BackgroundThe future of academic medicine is uncertain. Concerns regarding the future availability of qualified and willing trainee clinical academics have been raised worldwide. Of significant concern is our failure to retain postdoctoral trainee clinical academics, who are likely to be our next generation of leaders in scientific discovery.ObjectivesTo review the literature about factors that may influence postdoctoral career progression in early career clinical academics.DesignThis study employed a scoping review method. Three reviewers separately assessed whether the articles found fit the inclusion criteria.Data sourcesPubMed, Scopus, Web of Science and Google Scholar (1991–2015).Article selectionThe review encompassed a broad search of English language studies published anytime up to November 2015. All articles were eligible for inclusion, including research papers employing either quantitative or qualitative methods, as well as editorials and other summary articles.Data extractionData extracted from included publications were charted according to author(s), sample population, study design, key findings, country of origin and year of publication.ResultsOur review identified 6 key influences: intrinsic motivation, work–life balance, inclusiveness, work environment, mentorship and availability of funding. It also detected significant gaps within the literature about these influences.ConclusionsThree key steps are proposed to help support postdoctoral trainee clinical academics. These focus on ensuring that researchers feel encouraged in their workplace, involved in collaborative dialogue with key stakeholders and able to access reliable information regarding their chosen career pathway. Finally, we highlight recommendations for future research.

PurposeTo describe the influences on clinical academic physicians’ postdoctoral career decision making.MethodThirty-five doctoral trainee physicians from University College London took part in semistructured interviews in 2015 and 2016. Participants were asked open-ended questions about their career to date, their experiences undertaking a PhD, and their career plans post PhD. The interviews were audio-recorded and transcribed. Thematic analysis was used to generate, review, and define themes from the transcripts. Emerging differences and similarities in participants’ reasons for pursuing a PhD were then grouped to produce typologies to explore how their experiences influenced their career decision making.ResultsParticipants described four key reasons for undertaking a PhD, which formed the basis of the four typologies identified. These reasons included the following: to pursue a clinical academic career; to complete an extensive period of research to understand whether a clinical academic career was the desired path forward; to improve clinical career prospects; and to take a break from clinical training.ConclusionsThese findings highlight the need to target efforts at retaining clinical academic physicians according to their reasons for pursuing a PhD and their subsequent experiences with the process. Those responsible for overseeing clinical training must be well informed of the long-term benefits of training academically qualified physicians. In light of current political uncertainty, universities, hospitals, and external agencies alike must increase their efforts to inspire and assuage early-career clinical academic physicians’ fears regarding their academic future.

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