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

Abstract

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.

<p>Comments on: Emotional Intelligence Level Higher in Residents Who Took a Gap Year Before Medical School [Letter]</p>

“…In the UK, students and junior doctors take time off for various reasons including further application enhancement for specialty (residency) training or a career break to achieve life goals. 3,4 All of which may enhance emotional intelligence composites stated in this study, such as self-actualization and empathy.…”

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

“…The central importance of trainee doctors feeling over-worked and under-valued has been raised before in previous work, predominantly from questionnaire surveys (8,9,(12)(13)(14), and is a widespread concern across the NHS workforce (16). Similarly, a need for more support for Foundation doctors has been recently highlighted by other authors (17).…”

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

“…The central importance of trainee doctors feeling over-worked and under-valued has been raised before in previous work, predominantly from questionnaire surveys (8,9,(12)(13)(14) (8,9,(12)(13)(14), and is a widespread concern across the NHS workforce (15). Similarly, a need for more support for Foundation doctors has been recently highlighted by other authors (16).…”

“…A novel discrete choice experiment studied revealed that trainees place most value in their training post on good working conditions, good opportunities for their partners and desirable geographical location (8). More recent work has suggested some differences in socioeconomic status between trainees who do and do not take time out of the training pathway (9). A lack of flexibility may also be key with some experts describing the current system as "an inflexible training pipeline" (10).…”