Junior doctors’ early career choices do not predict career destination in neurology: 40 years of surveys of UK medical graduates

Abstract

Background The rapidly rising rates of brain diseases due to the growing ageing population and the explosion in treatment options for many neurological conditions increase the demand for neurologists. We report trends in doctors’ career choices for neurology; investigate factors driving their choices; and compare doctors’ original choices with their specialty destinations. Methods A multi-cohort, multi-purpose nation-wide study using both online and postal questionnaires collected data on career choice, influencing factors, and career destinations. UK-trained doctors completed questionnaires at one, three, five, and ten years after qualification. They were classified into three groups: graduates of 1974–1983, graduates of 1993–2002, and graduates of 2005–2015. Results Neurology was more popular among graduates of 2005–2015 than earlier graduates; however, its attraction for graduates of 2005–2015 doctors reduced over time from graduation. A higher percentage of men than women doctors chose neurology as their first career choice. For instance, among graduates of 2005–2015, 2.2% of men and 1.1% of women preferred neurology as first choice in year 1. The most influential factor on career choice was “enthusiasm for and commitment to the specialty” in all cohorts and all years after graduation. Only 39% who chose neurology in year 1 progressed to become neurologists later. Conversely, only 28% of practicing neurologists in our study had decided to become neurologists in their first year after qualification. By year 3 this figure had risen to 65%, and by year 5 to 76%. Conclusions Career decision-making among UK medical graduates is complicated. Early choices for neurology were not highly predictive of career destinations. Some influential factors in this process were identified. Improving mentoring programmes to support medical graduates, provide career counselling, develop professionalism, and increase their interest in neurology were suggested. Electronic supplementary material The online version of this article (10.1186/s12909-019-1650-7) contains supplementary material, which is available to authorized users.

Study protocol - Ascertaining the career Intentions of UK Medical Students (AIMS) post-graduation: a cross-sectional survey

“…While there have been: i) studies exploring which specialties junior doctors or medical students intend on pursuing (13,14,15,16,17,18), ii) studies which focused on career intentions of those pursuing one specialty or exploring factors that attract them to one speci c specialty (19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35), iii) studies speci cally focused on reasons why doctors are leaving the UK (36, 37,38,39,40), iv) studies exploring how medical students and junior doctors feel about speci c aspects of working within the NHS (41,42,43,44), v) studies investigating the desire for a career break post-foundation year 2 (also known as the 'F3') (45,46,47), there have been no recent, high-powered studies explicitly aimed at medical students, irrespective of current career ambitions or seniority, investigating overall career intentions and correlating it with demographic factors and medical student seniority. There has been one similar study, although focusing entirely on medical students and their intentions to leave the NHS, which is limited by its low power and lack of subanalysis regarding student seniority and demographic factor (48).…”

Study protocol - Ascertaining the career Intentions of UK Medical Students (AIMS) post-graduation: a cross-sectional survey

“…While there have been: i) studies exploring which specialties junior doctors or medical students intend on pursuing (13, 14, 15, 16, 17, 18), ii) studies which focused on career intentions of those pursuing one specialty or exploring factors that attract them to one specific specialty (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35), iii) studies specifically focused on reasons why doctors are leaving the UK (36, 37, 38, 39, 40), iv) studies exploring how medical students and junior doctors feel about specific aspects of working within the NHS (41, 42, 43, 44), v) studies investigating the desire for a career break post-foundation year 2 (also known as the ‘F3’) (45, 46, 47), there have been no recent, high-powered studies explicitly aimed at medical students, irrespective of current career ambitions or seniority, investigating overall career intentions and correlating it with demographic factors and medical student seniority. There has been one similar study, although focusing entirely on medical students and their intentions to leave the NHS, which is limited by its low power and lack of subanalysis regarding student seniority and demographic factor (48).…”

Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study

“…This is in line with the many studies done on the choice of specialization among medical students. Several studies have shown that for most medical students their preference for specialisation changes during medical school and often also in the period after graduation [34][35][36][37] and that females seem to make the final decision later than males [38]. A survey of German medical graduates shows that 77% of students make the decision about their choice of specialisation in the final year of medical school [39].…”