutral impact in terms of measures of patient safety, clinical outcomes and postgraduate training. The reduction in number of hours worked by junior doctors is one of the factors leading to blurring distinctions between them and other clinical professions such as nurse practitioners who also perform complex tasks. Migration An Organisation for Economic Co-operation and Development survey in December 2015 showed that 35.4% of NHS doctors, 34,000, were born abroad compared with 5% in Italy, 10.7% in Germany and 19.5% in France. The UK was the second highest exporter of doctors, second only to Germany, with 17,000 British doctors working in other OECD countries. These figures are for all doctors in the NHS, not just junior doctors. According to the Career Destination Report published by the UK Foundation Programme Office in 2019, an increasing number of UK junior doctors are seeking to take up work abroad. A report by the General Medical Council described a number of "push" and "pull" factors, including seeking a better work-life balance and wanting to take advantage of other opportunities abroad. Notably most doctors who complete foundation training do eventually return to specialty training in the UK within three years. Modernising medical careers In 2005 postgraduate medical training was significantly changed in the Modernising Medical Careers programme. A two-year Foundation Programme was introduced for newly qualified doctors, the number of years of postgraduate training changed in some specialities, and doctors needed to decide which speciality to follow sooner after graduation. There were later initiatives to engage junior doctors in NHS leadership; junior doctors are seen as essential to the drives to achieve efficiency savings in the NHS since 2010. Pay and conditions The NHS Careers web site stated in 2019: The basic salaries outlined are defined for a contract of 40 hours per week. Salaries are increased proportionally for any extra hours worked on average per week. Any hours outside "social" hours, namely 9pm and 7am, are supplemented by a 37% enhanced rate. Weekend duty is paid as a percentage bonus, up to 10% of the basic salary for working alternate (1 in 2) weekends. Other bonuses are also available for being non-resident on-call (being not physically on site, but available to answer calls or come in to hospital if necessary), for recruitment into academia and undersubscribed specialties, and for doctors living and working in London.