Relationship between sociodemographic factors and specialty destination of UK trainee doctors: a national cohort study

ObjectivesMany countries are driving forward policies to widen the socioeconomic profile of medical students and to train more medical students for certain specialties. However, little is known about how socioeconomic origin relates to specialty choice. Nor is there a good understanding of the relationship between academic performance and specialty choice. To address these gaps, our aim was to identify the relationship between socioeconomic background, academic performance and accepted offers into specialty training.DesignLongitudinal, cohort study using data from the UK Medical Education Database (https://www.ukmed.ac.uk/).Participants6065 (60% females) UK doctors who accepted offers to a specialty training (residency) post after completing the 2-year generic foundation programme (UK Foundation Programme) between 2012 and 2014.Main outcome measuresΧ2tests were used to examine the relationships between sociodemographic characteristics, academic ability and the dependent variable, specialty choice. Multiple data imputation was used to address the issue of missing data. Multinomial regression was employed to test the independent variables in predicting the likelihood of choosing a given specialty.ResultsParticipants pursuing careers in more competitive specialties had significantly higher academic scores than colleagues pursuing less competitive ones. After controlling for the presence of multiple factors, trainees who came from families where no parent was educated to a degree level had statistically significant lower odds of choosing careers in medical specialties relative to general practice (OR=0.78, 95% CI, 0.67 to 0.92). Students who entered medical school as school leavers, compared with mature students, had odds 1.2 times higher (95% CI, 1.04 to 1.56) of choosing surgical specialties than general practice.ConclusionsThe data indicate a direct association between trainees’ sociodemographic characteristics, academic ability and career choices. The findings can be used by medical school, training boards and workforce planners to inform recruitment and retention strategies.

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Patient consent to medical students in general practice

British Journal of General Practice ◽

10.3399/bjgp18x697229 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697229

Author(s):

Matthew Webb ◽

Sarah Thirlwall ◽

Bob McKinley

Keyword(s):

Medical Education ◽

General Practice ◽

Medical Students ◽

Medical School ◽

Undergraduate Students ◽

Teaching Quality ◽

School Students ◽

Patient Journey ◽

Patient Consent ◽

High Level

BackgroundInformed consent is required for active participation of patients in medical education. At Keele Medical School, we require practices to advertise that they teach undergraduate students and to obtain appropriate patient consent at various stages of the patient journey.AimThe study aimed to explore patients’ experience of consent to involvement in undergraduate medical education in general practice.MethodDuring the final year at Keele University Medical School, students undertake a patient satisfaction survey. A questionnaire was attached to the reverse of this survey during the academic year 2016–2017. The questionnaire explored the stage of the patient journey consent was obtained, whether they were offered an alternative appointment and how comfortable they were with medical students being involved in their care.ResultsA total of 489 questionnaires were completed covering 62 GP practices. 97% of patients reported that consent was obtained at least once during their encounter and the majority reported that this occurred at booking. 98% of patients were comfortable or very comfortable with a medical student leading their consultation. However, 28% of those surveyed stated that they were either not given the option of not seeing the student or there was no other alternative appointment available.ConclusionThe results indicate that in the vast majority of cases patient consent is obtained at least once during their attendance. Patients expressed a high level of satisfaction with medical students’ involvement in their care. Further work is required to evaluate the role of the data as a marker of individual practice teaching quality.

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Incidence of diabetes in a general practice population: a database cohort study on the relationship with haloperidol, olanzapine, risperidone or quetiapine exposure

International Clinical Psychopharmacology ◽

10.1097/00004850-200501000-00007 ◽

2005 ◽

Vol 20 (1) ◽

pp. 33-37 ◽

Cited By ~ 27

Author(s):

Emilio Sacchetti ◽

Cesare Turrina ◽

Giovanni Parrinello ◽

Ovidio Brignoli ◽

Giovanni Stefanini ◽

...

Keyword(s):

General Practice ◽

Cohort Study ◽

Practice Population ◽

The Relationship

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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 ◽

10.1136/bmjopen-2019-032021 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032021 ◽

Cited By ~ 3

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.

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How Can You Prepare?

Oxford Assess and Progress: Situational Judgement Test ◽

10.1093/oso/9780198805809.003.0016 ◽

2018 ◽

Author(s):

David Metcalfe ◽

Harveer Dev

Keyword(s):

Medical Students ◽

Medical School ◽

School Curriculum ◽

Foundation Programme ◽

First Choice ◽

Look Back ◽

The Difference ◽

The Right ◽

Situational Judgement ◽

Over Time

The Improving Selection to the Foundation Programme (ISFP) project does not believe that it is possible to be ‘coached’ through the SJT. This is generally true. Knowing the ‘right thing to do’ in any given situation is a matter of internalized values and intuition. However, no one seriously accepts that candidates are born with a fixed level of situational judgement. This is clearly something that develops over time and therefore can change. In addition, the SJT does not set out to test your values but whether you understand the values and attitudes expected of an FY1 doctor. This is why you are instructed to answer questions as you ‘should’, not as you ‘would’. The principles on which foundation doctors should base their behaviour are learnt and internalized throughout medical school. However, knowledge of these principles can clearly be learnt in the same way as any other part of the medical school curriculum. Most final- year medical students are satisfied with the FY1 posts to which they are allocated. For 2017 entry, 74% were appointed to their firstchoice foundation school, and 94% to one of their top five preferences. Those who were not initially pleased often look back in retrospect and are satisfied with their allocations. Your score on the SJT is unlikely to make or break your career. However, the same can be said of medical school finals. You will almost certainly pass finals— upwards of 95% of final- year students do so— and your ultimate career destination is unlikely to hinge on your cumulative examination score. But this is not a reason to go into finals unprepared. The truth is that every point on the SJT, as in finals, could mean the difference between your chosen outcome and something different. A point lost on the SJT could result in your leaving your first- choice foundation school and moving across the country for work, or not having a high enough score to capture your chosen specialty as a Foundation Programme rotation. Increasing competition for FY1 posts means that not everyone can be appointed.

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Ten books

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.035832 ◽

2007 ◽

Vol 191 (3) ◽

pp. 268-270

Author(s):

Michael King

Keyword(s):

General Practice ◽

Medical Students ◽

Medical School ◽

Vocational Training ◽

Junior Doctor ◽

Psychiatric Training

Choosing ten books that have most influenced my practice is an odd challenge. I wasn't one of those medical students who wanted to do psychiatry since he was 12, or read most of Freud or Jung. In fact throughout medical school, and for several years as a junior doctor, I thought psychiatry and psychiatrists were pretty weird. It was only in my general practice vocational training year that I realised how much of medicine concerned the psychological and began my psychiatric training. This influence came not through books that I read but through the patients whom I saw.

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“Thank You for Giving Me a Voice!” A Longitudinal Evaluation of Patients’ Experience of Partnering With Students in an Australian Medical School

Journal of Medical Education and Curricular Development ◽

10.1177/2382120517692776 ◽

2017 ◽

Vol 4 ◽

pp. 238212051769277 ◽

Cited By ~ 3

Author(s):

Kimberley Dale Ivory ◽

Georgina Luscombe ◽

Linda Ann Klein ◽

Alexandra Barratt

Keyword(s):

Medical Education ◽

Cohort Study ◽

Chronic Disease ◽

Medical Students ◽

Medical School ◽

Lived Experience ◽

Chronic Conditions ◽

Baseline Survey ◽

Illness Experiences ◽

Patients Experience

Background: We evaluated the patient-partner experience in a longitudinal program called Integrated Population Medicine in the Sydney Medical School to assess its acceptability. The program exposed senior medical students to the lived experience of chronic disease. Methods: We surveyed 267 people with chronic conditions recruited as patient-partners by the 2012 student cohort in a mixed-methods longitudinal cohort study. Surveys were administered ‘over’ 18 months: before, during, and after the program. Results: A total of 155 (58%) patient-partners completed the baseline survey; 52 patients returned all 3 surveys. Patient-partners remained very positive about the program across all surveys. More than 95% of respondents enjoyed interacting with the student, and most were very positive about their role in teaching the student. Three major themes emerged: willingness to help, a sense of gratitude and enjoyment, and a chance to teach and learn. Participants were willing to discuss their illness experiences and were keen to spend more time with students. Conclusions: Patients are willing participants in longitudinal patient-partner programs. They perceive benefits for themselves and others, for the health system, and for students and would like to become more actively involved in medical education.

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Relationship Between Medical Students’ Career Priority and Specialty Choice: A Nationwide Multicenter Survey

10.21203/rs.2.23412/v1 ◽

2020 ◽

Author(s):

Kenya Ie ◽

Akiko Murata ◽

Masao Tahara ◽

Manabu Komiyama ◽

Shuhei Ichikawa ◽

...

Keyword(s):

Internal Medicine ◽

Emergency Medicine ◽

General Practice ◽

Medical Students ◽

Regression Models ◽

Specialty Choice ◽

Multilevel Logistic Regression ◽

Logistic Regression Models ◽

Multicenter Survey ◽

Specific Care

Abstract Backgrounds The shortage of physicians in several specialties has been brought to public attention in several countries. However, little is known about factors affecting medical students’ specialty choice. The objectives of our study were to illustrate medical students’ career priority clusters and to assess their association with specialty preference. Methods We conducted a nationwide multicenter survey in 2015 at 17 medical schools. The study participants were asked their top three specialty preferences, demographic characteristics, and 14 career priority questions. Multilevel logistic regression models were used to determine the effect of each variables on student career choice. Results A total of 1,264 responses were included in the analyses. The top five specialty choice were internal medicine: 833, general practice: 408, paediatrics: 372, surgery: 344, and emergency medicine: 244. An exploratory factor analysis mapped the 14 career priorities into 3-factor solution; “primary care orientation”, “advanced and specific care”, and “personal life orientation”. Multilevel logistic regression models yielded satisfactory accuracy with the highest ROC curve (AUROC) noted in surgery (0.818), general practice (0.769), and emergency medicine (0.744). The career priorities under “primary care orientation” had positive association with choosing general practice, emergency medicine, internal medicine, and paediatrics. The “advanced and specific care” career priorities facilitated surgery and emergency medicine choice, while reducing the likelihood of choosing less procedure-oriented specialties, such as internal medicine, general practice, and paediatrics. Conclusions Our results demonstrated medical students’ career priorities and their association with specialty preference. Individualized career support may be beneficial for both medical students and each specialty fields.

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The meaning of humanization for first-year medical students - The use of narratives in medical school

10.21203/rs.2.24827/v1 ◽

2020 ◽

Author(s):

Luciana Tavares ◽

Sylvia Enns ◽

José Ricardo Ayres ◽

Patricia Tempski

Keyword(s):

Medical Students ◽

Medical School ◽

Role Models ◽

First Year ◽

Clear Understanding ◽

Human Being ◽

Personal Experiences ◽

Medical Program ◽

First Year Medical Students ◽

The Relationship

Abstract Purpose To analyze the meaning of humanization by first-year medical students as well as to find out about their role models and what were their personal experiences of humanization and dehumanization before entering medical school. Methods The authors performed a qualitative study using narratives of first-year medical students. The data were analyzed through content analysis. The narratives were used as a strategy to stimulate students' reflection and to understand their perspectives and values at the beginning of the medical program. Results The study included 167 participants: 67 females (40.1%) and 100 males (59.9%). The participants' ages ranged from 16 to 38 years. The analysis of the narratives showed three main themes: socio-political and economic aspects of medicine, humanization of healthcare, and dimensions of humanization and dehumanization. In their narratives, the students expressed the desire to become doctors, to help and improve people's lives, and the intention to emulate good role models. Another desire was to contribute to the development of the Brazilian healthcare system. The students considered the humanization of healthcare as an integral vision of the human being that includes perceiving the context and personal history, as well as the complexity, of the human being. The students emphasized the importance of "going beyond the technical dimension" in the relationship between physician and his/her patient. Some students recognized the transdisciplinary aspect of medicine. Conclusions The students in the first-year of the medical program have a clear understanding of the meaning of humanization in medical practice, regardless of their social and economic conditions, age, sex, and religion. The students' narratives expressed their expectations for a more humane society with respect, solidarity, and compassion. The use of narrative is a strategy to develop critical thinking and to better get to know our students: who they are, what they think, and how they feel.

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Medical Students’ Attitudes towards Careers in Primary Care in Singapore

10.21203/rs.3.rs-34481/v1 ◽

2020 ◽

Author(s):

Humairah Zainal ◽

Helen Elizabeth Smith

Keyword(s):

Primary Care ◽

General Practice ◽

Medical Students ◽

Family Medicine ◽

Medical School ◽

Medical Schools ◽

School Experience ◽

Ageing Population ◽

Family Doctors ◽

Students Attitudes

Abstract Background: Singapore needs more family doctors to care for its ageing population and their chronic conditions. To boost the recruitment of doctors within primary care, we need to better understand medical students’ attitudes and experience of General Practice and Family Medicine. While many studies have explored the facilitators and barriers to teaching undergraduate medical students in this field of medicine from the perspectives of GP teachers and trainers, few have examined students’ exposure to primary care in medical schools. Although there are works on factors influencing students’ attitudes towards primary care careers, the roles of medical schools, professional bodies and state institutions tend to be discussed independently of one another. This article explores medical students’ perceptions towards careers in primary care and how different stakeholders might collaborate in strengthening the medical school experience. Methods: Six focus groups involving 54 students from three medical schools in Singapore were conducted. Discussions focussed on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Thematic analysis was used to interpret the qualitative data. Results: 15 key themes emerged from the discussions; 10 reflected key concerns of pursuing primary care careers whereas 5 others highlighted their positive aspects. The former include society’s perceptions of primary care professions as sub-standard, specialists’ negative attitudes towards family doctors, the emphasis on the lifestyle benefits of primary care careers rather than their professional characteristics, mundane case mix, limited professional opportunities, lack of continuity of care, limited consultation time, low remuneration, need for business acumen, and conflicts created by business in clinical care. However, the respondents also articulated positive views, including its lifestyle benefits, autonomy of private practice and better patient care, opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for General Practice and Family Medicine. Conclusion: The findings demonstrate that coordinated initiatives from multiple stakeholders would help to increase the attractiveness of primary care as a career choice among students. Improvements in the medical school experience will significantly enhance the prestige of General Practice and Family Medicine.

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