Geographical movement of doctors from education to training and eventual career post: UK cohort studies

Goldacre, Michael J; Davidson, Jean; Maisonneuve, Jenny; Lambert, Trevor W

doi:10.1177/0141076812472617

Cited by 19 publications

(18 citation statements)

References 7 publications

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“…The importance of locality in terms of training near friends and family is of interest. Many studies have shown that medical graduates typical migrate back home at some point in their careers 64‐66 . Our definition of location, developed via qualitative work, 7 specifically included reference to being near family and friends who are important in terms of social support.…”

Section: Discussionmentioning

confidence: 99%

Today's doctors: What do men and women value in a training post?

et al. 2020

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Objectives: Recent studies suggest that traditional male-female differences may be changing in terms of what is valued in a medical career but there have been no studies directly quantifying the relationship between gender and stated career-related preferences. To address this gap, we examined the differences between male and female doctors in terms of the strength of their work-related preferences at the point of eligibility to enter residency or specialty training in the UK. Methods:This was a quantitative study using a survey incorporating a discrete choice experiment (DCE). Respondents were asked a series of questions in which they had to choose between two or more scenarios, differing in terms of attributes. The attributes were: location; familiarity with specialty; culture of the working and learning environment; earnings; working conditions, and opportunities for professional development. The main outcome measure was willingness to accept compensation to forgo a desirable attribute within a training position. Conditional logistic regression models were run separately for males and females. Results:A total of 5005 out of 6890 (73%) Foundation Year 2 doctors completed the DCE. The relative value of each attribute was similar for males and females, with location most valued and familiarity with the specialty least valued. There was a pattern of female respondents valuing the move between the best and worst levels of each training attribute more than men, and significantly more than men in respect of the importance of working culture. Conclusions:This study adds to existing knowledge in terms of quantifying gendered values in respect of training or residency preferences. That men value a supportive working culture significantly less than women is well established. However, our findings that location, working conditions and working culture are increasingly important to both men and women, suggests that traditional gender norms may be changing.This intelligence can inform gender-responsive workforce planning and innovation, and future research. | 409 SCANLAN et AL.

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Section: Discussionmentioning

confidence: 99%

Today's doctors: What do men and women value in a training post?

et al. 2020

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“…Research has examined how factors such as geographical location, gender, career aspiration, work-life balance and perceived financial rewards play a crucial role in determining the career choice of healthcare workforce 9–15. Other studies have looked at the relationship between socioeconomic origin and where doctors practice 16 17.…”

Section: Introductionmentioning

confidence: 99%

Relationship between sociodemographic factors and specialty destination of UK trainee doctors: a national cohort study

et al. 2019

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ObjectivesMany countries are driving forward policies to widen the socioeconomic profile of medical students and to train more medical students for certain specialties. However, little is known about how socioeconomic origin relates to specialty choice. Nor is there a good understanding of the relationship between academic performance and specialty choice. To address these gaps, our aim was to identify the relationship between socioeconomic background, academic performance and accepted offers into specialty training.DesignLongitudinal, cohort study using data from the UK Medical Education Database (https://www.ukmed.ac.uk/).Participants6065 (60% females) UK doctors who accepted offers to a specialty training (residency) post after completing the 2-year generic foundation programme (UK Foundation Programme) between 2012 and 2014.Main outcome measuresΧ2tests were used to examine the relationships between sociodemographic characteristics, academic ability and the dependent variable, specialty choice. Multiple data imputation was used to address the issue of missing data. Multinomial regression was employed to test the independent variables in predicting the likelihood of choosing a given specialty.ResultsParticipants pursuing careers in more competitive specialties had significantly higher academic scores than colleagues pursuing less competitive ones. After controlling for the presence of multiple factors, trainees who came from families where no parent was educated to a degree level had statistically significant lower odds of choosing careers in medical specialties relative to general practice (OR=0.78, 95% CI, 0.67 to 0.92). Students who entered medical school as school leavers, compared with mature students, had odds 1.2 times higher (95% CI, 1.04 to 1.56) of choosing surgical specialties than general practice.ConclusionsThe data indicate a direct association between trainees’ sociodemographic characteristics, academic ability and career choices. The findings can be used by medical school, training boards and workforce planners to inform recruitment and retention strategies.

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“… 30 Related to this, London and the South of England are where much of the UK population is based, and many medical students and early career doctors prefer to train and work nearby their family and friends. 31 32 Finally, applicants from areas of high educational participation and from independent schools—and note there is a strong relationship between these two factors 33 34— may be more likely to apply to highly competitive foundation schools (eg, London and the South of England). Taking these factors as a whole, London and the South of England are very popular places to train and work, and so there is more competition for places.…”

Section: Discussionmentioning

confidence: 99%

Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study

et al. 2018

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IntroductionKnowledge about allocation of doctors into postgraduate training programmes is essential in terms of workforce planning, transparency and equity issues. However, this is a rarely examined topic. To address this gap in the literature, the current study examines the relationships between applicants’ sociodemographic characteristics and outcomes on the UK Foundation Training selection process.MethodsA longitudinal, cohort study of trainees who applied for the first stage of UK postgraduate medical training in 2013–2014. We used UK Medical Education Database (UKMED) to access linked data from different sources, including medical school admissions, assessments and postgraduate training. Multivariable ordinal regression analyses were used to predict the odds of applicants being allocated to their preferred foundation schools.ResultsApplicants allocated to their first-choice foundation school scored on average a quarter of an SD above the average of all applicants in the sample. After adjusting for Foundation Training application score, no statistically significant effects were observed for gender, socioeconomic status (as determined by income support) or whether applicants entered medical school as graduates or not. Ethnicity and place of medical qualification were strong predictors of allocation to preferred foundation school. Applicants who graduated from medical schools in Wales, Scotland and Northern Ireland were 1.17 times, 3.33 times and 12.64 times (respectively), the odds of applicants who graduated from a medical school in England to be allocated to a foundation school of their choice.ConclusionsThe data provide supportive evidence for the fairness of the allocation process but highlight some interesting findings relating to ‘push-pull’ factors in medical careers decision-making. These findings should be considered when designing postgraduate training policy.

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Geographical movement of doctors from education to training and eventual career post: UK cohort studies

Abstract: Many doctors do not change geographical region in their successive career moves, and recent cohorts appear less inclined to do so.

Cited by 19 publications

References 7 publications

Today's doctors: What do men and women value in a training post?

Today's doctors: What do men and women value in a training post?

Relationship between sociodemographic factors and specialty destination of UK trainee doctors: a national cohort study

Relationship between sociodemographic factors and selection into UK postgraduate medical training programmes: a national cohort study

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