40 Across the Pond: Why Are Junior Doctors Seeking Surgical Training Abroad?

Introduction The loss of junior doctors from the NHS has been an ongoing issue. A subset are now seeking surgical training in other systems, such as the US. This is a costly and difficult process and many enter into undesignated positions with no guarantee of a job. With so much career uncertainty, why are trainees willing to take the risk? Method We performed a survey of trainees who graduated from British medical schools; all are currently enrolled in a US surgical training programme. They were asked about their experiences and perceptions of Results Nine trainees completed the survey. The most common time for trainees to move was during or after foundation training and the majority initially matched into preliminary positions. The most common reason cited to move was to receive better quality training. Many perceived the US training to be better and felt that they had a reasonable work-life balance. Conclusions The potential loss of the future NHS surgical workforce is worrying. Our survey highlights that surgical trainees place a high value on the quality of their training and were willing to enter an intense and uncertain process to achieve it. This needs to be addressed to retain potential trainees.

Potentially Prolonged Psychological Distress from Postponed Olympic and Paralympic Games during COVID-19—Career Uncertainty in Elite Athletes

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the world of sports due to periods of home quarantine, bans against public gatherings, travel restrictions, and a large number of postponed or canceled major sporting events. The literature hitherto is sparse, but early indications display signs of psychological impact on elite athletes due to the pandemic. However, beyond acute effects from lockdown and short-term interrupted athletic seasons, the postponed and still uncertain Olympic and Paralympic Games may represent a major career insecurity to many athletes world-wide, and may lead to severe changes to everyday lives and potentially prolonged psychological distress. Given the long-term perspective of these changes, researchers and stakeholders should address mental health and long-term job insecurity in athletes, including a specific focus on those with small financial margins, such as many female athletes, parasports athletes, athletes in smaller sports, and athletes from developing countries. Implications and the need for research are discussed.

The new cultural norm: reasons why UK foundation doctors are choosing not to go straight into speciality training

Background The number of UK foundation doctors choosing to go straight into speciality training has fallen drastically over the last 10 years: We sought to explore and understand the reasons for this change. Methods We undertook semi-structured interviews with 16 foundation year two doctors, who had not applied to speciality training, from two regional foundation schools. Transcripts were thematically analysed.Results The reasons that foundation doctors are choosing not to go straight into speciality training centre around the themes of feeling undervalued, career uncertainty and a new cultural norm. They report major feelings of uncertainty regarding career choice at such an early stage of their profession and this challenge was magnified by a perceived lack of flexibility of training and the growing normality of taking time out from training. Trainees feel a lack of support in planning and undertaking an “FY3” year and being helped back into the workforce. Trainees overwhelmingly reported that they feel undervalued by their employers. Importantly, however, not going into training directly was not always a reflection of dissatisfaction with training. Many trainees spoke very positively about their planned activities and often saw a break in training as an excellent way to recharge, develop skills and prepare for the rest of their careers in medicine.Conclusions Taking a year or more out of training after foundation years has become the new cultural norm for UK junior doctors and reasons for this include feeling undervalued, career uncertainty and the perception that this is now “normal”. Exploring these factors with participants has generated a number of recommendations related to improving the workplace environment, allowing more flexibility in training and supporting those who chose to take an FY3.

Responding to career uncertainty: Applying a 'dual-empathy' approach to career development using corporate strategy theory

We live in rapidly changing times, with workers continuously facing challenges as organisations go through repeat and rapid transformations. Furthermore, literature on Future of Work, including the rise of artificial intelligence in the workplace, predicts greater levels of occupational hybridisation and contingent working, which will further increase job uncertainty. This paper argues that by drawing on theory and practice from organisational literature, career practitioners can appreciate better the impact of organisational change on work, and the implications of this for people's careers. Thus, in understanding both organisational and individual transformation, they can offer a 'dual-empathy' approach to career practice.

The new cultural norm: reasons why UK foundation doctors are choosing not to go straight into speciality training

Background The number of UK foundation doctors choosing to go straight into speciality training has fallen drastically over the last 10 years: We sought to explore and understand the reasons for this change. Methods We undertook semi-structured interviews with 16 foundation year two doctors, who had not applied to speciality training, from two regional foundation schools. Transcripts were thematically analysed. Results The reasons that foundation doctors are choosing not to go straight into speciality training centre around the themes of feeling undervalued, career uncertainty and a new cultural norm. They report major feelings of uncertainty regarding career choice at such an early stage of their profession and this challenge was magnified by a perceived lack of flexibility of training and the growing normality of taking time out from training. Trainees feel a lack of support in planning and undertaking an “FY3” year and being helped back into the workforce. Trainees overwhelmingly reported that they feel undervalued by their employers. Importantly, however, not going into training directly was not always a reflection of dissatisfaction with training. Many trainees spoke very positively about their planned activities and often saw a break in training as an excellent way to recharge, develop skills and prepare for the rest of their careers in medicine. Conclusions Taking a year or more out of training after foundation years has become the new cultural norm for UK junior doctors and reasons for this include feeling undervalued, career uncertainty and the perception that this is now “normal”. Exploring these factors with participants has generated a number of recommendations related to improving the workplace environment, allowing more flexibility in training and supporting those who chose to take an FY3.

Stressors Experienced by Professional Jockeys

The purpose of this study was to explore the sources of stress reported by professional jockeys. In total, 15 jockeys participated in semistructured interviews that included apprentice, conditional, and senior jockeys. Reflexive thematic analysis was used to analyze qualitative data that included inductive and deductive approaches. Jockeys reported a wide range of stress sources. Four core themes were identified and categorized as competitive (current form or being in a slump, pressure, horse, injury, opponents, tactical, and race day), racing industry (weight, workload, travel demands, injury concerns, suspension, and facilities), interpersonal (trainer, other jockeys, expectations of others, support networks, and communication), and career stressors (career uncertainty, career opportunities, and transitions). The findings highlight unique stressors to the jockey population, as well as stressors common with other athlete groups. Practical applied recommendations and future research directions are provided.