scholarly journals Trends in attractiveness of general practice as a career: surveys of views of UK-trained doctors

2017 ◽  
Vol 67 (657) ◽  
pp. e238-e247 ◽  
Author(s):  
Trevor W Lambert ◽  
Fay Smith ◽  
Michael J Goldacre
Keyword(s):  
General Practice ◽  
Overall Response Rate ◽  
Response Rate ◽  
Specialty Choice ◽  
Hospital Practice ◽  
Career Option ◽  
Hospital Doctors ◽  
Questionnaire Surveys ◽  
The Uk ◽  
Over Time

BackgroundIt is current UK policy to expand the numbers of newly qualified doctors entering training to become GPs, to meet increased demand.Aim To report on trends in young doctors’ views on the attractiveness of general practice as a career, compared with hospital practice.Design and setting Questionnaire surveys in the UK.MethodSurveys of doctors, 3 years after graduation, conducted in successive year-of-qualification cohorts between 1999 and 2015.ResultsThe overall response rate from contactable doctors was 55%. In response to the statement ‘General practice is more attractive than hospital practice for doctors at present’, 59% of doctors agreed in the 1999 survey, 77% in 2005, and only 36% in 2015. One-third of doctors agreed that their exposure to general practice had been insufficient for them to assess it as a career option, but this improved over time: agreement fell from 39% in 1999 to 28% in 2015. As a factor influencing specialty choice, enthusiasm for, and commitment to, the specialty was rated as very important by 65% of intending GPs in 2015, up from 49% in 1999; the corresponding figures for intending hospital doctors were 91% in 2015, up from 61% in 1999.ConclusionOver the 16 years covered by this study, the attractiveness of general practice has fallen relative to hospital practice. This may not necessarily reflect a decline in attractiveness of general practice in absolute terms; rather, it may reflect a greater increase, over time, in the appeal of hospital practice.

scholarly journals Career specialty choices of UK medical graduates of 2015 compared with earlier cohorts: questionnaire surveys

2018 ◽  
Vol 94 (1110) ◽  
pp. 191-197 ◽  
Author(s):  
Trevor William Lambert ◽  
Fay Smith ◽  
Michael J Goldacre
Keyword(s):  
General Practice ◽  
Response Rate ◽  
Junior Doctors ◽  
Medical Specialties ◽  
Medical Graduates ◽  
Questionnaire Surveys ◽  
One Year ◽  
Career Specialty ◽  
Over Time

ObjectiveTo report the career specialty choices of UK medical graduates of 2015 one year after graduation and to compare these with the choices made at the same postgraduate stage by previous cohorts.DesignNational survey using online and postal questionnaires.SettingUK.ParticipantsUK-trained medical graduates.Main outcome measuresGrouped and individual specialty choices.ResultsThe response rate was 41.3% (3040/7095). Among the graduates of 2015, general practice (27.8% of first choices) and hospital medical specialties (26.5%) were the most frequent first choices of long-term career. First choices for general practice declined among women from 36.1% for the 2005–2009 cohorts to 33.3% for the 2015 cohort, and among men from 22.4% for the 2005–2009 cohorts to 19.3% for the 2015 cohort. First choices for surgery declined among men (from 29.5% for the 2005–2009 cohorts to 21.7% for the 2015 cohort), but not among women (12.3% for the 2005–2009 cohorts and 12.5% for the 2015 cohort). There was an increase in the percentage of first choices for anaesthesia, psychiatry, radiology and careers outside medicine. Anaesthesia, oncology, paediatrics and radiology increased in popularity over time among men, but not among women.ConclusionsCareer choices for general practice remain low. Other current shortage specialties, apart from radiology and psychiatry, are not showing an increase in the number of doctors who choose them. Large gender differences remain in the choices for some specialties. Further work is needed into the determinants of junior doctors’ choices for shortage specialties and those with large gender imbalances.

scholarly journals Combining parenthood with a medical career: questionnaire survey of the UK medical graduates of 2002 covering some influences and experiences

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016822 ◽  
Author(s):  
Trevor W Lambert ◽  
Fay Smith ◽  
Michael J Goldacre
Keyword(s):  
General Practitioners ◽  
Response Rate ◽  
Specialty Choice ◽  
Major Influence ◽  
Medical Graduates ◽  
Family Friendly ◽  
Hospital Doctors ◽  
Medical Career ◽  
The Uk ◽  
The Impact

ObjectivesTo report the self-assessed views of a cohort of medical graduates about the impact of having (or wanting to have) children on their specialty choice and the extent to which their employer was supportive of doctors with children.SettingUnited Kingdom (UK).ParticipantsUK medical graduates of 2002 surveyed by post and email in 2014.ResultsThe response rate was 64.2% (2057/3205). Most respondents were living with a spouse or partner (86%) and, of these, 49% had a medical spouse. Having children, or wanting to have children, had influenced specialty choice for 47% of respondents; for 56% of doctors with children and 29% of doctors without children; for 59% of women and 28% of men; and for 78% of general practitioners compared with 27% of hospital doctors and 18% of surgeons. 42% of respondents regarded the National Health Service as a family-friendly employer, and 64% regarded their specialty as family-friendly. More general practitioners (78%) than doctors in hospital specialties (56%) regarded their specialty as family-friendly, while only 32% of surgeons did so.Of those who had taken maternity/paternity/adoption leave, 49% rated the level of support they had received in doing so asexcellent/good, 32% said it wasacceptableand 18% said the support had beenpoor/very poor.ConclusionsHaving children is a major influence when considering specialty choice for many doctors, especially women and general practitioners. Surgeons are least influenced in their career choice by the prospect of parenthood. Almost half of doctors in hospital specialties regard their specialty as family-friendly.

scholarly journals Combining 308-monochromatic excimer phototherapy with monthly IM triamcinolone acetonide for the treatment of resistant alopecia totalis

2021 ◽  
pp. 37
Author(s):  
Keyword(s):  
General Practice ◽  
Triamcinolone Acetonide ◽  
Overall Response Rate ◽  
Response Rate ◽  
Young Patients ◽  
Interventional Study ◽  
Younger Patients ◽  
History Of ◽  
To Receive

Background: Treatment of resistant alopecia totalis AT is a major problem in general practice. Some studies reported the use of either excimer-308 or intra-muscular triamcinolone acetonide as a monotherapy, with conflicting results. Objective: To evaluate the therapeutic effect of combining 308-excimer phototherapy and intramuscular triamcinolone acetonide for the treatment of alopecia totalis. Methods and Material: Ten patients with alopecia totalis were evaluated in this prospective interventional study. All patients were assigned to receive the thera-peutic regimen that includes monthly IM triamcinolone acetonide (TAC) for a maximum of six pulses and twice-weekly excimer phototherapy for 24 sessions. Results: The overall response rate for this regimen was 90%, with four patients 40% achieving complete regrowth of hair (100%). Three patients have exhibited a satisfactory response (>70% regrowth). Unsatisfactory response ( >10-< 70% regrowth) was reported in two patients . Younger patients responded better, as did those with a shorter history of the disease P < 0.05. At follow-up, which continued for 8–12 months, recurrence was noted in two (22.2%) of the nine responders. Conclusions: Combining excimer phototherapy with triamcinolone acetonide showed a promising effect on resistant AT. This treatment modality was effective and well tolerated particularly in young patients.

scholarly journals Patient advice regarding participation in sport in children with disorders of cerebrospinal fluid (CSF) circulation: a national survey of British paediatric neurosurgeons

2020 ◽  
Vol 36 (11) ◽  
pp. 2783-2787
Author(s):  
M. Zaben ◽  
S. Manivannan ◽  
C. Petralia ◽  
I. Bhatti ◽  
C. Patel ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Personal Experience ◽  
Overall Response Rate ◽  
Response Rate ◽  
Age Group ◽  
Csf Circulation ◽  
Integral Role ◽  
Patient Advice ◽  
The Uk ◽  
Evidence Based Guidelines

Abstract Background Management of children with disorders of cerebrospinal fluid (CSF) circulation is a common aspect of paediatric neurosurgical practice. Sport and physical activity play an integral role in the lives of patients in this age group. However, there is little evidence to support the dissemination of appropriate advice to children regarding such activities. The aim of this study was to evaluate the perspectives of clinicians across the UK regarding the participation of children with disorders of CSF circulation in sports. Methods Questionnaires were distributed to Consultant Paediatric Neurosurgeons practising across the UK via the Society of British Neurological Surgeons (SBNS). Five different patient scenarios were supplied, and participants were asked to choose whether they would advise participation in the following sports: Taekwondo, rugby, skiing, and football. Results An overall response rate of 66.7% (36 out of 54 paediatric neurosurgeons) was achieved. The following percentages of clinicians advocated football, rugby, Taekwondo, and skiing across all scenarios: 96%, 75%, 77%, and 97%, respectively. The majority of responders (91.2%) relied on personal experience when providing advice, whilst 50% used available literature and 19.4% used available guidelines. Conclusions There is a paucity of evidence in the literature to support the dissemination of appropriate advice to children with disorders of CSF circulation regarding participation in sports. Our findings demonstrate that the majority of clinicians rely on personal experience to make such decisions, emphasizing the necessity of larger scale studies to inform evidence-based guidelines.

An Open-Label Phase II Study to Investigate the Safety and Efficacy of Rituximab Plus Chlorambucil in Previously Untreated Patients with CD20-Positive B-Cell Chronic Lymphocytic Leukaemia (CLL).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3428-3428 ◽  
Author(s):  
Peter Hillmen ◽  
John G. Gribben ◽  
George A Follows ◽  
Donald W. Milligan ◽  
Hazem A. Sayala ◽  
...  
Keyword(s):  
Interim Analysis ◽  
Overall Response Rate ◽  
Response Rate ◽  
Residual Disease ◽  
Lymphocytic Leukemia ◽  
Phase Iii ◽  
Open Label ◽  
Overall Response ◽  
Binet Stage ◽  
The Uk

Abstract Abstract 3428 Poster Board III-316 Introduction Despite the increasing use of fludarabine (F) plus cyclophosphamide (C), and recently rituximab (R)-FC combinations in CLL, chlorambucil (Chl) remains a first-line treatment option, particularly for elderly patients and those with co-morbidities with chronic lymphocytic leukemia (CLL). However, rates of complete response (CR) are relatively low (up to 7%) as are overall responses (approximately 65%) with Chl. In this study we assessed the feasibility of adding R to Chl in order to improve outcomes. Methods Previously untreated patients with CLL who required therapy according to IWCLL criteria received R (day 1; 375 mg/m2 i.v. cycle 1, 500 mg/m2 cycles 2–6) plus Chl (days 1-7; 10mg/m2/day p.o.) repeated every 28 days for 6 cycles. A further 6 cycles of Chl alone was permitted in patients with continuing clinical response at 6 cycles. The primary endpoint was the adverse event (AE) profile. Secondary endpoints included response rates, progression-free and overall survival and assessment of minimal residual disease. Efficacy results from this study were compared with historical data from patients in the UK LRF CLL4 study who received Chl at the same dose but as monotherapy between 1999 and 2004. Each of the 50 patients in the Chl-R trial were matched to 3 patients from the CLL4 trial by Binet Stage (B or C), VH Mutation (mutated or unmutated), 11q FISH (deleted or not) and age. Results This is a planned interim analysis (IA) based on the first 50 patients out of the total 100 patients from 12 centres. Of these 47 patients were evaluable (2 missing bone marrow at time of IA; 1 protocol violation received only 1 cycle). The median age of patients was 70.5 years (range 48–86), 62% were male and 52% had Binet stage C CLL. The most common AEs were gastrointestinal disorders. There were 25 serious AEs (SAEs) reported in 17 patients. The most common SAEs were infections (10 SAEs, in 6 patients). Additionally there were 3 SAEs (in 3 patients) of febrile neutropenia – grade 3 or 4 neutropenia was reported in 40% of patients. Overall response rate on an intent-to-treat analysis was 84%. When compared with the well matched subset of Chl patients from the UK LRF CLL4 study, the overall response rate was 17.3% higher (95% CI 4.7% - 30.0%), indicating that the Chl-R patients have improved responses. Conclusions Based on this planned interim analysis, the addition of R to Chl is a feasible combination with no unexpected AEs. The combination of R and Chl was effective for untreated patients with CLL. It is important to note that the median age of patients in this study was considerably greater than the median age of patients in the UK LRF CLL4 and other large trials in CLL, and more representative of the typical age of patients presenting with CLL in the clinic. The combination of R and Chl was well-tolerated and effective for untreated patients with CLL who cannot tolerate a more intensive regimen, and suggest investigation in a Phase III study is warranted. Disclosures Hillmen: Alexion Pharmaceuticals: Consultancy; F.Hoffmann-La Roche Ltd: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Bayer Schering: Consultancy. Hayward:F.Hoffmann-La Roche Ltd: Former Employee.

scholarly journals Student nurses’ career intentions following placements in general practice through the advanced training practices scheme (ATPS): findings from an online survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Robin Lewis ◽  
Rachel Ibbotson ◽  
Shona Kelly
Keyword(s):  
General Practice ◽  
Nursing Students ◽  
Online Survey ◽  
Clinical Skills ◽  
Graduate Nurses ◽  
New Graduate Nurses ◽  
Career Option ◽  
New Graduate ◽  
Increasing Demand ◽  
The Uk

Abstract Background The demand for General Practice services in the UK, and elsewhere, is rising quickly. In part, the increasing demand is from an aging population that requires management of multiple long-term conditions. The General Practice Nurse is increasingly taking on the role. It is acknowledged that if general practice is to be able to recruit sufficient General Practice Nurses (GPNs) to meet this increasing demand in the future, new graduate nurses must be encouraged to consider general practice as a viable career option. This research is part of a review of the Advanced Training Practice Scheme (ATPS) which supported clinical placements in participating general practices. Methods The aim of the study was to examine nursing students’ perceptions of GP placements, and their effect upon career intentions following graduation from Sheffield Hallam University (SHU), in the UK. Interviews and an online survey were used collect data. Only the survey is reported here. The bespoke survey examined students’ views of: opportunities for learning new clinical skills and consolidating existing clinical skills; the learning environment in general practice and their views on a career in general practice. Results One thousand one hundred twenty undergraduate adult-field nursing students were contacted, with a response rate of 41% (N = 462). Ninety respondents had a placement and, 92% (N = 84) viewed practice nursing positively, and 77% (N = 70) felt that the placement had transformed their views on general practice. The opportunity to participate in the management of the various aspects of chronic disease was identified by 84% (N = 76) of the students as a key new skill they had acquired. They also reported that they valued a team ethos, control over aspects of work, and the variety of health problems they encountered. Conclusion The findings from this study demonstrate a positive experience arising from the provision of General Practice placements for nursing students. The use of ‘targeted’ placement schemes with appropriate support such as this may be seen as a viable way of exposing nursing students to General Practice nursing, and of encouraging new graduate nurses to consider General Practice nursing as a viable career option.

scholarly journals UK-trained junior doctors' intentions to work in UK medicine: questionnaire surveys, three years after graduation

2017 ◽  
Vol 110 (12) ◽  
pp. 493-500 ◽  
Author(s):  
Geraldine Surman ◽  
Michael J Goldacre ◽  
Trevor W Lambert
Keyword(s):  
Medical Practice ◽  
Response Rate ◽  
Junior Doctors ◽  
Foreseeable Future ◽  
Career Intentions ◽  
Medical Graduates ◽  
The United Kingdom ◽  
Questionnaire Surveys ◽  
The Uk

Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates’ intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ‘ Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would ‘definitely or probably’ practise medicine in the UK in the surveys of 1977–1986, 81% in 1996–2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977–1986, 8% in 1996–2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys.

scholarly journals Evaluation of the association between presenteeism and perceived availability of social support among hospital doctors in Zhejiang, China

2020 ◽  
Author(s):  
Xiaoyu Xi ◽  
Qianni Lu ◽  
Mengqing Lu ◽  
Ailin Xu ◽  
Hao Hu ◽  
...  
Keyword(s):  
Social Support ◽  
Data Analysis ◽  
Logit Model ◽  
Overall Response Rate ◽  
Response Rate ◽  
Perceived Availability ◽  
Appraisal Support ◽  
Unit Increase ◽  
Tangible Support ◽  
Hospital Doctors

Abstract Background: This study investigated the association between presenteeism and the perceived availability of social support among hospital doctors in China. Methods: A questionnaire was administered by doctors randomly selected from 13 hospital in Hangzhou China using stratified sampling. Logit model was used for data analysis. Results: The overall response rate was 88.16%. Among hospital doctors, for each unit increase of the perceived availability of social support, the prevalence of presenteeism was decreased by 8.3% (OR=0.91, P=0.000). In particular, if the doctors perceived availability of appraisal support, belonging support and tangible support as sufficient, the act of presenteeism was reduced by 20.2% (OR=0.806, P=0.000) 20.4% (OR=0.803, P=0.000) and 21.0% (OR=0.799, P=0.000) respectively with statistical differences. Conclusion: In China, appraisal support, belonging support and tangible support, compared to other social support, had a stronger negative correlation with presenteeism among hospital doctors. The benefits of social support in alleviating doctors’ presenteeism warrant further investigation.

scholarly journals Evaluation of the association between presenteeism and perceived availability of social support among hospital doctors in Zhejiang, China

2020 ◽  
Author(s):  
Xiaoyu Xi ◽  
Qianni Lu ◽  
Mengqing Lu ◽  
Ailin Xu ◽  
Hao Hu ◽  
...  
Keyword(s):  
Social Support ◽  
Data Analysis ◽  
Logit Model ◽  
Overall Response Rate ◽  
Response Rate ◽  
Perceived Availability ◽  
Appraisal Support ◽  
Unit Increase ◽  
Tangible Support ◽  
Hospital Doctors

Abstract Objective: This study investigated the association between presenteeism and the perceived availability of social support among hospital doctors in China. Method: A questionnaire was administered by doctors randomly selected from 13 hospital in Hangzhou China using stratified sampling. Logit model was used for data analysis. Results: The overall response rate was 88.16%. Among hospital doctors, for each unit increase of the perceived availability of social support, the prevalence of presenteeism was decreased by 8.3% (OR=0.91, P=0.000). In particular, if the doctors perceived availability of appraisal support, belonging support and tangible support as sufficient, the act of presenteeism was reduced by 20.2% (OR=0.806, P=0.000) 20.4% (OR=0.803, P=0.000) and 21.0% (OR=0.799, P=0.000) respectively with statistical differences. Conclusion: In China, appraisal support, belonging support and tangible support, compared to other social support, had a stronger negative correlation with presenteeism among hospital doctors. The benefits of social support in alleviating doctors’ presenteeism warrant further investigation.

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