Thinking About Giving Up Clinical Practice? A Gender-Stratified Approach to Understanding Junior Doctorsʼ Choices

Ochsmann, Elke

doi:10.1097/acm.0b013e31823aba03

Cited by 22 publications

(50 citation statements)

References 33 publications

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“…The process of losing physicians from public teaching hospitals typically begins after graduation. Among the publications studied [42, 43, 45–47, 49–51], there is no unanimity with regard to the factors that affect turnover, with aspects such as age, specialty, and post-graduation studies having been identified. However, there is a trend to agree that the more specialized physicians tend to remain in higher-complexity services.…”

Section: Discussionmentioning

confidence: 99%

Physicians’ job satisfaction and motivation in a public academic hospital

et al. 2016

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BackgroundPhysician shortage is a global issue that concerns Brazil’s authorities. The organizational structure and the environment of a medical institution can hide a low-quality life of a physician. This study examines the relationship between the hospital work environment and physicians’ job satisfaction and motivation when working in a large public academic hospital.MethodsThe study was restricted to one large, multispecialty Brazil’s hospital. Six hundred hospital physicians were invited to participate by e-mail. A short version of the Physician Worklife Survey (PWS) was used to measure working satisfaction. Physicians were also asked for socio-demographic information, medical specialty, and the intention to continue working in the hospital.ResultsData from 141 questionnaires were included in the analyses. Forty-five physicians graduated from the hospital’s university, and they did not intend to leave the hospital under any circumstance (affective bond). The motivating factor for beginning the career at the hospital and to continue working there were the connection to the medical school and the hospital status as a “prestigious academic hospital”; the physicians were more satisfied with the career than the specialty. Only 30% completely agreed with the statement “If I had to start my career over again, I would choose my current specialty,” while 45% completely agreed with the statement “I am not well compensated given my training and experience.” The greater point of satisfaction was the relationship with physician colleagues. They are annoyed about the amount of calls they are requested to take and about how work encroaches on their personal time. No significant differences between medical specialties were found in the analysis.ConclusionsThe participants were satisfied with their profession. The fact that they remained at the hospital was related to the academic environment, the relationship with colleagues, and the high prestige in which society holds the institution. The points of dissatisfaction were inadequate remuneration and the fact that work invaded personal time. Routinely, there is a need for organizations to examine the impact of their structures, policies, and procedures on the stress and quality of life of physicians.

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Section: Discussionmentioning

confidence: 99%

Physicians’ job satisfaction and motivation in a public academic hospital

et al. 2016

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“…Many studies investigating intention to leave use single-item measures, such as thinking about giving up clinical practice [2] or intention to change profession [14]. To our knowledge, no validation study comparing single-item measures and multiple-item measures of intention to leave has yet been conducted.…”

Section: Discussionmentioning

confidence: 99%

“…USA [1], Germany [2], Finland [3], Australia [4] and OECD Countries [5]). Although the volume of admissions to medical schools is adequate in most countries to overcome this shortage, not all medical students begin working or spend the duration of their working life in direct patient care [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…We found two studies that investigated specifically junior doctors undergoing residency training [2,10]. Moss et al [10] showed that the most frequently mentioned reasons by 279 UK medical postgraduates who considered leaving medicine belong to working conditions; e.g.…”

Section: Introductionmentioning

confidence: 99%

“…poor working environment, high workload, long working hours and poor support within work. Ochsmann [2] reported that among 637 German residents, adverse work characteristics, such as work-related support, availability of postgraduate training possibilities and overtime, increase the risk of thinking about leaving clinical care. Furthermore, Westerman et al [13] showed for transition from specialty training to a position as hospital consultant that social support facilitates the process through this phase .…”

Section: Introductionmentioning

confidence: 99%

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The impact of training and working conditions on junior doctors’ intention to leave clinical practice

et al. 2014

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BackgroundThe shortage of physicians is an evolving problem throughout the world. In this study we aimed to identify to what extent junior doctors’ training and working conditions determine their intention to leave clinical practice after residency training.MethodsA prospective cohort study was conducted in 557 junior doctors undergoing residency training in German hospitals. Self-reported specialty training conditions, working conditions and intention to leave clinical practice were measured over three time points. Scales covering training conditions were assessed by structured residency training, professional support, and dealing with lack of knowledge; working conditions were evaluated by work overload, job autonomy and social support, based on the Demand–Control–Support model. Multivariate ordinal logistic regression analyses with random intercept for longitudinal data were applied to determine the odds ratio of having a higher level of intention to leave clinical practice.ResultsIn the models that considered training and working conditions separately to predict intention to leave clinical practice we found significant baseline effects and change effects. After modelling training and working conditions simultaneously, we found evidence that the change effect of job autonomy (OR 0.77, p = .005) was associated with intention to leave clinical practice, whereas for the training conditions, only the baseline effects of structured residency training (OR 0.74, p = .017) and dealing with lack of knowledge (OR 0.74, p = .026) predicted intention to leave clinical practice.ConclusionsJunior doctors undergoing specialty training experience high workload in hospital practice and intense requirements in terms of specialty training. Our study indicates that simultaneously improving working conditions over time and establishing a high standard of specialty training conditions may prevent junior doctors from considering leaving clinical practice after residency training.

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The Attitude and Perceptions of Work–life Balance: A Comparison Among Women Surgeons in Japan, USA, and Hong Kong China

et al. 2012

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Thinking About Giving Up Clinical Practice? A Gender-Stratified Approach to Understanding Junior Doctorsʼ Choices

Abstract: Workplace factors predict the wish for leaving clinical care for junior doctors. Male and female junior doctors seem to have different priorities in the workplace, which should be addressed in order to retain them in patient care.

Cited by 22 publications

References 33 publications

Physicians’ job satisfaction and motivation in a public academic hospital

Physicians’ job satisfaction and motivation in a public academic hospital

The impact of training and working conditions on junior doctors’ intention to leave clinical practice

The Attitude and Perceptions of Work–life Balance: A Comparison Among Women Surgeons in Japan, USA, and Hong Kong China

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