Completion of paediatric training: trends across 2011–2017 cohorts

2020 ◽  
pp. archdischild-2020-320163
Author(s):  
Melody Grace Redman ◽  
Davide Carzedda ◽  
Nicola Jay ◽  
Simon J Clark ◽  
Marie Rogers
Keyword(s):  
Outcome Measures ◽  
Response Rate ◽  
Workforce Planning ◽  
Evidence Based ◽  
Specialty Training ◽  
Full Time ◽  
Retrospective Survey ◽  
Training Time ◽  
Grace Period ◽  
The Uk

ObjectiveTo determine trends in the demographics and destinations of doctors who have recently completed paediatric training in the UK.DesignA survey was sent to all new paediatric certificate holders 1 year on from completing specialty training every year from 2011 to 2017.SettingRetrospective survey.Outcome measuresDemographics, career destinations, time to complete training, working patterns, subspecialty registration, numbers of job applications, and use of the period of grace are reported.Results1262 people who gained their paediatric certificate in the UK between 2011 and 2017 completed the survey (60.6% response rate). 58.5% (n=738) of respondents were female, and 32.4% (n=224) of women work less than full time, compared with 4.6% (n=23) of men. 85.9% (n=1056) of respondents were in a UK consultant post. 7.6% (n=94) were working overseas. 65.1% (n=722) remained in the region they trained in. 64.8% (n=1348) were registered for general paediatrics, whereas 35.2% (n=733) had subspecialised.Respondents who held a non-UK medical degree (47.5%, n=501) made more job applications on average (mean=2.2; 95% CI 2.0 to 2.5) than those with a UK degree (52.5%, n=554) (mean=1.1; 95% CI 1.0 to 1.2) (p<0.001). Average training time increased from 9.8 years (95% CI 9.4 to 10.2) to 11.3 years (95% CI 11.1 to 11.6) (p<0.001). Respondents’ use of their grace period reduced from 42.7% (n=47) to 20.6% (n=29) (p<0.001).ConclusionsThe data reflect the diverse paediatric workforce and doctors’ working patterns following the completion of paediatric training in the UK. The trends demonstrated are vital to consider for evidence-based workforce planning.

scholarly journals Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032021 ◽  
Author(s):  
Jennifer Cleland ◽  
Gordon Prescott ◽  
Kim Walker ◽  
Peter Johnston ◽  
Ben Kumwenda
Keyword(s):  
Medical School ◽  
Workforce Planning ◽  
Sociodemographic Factors ◽  
Specialty Training ◽  
Time Out ◽  
Foundation Programme ◽  
Training Post ◽  
Multivariable Regression ◽  
The Uk ◽  
Participation In Higher Education

IntroductionKnowledge about the career decisions of doctors in relation to specialty (residency) training is essential in terms of UK workforce planning. However, little is known about which doctors elect to progress directly from Foundation Year 2 (F2) into core/specialty/general practice training and those who instead opt for an alternative next career step.ObjectiveTo identify if there were any individual differences between these two groups of doctors.DesignThis was a longitudinal, cohort study of ‘home’ students who graduated from UK medical schools between 2010 and 2015 and completed the Foundation Programme (FP) between 2012 and 2017.We used the UK Medical Education Database (UKMED) to access linked data from different sources, including medical school performance, specialty training applications and career preferences. Multivariable regression analyses were used to predict the odds of taking time out of training based on various sociodemographic factors.Results18 380/38 905 (47.2%) of F2 doctors applied for, and accepted, a training post offer immediately after completing F2. The most common pattern for doctors taking time out of the training pathway after FP was to have a 1-year (7155: 38.8%) or a 2-year break (2605: 14.0%) from training. The odds of not proceeding directly into core or specialty training were higher for those who were male, white, entered medical school as (high) school leavers and whose parents were educated to degree level. Doctors from areas of low participation in higher education were significantly (0.001) more likely to proceed directly into core or specialty training.ConclusionThe results show that UK doctors from higher socioeconomic groups are less likely to choose to progress directly from the FP into specialty training. The data suggest that widening access and encouraging more socioeconomic diversity in our medical students may be helpful in terms of attracting F2s into core/specialty training posts.

Searching for the true attrition rate of UK paediatric trainees

2021 ◽  
pp. archdischild-2020-321415
Author(s):  
Melody Grace Redman ◽  
Davide Carzedda ◽  
Nicola Jay ◽  
Simon J Clark ◽  
Marie Rogers
Keyword(s):  
Geographical Area ◽  
Workforce Planning ◽  
Training Programme ◽  
Attrition Rate ◽  
Freedom Of Information ◽  
Evidence Based ◽  
Record Keeping ◽  
Retrospective Data Analysis ◽  
Level Of Training ◽  
The Uk

ObjectiveTo quantitatively analyse the number of doctors leaving the paediatric specialty training (ST) programme in the UK, to assist with evidence-based workforce planning.DesignData were sought on those leaving the UK paediatrics training programme between 2014 and 2019 from Heads of Schools of Paediatrics and Freedom of Information Act requests.SettingRetrospective data analysis.Outcome measuresOverall attrition rate, attrition rate across level of training, attrition rate across geographical area, recorded reason for leaving.ResultsAll results must be interpreted with caution due to limitations in record keeping and analysis. The annual attrition rate across all ST levels between 2014 and 2019 is estimated at 3.7%–4.2% (ie, 749–845 trainees may have left the paediatric training programme over 2014–2019). No reason for leaving was recorded for three-quarters of individuals, around 630 doctors. Of those leaving paediatrics, significantly more (χ², p=0.015) did so at ST3 (20.3%) versus the next highest training year, ST2 (13.6%).ConclusionsThis project seems to demonstrate worryingly poor record-keeping of the true attrition rate of paediatric trainees by organisations responsible for workforce planning, including Health Education England, the Royal College of Paediatrics and Child Health and individual paediatric schools across the UK. To allow evidence-based workforce planning for the benefit of UK children, it is vital that accurate records on trainees who leave the training programme are kept and shared across the UK.

scholarly journals Cross-sectional survey of orthotic service provision in the UK: does where you live affect the service you receive?

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028186
Author(s):  
Nachiappan Chockalingam ◽  
Nicola Eddison ◽  
Aoife Healy
Keyword(s):  
Outcome Measures ◽  
Service Provision ◽  
Response Rate ◽  
Waiting Times ◽  
Lead Times ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Uk

ObjectiveTo investigate the quantity and quality of orthotic service provision within the UK.DesignCross-sectional survey obtained through freedom of information request in 2017.SettingNational Health Service (NHS) Trusts/Health Boards (HBs) across the UK.Main outcome measuresDescriptive statistics of survey results, including information related to finance, volume of appointments, patients and orthotic products, waiting times, staffing, complaints, outcome measures and key performance indicators.ResultsResponses were received from 61% (119/196) of contacted Trusts/HBs; 86% response rate from Scotland (12/14) and Wales (6/7), 60% (3/5) from Northern Ireland and 58% (98/170) from England. An inhouse service was provided by 32% (35/110) of responses and 68% (74/110) were funded by a block contract. Long waiting times for appointments and lead times for footwear/orthoses, and large variations in patient entitlements for orthotic products across Trusts/HBs were evident. Variations in the length of appointment times were also evident between regions of the UK and between contracted and inhouse services, with all appointment times relatively short. There was evidence of improvements in service provision; ability for direct general practitioner referral and orthotic services included within multidisciplinary clinics. However, this was not found in all Trusts/HBs.ConclusionsThe aim to provide a complete UK picture of orthotic service provision was hindered by the low response rate and limited information provided in some responses, with greater ability of Trusts/HBs to answer questions related to quantity of service than those that reflect quality. However, results highlight the large discrepancies in service provision between Trusts/HBs, the gaps in data capture and the need for the UK NHS to establish appropriate processes to record the quantity and quality of orthotic service provision. In addition to standardising appointment times across the NHS, guidelines on product entitlements for patients and their lead times should be prescribed to promote equity.

Adenoidectomy techniques: UK survey

2009 ◽  
Vol 124 (2) ◽  
pp. 199-203 ◽  
Author(s):  
G Dhanasekar ◽  
A Liapi ◽  
N Turner
Keyword(s):  
Otitis Media ◽  
Outcome Measures ◽  
Questionnaire Survey ◽  
Response Rate ◽  
Standard Technique ◽  
Postal Questionnaire ◽  
Direct Vision ◽  
Digital Palpation ◽  
The Uk ◽  
Serous Otitis Media

AbstractObjectives:To determine (1) the preferred adenoidectomy technique among UK ENT consultants, and (2) the need for revision adenoidectomy following the standard technique of blind curettage with digital palpation.Method:Postal questionnaire.Participants:We included 539 consultant members of the ENT–UK.Main outcome measures:Commonly used adenoidectomy techniques, and whether revision adenoidectomy was considered a problem.Results:The response rate was 66.6 per cent (359 respondents). Twenty-seven respondents did not perform adenoidectomy, while 332 did. A total of 312/332 respondents (94 per cent) believed that adenoidectomy had a role in the treatment of chronic serous otitis media. The majority of respondents (232/332; 69.9 per cent) reported examining the postnasal space digitally at adenoidectomy. The preferred routine adenoidectomy technique was blind curettage for 263 respondents (79.2 per cent), suction diathermy ablation for 27 (8.1 per cent) and curettage under direct vision (using a mirror) for 13 (3.9 per cent). In response to the question ‘Do you recognise the need for revision adenoidectomy as a problem?’, 205 (61.7 per cent) respondents replied ‘never’, 39 (11.7 per cent) ‘rarely’, 54 (16.3 per cent) ‘< 2 per cent’ and 36 (10.8 per cent) ‘>2 per cent’.Conclusions:The most commonly used adenoidectomy technique in the UK is digital palpation followed by blind curettage, according to this postal questionnaire survey. Few respondents reported performing adenoidectomy under direct vision: only 10 per cent used a mirror during the procedure and only 8 per cent used an endoscope.

scholarly journals Motivators and barriers to engagement with evidence-based practice among medical and dental trainees from the UK and Republic of Ireland: a national survey

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031809 ◽  
Author(s):  
Bosun Hong ◽  
Eoin Daniel O'Sullivan ◽  
Christin Henein ◽  
Christopher Mark Jones
Keyword(s):  
Response Rate ◽  
Evidence Based Practice ◽  
Evidence Base ◽  
Management Plan ◽  
Secondary Outcome ◽  
Evidence Based ◽  
Web Based ◽  
Republic Of Ireland ◽  
Mailing Lists ◽  
The Uk

ObjectivesTo explore the extent to which doctors and dentists in training within the UK and Republic of Ireland (RoI) engage in and with evidence-based practice (EBP), and to identify motivators and barriers to them doing so.DesignAn observational, prepiloted web-based survey developed by a trainee-led focus group.SettingThe survey instrument was disseminated to doctors and dentists in training within the UK and RoI during June 2017 via social media and through deaneries, Royal Colleges and specialty-specific mailing lists.ParticipantsData from 243 trainees were analysed; 188 doctors from 31 specialties and 55 dentists from 9 specialties. Responses were received from trainees at all stages of postgraduate training though the overall response rate was low.Primary and secondary outcome measuresThe motivators and barriers to, and the extent of, trainee engagement with EBP.ResultsCronbach’s α was 0.83. Most trainees (87.6% (n=148) of doctors and 75.1% (n=39) of dentists) consulted the evidence base at least monthly, while 23.1% [n=39 doctors, 12 dentists] of both specialties did so daily. The two most commonly cited barriers to engagement with EBP for both doctors and dentists, respectively, were insufficient time (57.6% (n=95) and 45.1% (n=23)) and a tendency to follow departmental practice (40.6% (n=67) and 45.1% (n=23)). Key motivators for EBP included curiosity, following the example set by senior colleagues and a desire to avoid harm. Most trainees reported high levels of confidence interpreting evidence yet for 26.8% (n=45) of doctors and 36.5% (n=19) of dentists, medical hierarchy would impede them querying a colleague’s management plan based on their own reading of the evidence.ConclusionsTime, accepted departmental practice and the behaviour of senior clinicians all highly impact on trainee engagement with EBP. Given the low response rate, the extent to which these data represent the overall population is unclear.

The Acshpri: Shaping Surgical Workforce Policy Through Evidence-Based Analyses

2011 ◽  
Vol 93 (5) ◽  
pp. 1-5 ◽  
Author(s):  
Erin P Fraher ◽  
Stephanie T Poley ◽  
George F Sheldon ◽  
Thomas C Ricketts ◽  
Kristie W Thompson
Keyword(s):  
Royal College ◽  
Health Reform ◽  
Policy Research ◽  
Workforce Planning ◽  
Evidence Based ◽  
Surgical Workforce ◽  
The Us ◽  
American College Of Surgeons ◽  
Workforce Policy ◽  
The Uk

Editor's note: This article is being published jointly in the Bulletin of the American College of Surgeons and the Bulletin of The Royal College of Surgeons of England. With health reform underway in both countries, the issues confronting the surgical workforce in the US are strikingly similar to the challenges facing the surgical workforce in England. This article describes the American College of Surgeons (ACS) Health Policy Research Institute's (HPRI) role in collecting, analysing and disseminating information about the surgical workforce in the US and suggests that HPRI might serve as a model for The Royal College of Surgeons of England to assist the UK government in workforce planning.

scholarly journals The changing UK paediatric consultant workforce: report from the Royal College of Paediatrics and Child Health

2016 ◽  
Vol 102 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Martin McColgan ◽  
Rachel Winch ◽  
Simon J Clark ◽  
Carol Ewing ◽  
Neena Modi ◽  
...  
Keyword(s):  
Child Health ◽  
Outcome Measures ◽  
Royal College ◽  
Median Number ◽  
Full Time ◽  
Professional Activities ◽  
Time Period ◽  
The Uk ◽  
And Child Health

ObjectivesTo determine if there had been changes in the size of the UK paediatric workforce and working patterns between 1999 and 2013.DesignAnalysis of prospectively collected datasets.SettingUK consultant paediatricians.InterventionsData from the Royal College of Paediatrics and Child Health's workforce census from 1999 to 2013 and the annual surveys of new paediatric Certificate of Completion of Training (CCT) and Certificate of Equivalence of Specialist Registration (CESR) holders between 2010 and 2013.Main outcome measuresPaediatric consultant numbers, programmed activities (PAs) and resident shift working.ResultsThe UK paediatric consultant workforce grew from 1933 in 1999 to 3718 in 2013. Over the same time period, there was a decline in the number of consultants with a primary academic contract from 210 to 143. There was an increase in the proportion of consultants who were female (40% in 1999 to 50% in 2013, p<0.01). The median number of PAs declined from 11 in 2009 to 10 in 2013 (p<0.001) as did the median number of PAs for supporting professional activities (2.5–2.3, p<0.001). In 2013, 38% of new consultants in general paediatrics or neonatology were working resident shifts. Between 2009 and 2013, the proportion of less than full-time working consultants rose from 18% to 22%, which was more common among female consultants (35% vs 9%).ConclusionThe paediatric consultant workforce has doubled since 1999, but more are working less than full time. The decline in those with a primary academic contract is of concern.

468 Free Flap Breast Reconstruction in the UK: Are We Meeting the Demand?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Begaj ◽  
F Marlborough ◽  
K P Allison
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Response Rate ◽  
Breast Surgery ◽  
Workforce Planning ◽  
Free Flaps ◽  
Evidence Base ◽  
Breast Cancer Patients ◽  
The Mean ◽  
The Uk

Abstract The demand for free flap breast reconstruction appears to be increasing. This study aims to evaluate the capacity for microsurgical breast reconstruction across the UK and compare this to the apparent demand to inform future workforce planning. A questionnaire was sent to all the plastic surgery units in the UK to establish whether they performed reconstructive breast surgery, the number of free flaps they performed a year and what issues they were encountering in meeting the demand. The response rate was 92.8% of 56 units. Current workforce planning figures show that there are 161 Consultant Plastic Surgeons who perform free tissue breast reconstruction. Across the UK, the total number of extra breast reconstructive surgeons felt to be needed was 78. The mean number of free flaps per year per surgeon was 20 [11-37]. Responders suggested that they felt 20 [12-30] free flaps were a suitable number to maintain their skills. 66% of the responders reported issues impairing delivery of their free flap service with access to theatre (41%) and inability to meet the demand (18%) as 2 of the key reasons. Our results show that there is a demand for microsurgical breast reconstruction that is not being fully met at present. The authors hope that this survey may add to the evidence base that plastic surgeons remain an integral part of the care of many breast cancer patients and will encourage trainees to consider it as a subspecialty of choice.

Evidence-based Practice regarding knowledge, attitude and perceived barriers of Mangalore Physical Therapists: A Survey

2020 ◽  
Vol 11 (4) ◽  
pp. 7056-7063
Author(s):  
Vineel P ◽  
Gopala Krishna Alaparthi ◽  
Kalyana Chakravarthy Bairapareddy ◽  
Sampath Kumar Amaravadi
Keyword(s):  
Response Rate ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Medical Profession ◽  
Demographic Data ◽  
Perceived Barriers ◽  
Hard Copy ◽  
Evidence Based ◽  
Research Committee ◽  
The Individual

  Evidence-based Practice is defined as usage of current best evidence which is conscientious, explicit and judicious in deciding on the care of the individual. It is one of the vital decision-making processes in the medical profession. Though India is renowned as a center for medical education, there is scarcity regarding the literature on evidence-based practice. The survey aims to identify the prevalence of evidence-based practice among the physical therapists of Mangalore. The study protocol submitted to scientific research committee and Ethical institutional committee, K.M.C. Mangalore Manipal University. On approval, the questionnaire had been distributed among the physical therapists of Mangalore through mails and in the written form. The questionnaire consists of questions divided into eight sections: 1) consent form 2) current practice status; 3) demographic data; 4) behavior; 5) previous knowledge of E.B.P. resources; 6) skills and available resources; 7) Opinions regarding E.B.P.; 8)Perceived barriers regarding E.B.P. The emails were sent through Google forms to all the physical therapists, and hard copies were distributed among the selected physical therapists. The response rate for the emails was 13.1%. The response collected through hard copies was 178, whereas total hard copies distributed was 320, the participants rejected some due to lack of interest. In total, including emails and hard copy questionnaire 205 was the response rate in which all were practicing physical therapy as their primary profession. The findings of the study will pave the way to identify the status of evidence-based practice as well as help in designing promotional programmers for evidence-based practice.

scholarly journals Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

2017 ◽  
Vol 46 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Laura Pass ◽  
Carl W. Lejuez ◽  
Shirley Reynolds
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Adolescent Depression ◽  
Psychological Intervention ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Behavioural Activation ◽  
Evidence Based Treatments ◽  
The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

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