How do workplaces, working practices and colleagues affect UK doctors’ career decisions? A qualitative study of junior doctors’ career decision making in the UK

ObjectivesThis study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors.SettingJunior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors’ career decisions.ParticipantsTwenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey.ResultsNarrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.Junior doctors’ decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.Events linked with specific specialties influenced doctors’ attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect.ConclusionsJunior doctors’ preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers.

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The Society for Acute Medicine (UK) Acute Medicine Training Survey 2007

Acute Medicine Journal ◽

10.52964/amja.0195 ◽

2008 ◽

Vol 7 (1) ◽

pp. 50-54

Author(s):

Hannah Skene ◽

◽

David K Ward ◽

Keyword(s):

Online Survey ◽

Workforce Planning ◽

Skills Training ◽

Training Programme ◽

Current Situation ◽

Acute Medicine ◽

Part Time ◽

The Uk

An online survey of training in Acute Medicine was conducted to assemble a true picture of the current situation in the UK. The specialty is flourishing, with over 60 trainees having predicted CCT dates in Acute Medicine in 2010 and 2011 alone. 128 respondents highlighted a multitude of issues, including the need for improvements in management and special skills training and part time opportunities. We have used the results of this survey to suggest action points for Deaneries, Training Programme Directors, the Society for Acute Medicine (UK) and those involved in workforce planning.

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Modernising Medical Careers: a urological workforce perspective

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363508x265613 ◽

2008 ◽

Vol 90 (1) ◽

pp. 22-26

Author(s):

GO Hellawell ◽

SS Kommu ◽

F Mumtaz

Keyword(s):

Junior Doctors ◽

Specialty Training ◽

Medical Careers ◽

Foundation Programme ◽

The Future ◽

Training Programmes ◽

The Uk ◽

And Training

The training of junior doctors in the UK is undergoing an evolution to ensure that those concerned are adequately trained and specialised for current and future consultant practice. The implementation of this training evolution is currently widespread at the foundation level (SHO-equivalent) and will expand to specialty training programmes as foundation programme trainees complete their training in 2007. Urology has led the change to the specialty training, with three-year trainees having entered the specialty in 2005. The emergence of urology as the lead specialty for change originated in part from a meeting in 1998 that addressed the future of urology and training, the summary of which was published later that year.

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Motivations of medical students and doctors leaving the NHS explored in a residency training application webinar series

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140795 ◽

2021 ◽

pp. postgradmedj-2021-140795

Author(s):

Setthasorn Zhi Yang Ooi ◽

Rucira Ooi ◽

Amanda Godoi ◽

Eu Fang Foo ◽

Timothy Woo ◽

...

Keyword(s):

Quality Of Life ◽

Medical Students ◽

Residency Training ◽

Wilcoxon Test ◽

Junior Doctors ◽

Specialty Training ◽

Motivating Factors ◽

The Difference ◽

The Uk

BackgroundRecent reports show that about 10% of UK-graduate doctors leave the country to pursue specialty training elsewhere. Our article aims to evaluate the motivating factors for UK graduates to leave the National Health Service (NHS), especially during the COVID-19 pandemic and Brexit.Study designCross-sectional study.MethodA novel 22-item questionnaire was disseminated at a webinar series regarding the application process to pursue residency training in six different countries/regions from 2 August 2020 to 13 September 2020. The data was analysed using Kruskal-Wallis rank-sum with post-hoc Wilcoxon test to compare the difference in significance among the motivating factors.Results1118 responses from the UK medical students and doctors were collected; of which, 1001 (89.5%) were medical students, and 88 (7.9%) were junior doctors. There was a higher propensity for leaving after the Foundation Programme compared with other periods (p<0.0001 for all comparisons). There was no difference between desire for leaving after core surgical/medical training and specialty training (p=0.549). However, both were significantly higher than leaving the NHS after medical school (p<0.0001). Quality of life and financial prospects (both p<0.0001) were the most agreed reasons to leave the NHS, followed by clinical and academic opportunities and, subsequently, family reasons.ConclusionFuture work on the quality of life for doctors in the UK should be explored, especially among those considering leaving the NHS. Policymakers should focus on assessing the difference in working hours, on-call hours and wages that may differ among healthcare systems.

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Assessing the preparedness of Foundation Year 1 (FY1) doctors during the transition from medical school to the Foundation Training Programme

10.21203/rs.2.17164/v1 ◽

2019 ◽

Author(s):

Athena Michaelides ◽

Melina Mahr ◽

Gaurav Pydisetty ◽

Jerocin Vishani Loyala

Keyword(s):

Standard Deviation ◽

Medical School ◽

Patient Care ◽

Online Survey ◽

Diagnostic Procedures ◽

Training Programme ◽

Junior Doctors ◽

Telephone System ◽

Therapeutic Procedures ◽

Hospital Systems

Abstract Background: To assess how ready current FY1 doctors felt when they started their first posting as newly qualified doctors. Methods: We created an online survey where 45 FY1 doctors in South Yorkshire rated how confident they were across different domains (induction and assistantship, hospital systems, and skills) using a scale ranging from 0 (no confidence in performing task) to 5 (highly confident in performing task). Results: Responses showed that the ICE system and observations had a mean rating of 3.645 (95% CI 3.45 to 3.86), 4.425 (95% CI 4.25 to 4.6) with a standard deviation (SD) of 1.1 and 0.83 respectively. The radiological viewing platform, referral system, telephone system, and hospital notes had a mean score of 3.149 (95% CI 2.88 to 3.42), 2.341 (95% CI 2.1 to 2.58), 3.573 (95% CI 3.41 to 3.74) and 4.061 (95% CI 3.93 to 4.19), with a SD of 1.281, 1.154, 0.961 and 0.752 respectively. FY1’s wanted more training on referrals [(84.09%(n=37)) and use of phones [43.2% (n=19)]. Vital observations and diagnostic procedures scored a mean score of 3.933 (95% CI 3.75 to 4.12) and 4.251 (95% CI 4.14 to 4.36) with a SD of 1.19 and 0.944 respectively. The patient care category, the prescribing category and therapeutic procedures gave a mean score of 3.634 (95% CI 3.44 to 3.83), 4.13 (95% CI 3.96 to 4.3), 3.386 (95% CI 3.23 to 3.54) and an SD of 1.128, 0.954 and 1.253 respectively.Conclusion: Overall, junior doctors are confident in most tasks and jobs expected of them. A greater sample size would enable us to compare how different medical schools and deaneries aid this transition.

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1559 Motivations of Medical Students and Doctors Leaving the NHS Explored in a Residency Training Application Webinar Series

British Journal of Surgery ◽

10.1093/bjs/znab258.007 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

S Z Y Ooi ◽

R Ooi ◽

A Godoi ◽

E F Foo ◽

T Woo ◽

...

Keyword(s):

Quality Of Life ◽

Medical Students ◽

Medical Training ◽

Junior Doctors ◽

Specialty Training ◽

Motivating Factors ◽

Surgical Trainees ◽

The Difference ◽

The Uk

Abstract Aim Traditionally, the UK has been highly regarded as a place for doctors to pursue undergraduate medical training and postgraduate training. However, recent reports show that more than 40% of UK-graduate doctors leave the country to pursue specialty training elsewhere. This paper aims to identify and evaluate the motivating factors for UK graduates to leave the NHS. Method An anonymised questionnaire was disseminated at a webinar series regarding the application process to pursue residency overseas. The data was independently analysed by two reviewers. A one-way ANOVA (with Tukey’s Post Hoc test) was utilised to compare the difference between motivating factors. Results were considered statistically significant for p-values <0.05. Results 1,118 responses from the UK medical students and doctors were collected; of which, 1,001 (89.5%) were medical students, and 88 (7.9%) were junior doctors. There was a higher preference for leaving after the Foundation Programme compared to the other periods (p < 0.0001). There was no difference between leaving after core surgical/medical training and specialty training (p = 0.549). However, both were significantly higher than leaving the NHS after medical school (p < 0.0001). Quality of life and financial prospects (both P-corrected<0.0001 compared individually and to other groups) were the most agreed reasons to leave the NHS, followed by clinical and academic opportunities and, subsequently, family reasons. Conclusions Future work on the quality of life for doctors in the UK, especially for prospective surgical trainees, should be explored. Policymakers should focus on assessing the difference in working hours, on-call hours or wages that may differ among the healthcare systems.

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Portuguese Junior Doctors Exchanging in the Uk – Reflections From the Experience

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1808 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S492-S492

Author(s):

H. Salgado ◽

M. Pinto da Costa ◽

H. Walker ◽

J. Powell ◽

L. Potter ◽

...

Keyword(s):

Mental Health Problems ◽

Current System ◽

Training Programme ◽

European Federation ◽

Junior Doctors ◽

The United Kingdom ◽

Exchange Programme ◽

Competing Interest ◽

The Uk ◽

The Impact

IntroductionThe interest in experiencing training abroad has grown and its benefits have been progressively recognized. For these reasons, several psychiatric trainees seek to extend their competencies, skills and knowledge through these exchange opportunities, such as the European Federation of Psychiatric Trainees (EFPT) Exchange Programme.ObjectivesWith this work we intend to describe these international experiences of being acquainted with a different health system and psychiatry training programme.AimsReflect on the impact of these experiences, considering on how these can be used to benefit the patient care provided across countries, further to the professional and personal individual benefits that colleagues gain.MethodsPresenting the testimonials of junior doctors from abroad that have had the opportunity to observe and collaborate in the current system of the United Kingdom.ResultsThe EFPT Exchange Programme is an excellent opportunity for psychiatry trainees to share experiences, knowledge and good practices. The cultural and social framework of psychiatry certainly has an impact on the approach to mental health problems, and being knowledgeable of these differences can provide benefits not only to the junior doctors who complete these exchanges abroad, but also to their colleagues working at their hosting institutions that become acquainted with different realities through their presence and feedback.ConclusionsThe benefits of these exchange mobility experiences are unequivocal. Therefore, it is fundamental to share these experiences and promote these opportunities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Negative attitudes to cyclists affect road space given to them: variation in drivers’ perceptions of adequate space when overtaking a cyclist on the road

10.31234/osf.io/7659j ◽

2021 ◽

Author(s):

Tamsin Saxton ◽

Andrew Thorp

Keyword(s):

Online Survey ◽

Big Five Personality ◽

Negative Attitudes ◽

The Road ◽

Perceptions Of Risk ◽

Driving Anger ◽

North East ◽

The North ◽

On The Road ◽

The Uk

Cycling has individual and collective benefits, and thus various initiatives have attempted to increase cycling uptake. Motivations and intentions around cycling can be influenced by perceptions of risk and safety, which can be derived in part from the overtaking manoeuvres of other road users. Yet we know little about the systematic variables between drivers that might give rise to differences in their overtaking of cyclists. Accordingly, we investigated how people’s personality and attitudinal variables covary with their perceptions of adequate space when overtaking cyclists. We recruited 386 participants (including 349 regular drivers and 114 regular cyclists) from networks within the UK (particularly the north-east of England) who completed an online survey where we assessed their Big Five personality traits, attitudes to cyclists, driving anger, optimism, and their perceptions of the acceptability of overtaking manoeuvres by drivers passing cyclists on roads, depicted in photographs. We found that people evaluated a greater number of overtaking manoeuvres as more acceptable in particular if they had more negative views of cyclists, and also if they did not cycle regularly, and if they reported more driving anger. People often report negative attitudes towards cyclists, but attitudes are subject to change, and future work could investigate whether encouraging drivers to view cyclists more positively could also reduce drivers’ close-pass overtaking manoeuvres.

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Does training adequately equip psychiatrists for intellectual disability?

Advances in Mental Health and Intellectual Disabilities ◽

10.1108/amhid-07-2019-0020 ◽

2020 ◽

Vol 14 (3) ◽

pp. 69-82

Author(s):

Geraldine Lines ◽

Jodie Allen ◽

Caryl Jane Marshall

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Mental Health Services ◽

Health Services ◽

Online Survey ◽

Significant Proportion ◽

Training Programme ◽

Practical Experience ◽

Content Type ◽

The Uk

Purpose People with intellectual disability (ID) experience significant health and social inequality compared to their non-disabled peers. Individuals with ID who access mental health services can have complex comorbidities and presentations. In the UK, a significant proportion of individuals with ID are supported within general adult mental health services not by specialist ID teams. The purpose of this study is to explore whether psychiatry trainees in the Maudsley Training Programme (MTP) feel adequately skilled to support individuals with ID. Design/methodology/approach An online survey of trainee psychiatrists in the MTP was completed to evaluate self-perceived skills and knowledge in the care of individuals with ID in mental health services. Statistical analysis of the results was completed. Findings Experience of working in specialist ID teams is positively associated with greater confidence and skills among trainees in the care of people with ID; this is beyond what would be expected based on seniority alone. Research limitations/implications The response rate was 16.7 per cent; a larger sample size would add strength to the study. Like all online surveys, there exists the risk of selection bias. Practical implications UK Policy states that people with ID should be supported to access mainstream services where possible, including psychiatric care. Practical experience for all psychiatry trainees involving specialist ID services and people with ID could improve the care given to that particularly disadvantaged group. Originality/value This is the only paper known to the authors that has focused specifically on the skills and knowledge of psychiatry trainees in the UK with regards to ID.

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Should midwives learn to scan for presentation? Findings from a large survey of midwives in the UK

British Journal of Midwifery ◽

10.12968/bjom.2019.27.5.305 ◽

2019 ◽

Vol 27 (5) ◽

pp. 305-311

Author(s):

Lauren Barnfield ◽

Jacqueline Bamfo ◽

Lynne Norman

Keyword(s):

Significant Variation ◽

Online Survey ◽

Breech Presentation ◽

Maternal Anxiety ◽

Junior Doctors ◽

Local Practices ◽

Short Course ◽

The Uk ◽

Large Survey ◽

Do So

Background Undiagnosed breech presentation in labour is associated with fetal morbidity and mortality, and may cause significant maternal anxiety. With increasing availability of scan machines, ultrasound is now widely used in UK maternity settings. Bedside presentation scans are usually undertaken by junior doctors, often leading to delays and frustration among staff and patients. Aims To assess local practices and attitudes towards midwives scanning for presentation. Methods A nine-question anonymous online survey was first disseminated by email locally, and then via social media. It was open to all UK non-sonographer midwives and midwifery students. A total of 870 responses were received between January and April 2018. Findings The survey highlighted significant variation in practice across the UK. Of those who did not scan for presentation, 85.2% felt that being able to do so would improve their practice, with the majority of respondents highlighting improvements in patient safety and satisfaction as well as workflow. Conclusions This demonstrates that demand exists for a postgraduate or accredited short course to teach midwives how to safely and accurately scan to assess fetal presentation.

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Cultural Values Influence Mental-Health Help-Seeking in Asian and Latinx College Students

10.31234/osf.io/674h9 ◽

2019 ◽

Author(s):

Elayne Zhou ◽

Yena Kyeong ◽

Cecilia Cheung ◽

Kalina Michalska;Michalska

Keyword(s):

Mental Health ◽

College Students ◽

Cultural Values ◽

Mental Health Treatment ◽

Help Seeking ◽

Online Survey ◽

Negative Attitudes ◽

Help Seeking Behaviors ◽

Seeking Behavior ◽

Ethnic Group Membership

The current study examined the influence of cultural values on mental health attitudes and help-seeking behaviors in college students of diverse ethnic backgrounds. Asian and Latinx college students (N = 159) completed an online survey in which they reported their adherence to cultural values and general attitudes towards mental health and help-seeking behavior. Factor analysis revealed two common factors of cultural values irrespective of ethnic background: Interdependent Orientation (IO) and Cultural Obligation (CO). Regardless of ethnicity, the more students endorsed IO values, the less likely they were to perceive a need for mental health treatment. IO value adherence also predicted more negative attitudes towards mental health. CO values were not predictive of perceived need or help-seeking behaviors. Findings highlight the importance of assessing certain cultural values independently from ethnicity and considering how the multidimensionality of culture may help explain shared mental health behaviors across ethnic group membership.

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