scholarly journals Barriers to getting into postgraduate specialty training for junior Australian doctors: An interview-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258584
Author(s):  
Belinda O’Sullivan ◽  
Matthew McGrail ◽  
Tiana Gurney ◽  
Priya Martin
Keyword(s):  
Medical Training ◽  
Negative Impact ◽  
Well Being ◽  
Training System ◽  
Early Career ◽  
Junior Doctors ◽  
Specialty Training ◽  
Structured Interviews ◽  
Specialty Fields ◽  
The Right

Background Medical training is a long process that is not complete until doctors finish specialty training. Getting into specialty training is challenging because of strong competition for limited places, depending on doctors’ chosen field. This may have a negative impact on doctor well-being and reduce the efficiency of the medical training system. This study explored the barriers of pre-registrar (junior) doctors getting into specialty training programs to inform tailored support and re-design of speciality entry systems. Methods From March to October 2019, we conducted 32 semi-structured interviews with early-career doctors in Australia, who had chosen their specialty field, and were either seeking entry, currently undertaking or had recently completed various fields of specialty training. We sought reflections about barriers and major influences to getting into specialty training. In comparing and contrasting generated themes, different patterns emerged from doctors targeting traditionally non-competitive specialty fields like General Practice (GP) and other specialties (typically more competitive fields). As a result we explored the data in this dichotomy. Results Doctors targeting entry to GP specialties had relatively seamless training entry and few specific barriers. In contrast, those pursuing other specialties, regardless of which ones, relayed multiple barriers of: Navigating an unpredictable and complex system with informal support/guidance; Connecting to the right people/networks for relevant experience; Pro-actively planning and differentiating skills with recurrent failure of applications. Conclusions Our exploratory study suggests that doctors wanting to get into non-GP specialty training may experience strong barriers, potentially over multiple years, with the capacity to threaten their morale and resilience. These could be addressed by a clearinghouse of information about different speciality programs, broader selection criteria, feedback on applications and more formal guidance and professional supports. The absence of challenges identified for doctors seeking entry to GP could be used to promote increased uptake of GP careers.

scholarly journals ‘The hardest job I’ve ever done’: a qualitative exploration of the factors affecting junior doctors’ mental health and well-being during medical training in Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katherine Petrie ◽  
Mark Deady ◽  
Deborah Lupton ◽  
Joanna Crawford ◽  
Katherine M. Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Training ◽  
Well Being ◽  
Poor Mental Health ◽  
Junior Doctors ◽  
Structured Interviews ◽  
Related Factors ◽  
Emotional Labour ◽  
Work Related ◽  
Health And Well Being

Abstract Background Medical practitioners can experience considerable stress and poor mental health during their careers, with doctors in training known to be particularly vulnerable. Previous research has documented work-related factors that may play a role in the mental health status of junior doctors. However, these and additional factors, need to be explored further by considering theory-driven, social, structural and contextual issues. This qualitative study aimed to explore the experiences of junior doctors working in Australian hospitals to identify factors that impact their mental health during medical training. Method Semi-structured interviews were conducted with 12 junior medical officers (JMOs) employed across six hospitals in Australia. Transcribed de-identified interviews were analysed thematically using a data-driven inductive approach. Results Four interrelated main themes were identified: i) professional hierarchies; ii) occupational stress; iii) emotional labour, and iv) taking distress home; which detail the complex affective, relational and professional experiences of JMOs. The accounts demonstrate how the social, professional and organisational dimensions of these experiences impact upon trainee’s well-being and mental health, both positively and negatively. Together, the findings document the dynamic, nuanced aspects of junior doctors’ experiences of medical training and practice and highlights the importance of relational connections and the workplace environment in shaping JMOs’ social and emotional well-being. Conclusion The current study adds to the understanding of how junior doctors navigate medical training in Australian hospitals and highlights the complexities of this experience, particularly the ways in which mental health and well-being are shaped by different elements. These findings have important implications to inform new strategies to improve JMO mental health and to leverage work and non-work contexts to better support JMOs during medical training.

scholarly journals Changes And New Constraints In The Competition Rules Enforcement Due To Accession: The Perception Of The Romanian Companies

2011 ◽  
Vol 7 (4) ◽  
Author(s):  
Alina Mihaela Dima
Keyword(s):  
Competition Policy ◽  
Negative Impact ◽  
Free Market ◽  
National Level ◽  
Well Being ◽  
Business Environment ◽  
Competition Rules ◽  
Set Up ◽  
The One ◽  
The Right

Many times, in the attempt to win or to maintain an advantageous position on the market, the economic agent will use a whole arsenal of practices (inclusively and mostly from the marketing field), most of them anticompetitive, with a negative impact on the business environment, which also affects the well-being of the consumer. The policy in the field of competition is the one that defines these types of behaviour and penalizes them depending on the importance of their negative impact, by creating a complex and coherent legislative and institutional mechanism. The right enforcement of the competition policy at the national level is the key in this process, but this should be coordinated with the regional and international objectives and regulations in this field. Romania is facing a double challenge: on the one side, it had to set up a competition policy, which was almost ignored before the90s, on the other side, it had to comply, recently, with high standards in the field, as an EU candidate. Now, as a member state, the promotion of a competition culture becomes a must, along with the design of an adequate system of information and knowledge dissemination for all of those involved. The paper is based on a original and qualitative research and aims at emphasising the increased necessity of the promotion of a competition culture for the competitiveness of the Romanian business environment on the European level in the new context of accession. This will help Romanian business to face the competition challenges within a more extended single European market, as an essential issue of the free market economy status recently granted, and accordingly to the most important EU objectives set up at Lisabon to become the most competitive economy in the world up to 2010.

The Impact of Rape Myths and Current Events on the Well-Being of Sexual Violence Survivors

2020 ◽  
pp. 107780122093778
Author(s):  
Gwendolyn D. Anderson ◽  
Rebekah Overby
Keyword(s):  
Sexual Violence ◽  
Media Coverage ◽  
Negative Impact ◽  
Rape Myths ◽  
Well Being ◽  
Structured Interviews ◽  
Political Event ◽  
High Profile ◽  
Current Events ◽  
The Impact

Rape myths perpetuate blaming survivors of sexual violence for their own victimization. Although research has explored how public and political discourse, current events, and media coverage of sexual violence impacts the well-being of survivors, few studies have examined it from the perspectives of participants as a significant event is unfolding. This study presents findings from semi-structured interviews with female, trans, and nonbinary identified survivors during the Kavanaugh confirmation hearings. We found most participants experienced the negative impact of rape myths, and victim blaming reactions from friends, family, and professionals, both initially and with renewed intensity during this high-profile political event.

scholarly journals Repercussions of The COVID-19 Pandemic on the Well-Being and Training of Medical Clerks: A Pan-Canadian Survey

2020 ◽  
Author(s):  
Myriam Abbas ◽  
Malek Dhane ◽  
Michèle Beniey ◽  
Léamarie Meloche-Dumas ◽  
Mohamed Eissa ◽  
...  
Keyword(s):  
Medical Training ◽  
Medical Curriculum ◽  
Well Being ◽  
Training System ◽  
World Health ◽  
Considerable Proportion ◽  
Stressful Event ◽  
Protected Time ◽  
The Impact ◽  
Residency Match

Abstract Background: The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019-2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors.Methods: An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results: Clerks from 10 of the 17 Canadian medical faculties participated in this study (n=627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25  4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion: The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.

scholarly journals Repercussions of the COVID-19 Pandemic on the Well-being and Training of Medical Clerks: A Pan-Canadian Survey

2020 ◽  
Author(s):  
Myriam Abbas ◽  
Malek Dhane ◽  
Michèle Beniey ◽  
Léamarie Meloche-Dumas ◽  
Mohamed Eissa ◽  
...  
Keyword(s):  
Medical Training ◽  
Medical Curriculum ◽  
Well Being ◽  
Training System ◽  
World Health ◽  
Considerable Proportion ◽  
Stressful Event ◽  
Protected Time ◽  
The Impact ◽  
Residency Match

Abstract Background: The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019-2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact of the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors.Methods: An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results: Clerks from 10 of the 17 Canadian medical faculties participated in this study (n=627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25 ± 4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion: The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.

scholarly journals Repercussions of the COVID-19 pandemic on the well-being and training of medical clerks: a pan-Canadian survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Myriam Abbas ◽  
Malek Dhane ◽  
Michèle Beniey ◽  
Léamarie Meloche-Dumas ◽  
Mohamed Eissa ◽  
...  
Keyword(s):  
Medical Training ◽  
Medical Curriculum ◽  
Well Being ◽  
Training System ◽  
World Health ◽  
Considerable Proportion ◽  
Stressful Event ◽  
Protected Time ◽  
The Impact ◽  
Residency Match

Abstract Background The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019–2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact of the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors. Methods An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results Clerks from 10 of the 17 Canadian medical faculties participated in this study (n = 627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25 ± 4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.

scholarly journals Young surgeons’ challenges at the start of their clinical residency: a semi-qualitative study

2018 ◽  
Vol 3 (4) ◽  
pp. 235-243 ◽  
Author(s):  
Maria-Christina Stefanescu ◽  
Jasmina Sterz ◽  
Sebastian Herbert Hoefer ◽  
Miriam Ruesseler
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Professional Training ◽  
Medical Training ◽  
Qualitative Content Analysis ◽  
Trauma Surgery ◽  
Well Being ◽  
Structured Interview ◽  
Junior Doctors ◽  
Study Participants

AbstractIntroductionAccording to German regulations on licensing to practice medicine, the aim of undergraduate medical training is to produce a scientifically and practically trained physician who is able to work independently. More precisely, medical training has to impart the required knowledge and skills in diagnostics, therapy, health promotion, prevention, and rehabilitation. From the young residents’ point of view, this aim is not achieved, and they do not feel prepared to be a doctor. However, the literature on this subject relies mostly on data based on surveys, and there is a lack of deep analysis of the specific details of the topic. The aim of this study was to analyze in depth how junior doctors in their first and second years felt about their preparation for clinical practice as a doctor from their undergraduate training, as well as which teaching formats and factors influence their preparedness.MethodsThis semi-qualitative study is based on recorded interviews conducted using a structured interview manual. This serves to limit the subject matter of the interview and to target the topics. The study participants were 35 residents of general and visceral surgery, trauma surgery, and urology in their first and second years of medical specialty training. The number of participants was defined by the concept of saturation of the content. Basic data regarding age and the location and length of study were collected using a questionnaire. The audio recordings were transcribed word by word and analyzed with structured qualitative content analysis techniques.ResultsOnly 43% (n=15) of the 35 participating residents stated they were sufficiently prepared to be a doctor from undergraduate medical training, and 22.9% stated that they were not prepared for their work as a resident (8/35). However, 34.3% of the residents stated that undergraduate medical training did prepare them for some of the parts they were expected to master in daily clinical practice, but not other parts. Most of the participants described their first weeks as doctors as particularly stressful and exhausting. As major hurdles during their daily clinical work, participants described knowledge gaps regarding organizational and administrative pathways (71%), deficits in linking knowledge to clinical reasoning (71%), decision making (54%), and therapy planning (51%). Most participants stated that the practical placements during the semester, the clinical clerkships, and the last year internship were most effective as preparation for clinical residency. To be better prepared for clinical practice, participants suggested providing a clearer structure and that the course subjects bear better relations to each other. Nearly all participants proposed increasing patient encounters directly from the beginning of medical training as a longitudinal approach.DiscussionEven though we were able to demonstrate an increase in residents’ preparedness, 57% of the study participants still felt unprepared for their job to some extent. One might argue that starting a new profession will always result in a feeling of being unprepared to some extent. However, this unpreparedness can increase the risk for patients’ well being due to medical errors, which actually represents the third leading cause of death in the US after malignant tumors and cardiovascular diseases. Structured on-the-job adjustment, structured qualification training, and guided professional training are becoming increasingly important for future doctors as selection criteria for career choice and choice of employer. Thus, the surgical disciplines that are struggling with new young residents have to improve their concepts.

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

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.

scholarly journals Extending a Conceptual Framework for Junior Doctors’ Career Decision Making and Rural Careers: Explorers versus Planners and Finding the ‘Right Fit’

2020 ◽  
Vol 17 (4) ◽  
pp. 1352
Author(s):  
Beatriz Cuesta-Briand ◽  
Mathew Coleman ◽  
Rebekah Ledingham ◽  
Sarah Moore ◽  
Helen Wright ◽  
...  
Keyword(s):  
Decision Making ◽  
Western Australia ◽  
Career Decision ◽  
Early Career ◽  
Junior Doctors ◽  
Career Decision Making ◽  
Rural Workforce ◽  
Decision Making Processes ◽  
Rural Work ◽  
The Right

This study uses data from a Rural Clinical School of Western Australia (RCSWA) and WA Country Health (WACHS) study on rural work intentions among junior doctors to explore their internal decision-making processes and gain a better understanding of how junior doctors make decisions along their career pathway. This was a qualitative study involving junior doctor participants in postgraduate years (PGY) 1 to 5 undergoing training in Western Australia (WA). Data was collected through semi-structured telephone interviews. Two main themes were identified: career decision-making as an on-going process; and early career doctors’ internal decision-making process, which fell broadly into two groups (‘explorers’ and ‘planners’). Both groups of junior doctors require ongoing personalised career advice, training pathways, and career development opportunities that best “fit” their internal decision-making processes for the purposes of enhancing rural workforce outcomes.

scholarly journals Dogs at the Workplace: A Multiple Case Study

Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Elisa Wagner ◽  
Miguel Pina e Cunha
Keyword(s):  
Well Being ◽  
Positive Influence ◽  
Structured Interviews ◽  
Business World ◽  
Organizational Policies ◽  
Multiple Case ◽  
Multiple Case Studies ◽  
The Right ◽  
The Impact

As the work environment is increasing in competitiveness and stressfulness, more and more companies try to increase employee well-being. One option is allowing employees to bring their dogs to work, building on the considerable evidence that dogs have a positive influence on people’s well-being. However, little is known about how a dog’s presence influences the employees and the companies in offices. Therefore, we empirically scrutinize the presence of dogs in organizations and the impact of pet-friendly organizational policies, with multiple case studies with semi-structured interviews as their foundation. Based on an inductive approach for the data analysis, we found that organizational members consider that dogs can lower their stress, improve communication, and foster social cohesion when a flexible organizational culture is in place. This includes the following: Problems in the company are openly addressed; employees have job autonomy, with flexibility to take breaks; and mistakes and errors are allowed to be made by employees and their companions alike, and room to find solutions is given. The inflexible permission of pets at work can, on the contrary, create pressure and stress in employees. For the business world, this implicates that this kind of incentive only leads to success if the right framework and culture is in place, and it cannot only be seen as an instrument to increase employee well-being.

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