Views of UK doctors in training on the timing of choosing a clinical specialty: quantitative and qualitative analysis of surveys 3 years after graduation.

BACKGROUND: Workforce studies show a declining proportion of UK junior doctors proceeding directly to specialist training, with many taking career breaks. Doctors may be choosing to delay this important career decision. AIM: To assess doctors' views on the timing of choosing a clinical specialty. METHODS: Surveys of two cohorts of UK-trained doctors 3 years after qualification, in 2011 and 2015. RESULTS: Presented with the statement 'I had to choose my career specialty too soon after qualification', 61% agreed (27% strongly) and 22% disagreed (3% strongly disagreed). Doctors least certain about their choice of specialty were most likely to agree (81%), compared with those who were more confident (72%) or were definite regarding their choice of long-term specialty (54%). Doctors not in higher specialist training were more likely to agree with this statement than those who were (72% vs 59%). Graduate medical school entrants (ie, those who had completed prior degrees) were less likely to agree than non-graduates (56% vs 62%). Qualitative analysis of free text comments identified three themes as reasons why doctors felt rushed into choosing their future career: insufficient exposure to a wide range of specialties; a desire for a greater breadth of experience of medicine in general; and inadequate career advice. CONCLUSIONS: Most UK-trained doctors feel rushed into choosing their long-term career specialty. Doctors find this difficult because they lack sufficient medical experience and adequate career advice to make sound choices. Workforce trainers and planners should enable greater flexibility in training pathways and should further improve existing career guidance.

Career specialty choices of UK medical graduates of 2015 compared with earlier cohorts: questionnaire surveys.

OBJECTIVE: To report the career specialty choices of UK medical graduates of 2015 one year after graduation and to compare these with the choices made at the same postgraduate stage by previous cohorts. DESIGN: National survey using online and postal questionnaires. SETTING: UK. PARTICIPANTS: UK-trained medical graduates. MAIN OUTCOME MEASURES: Grouped and individual specialty choices. RESULTS: The response rate was 41.3% (3040/7095). Among the graduates of 2015, general practice (27.8% of first choices) and hospital medical specialties (26.5%) were the most frequent first choices of long-term career. First choices for general practice declined among women from 36.1% for the 2005-2009 cohorts to 33.3% for the 2015 cohort, and among men from 22.4% for the 2005-2009 cohorts to 19.3% for the 2015 cohort. First choices for surgery declined among men (from 29.5% for the 2005-2009 cohorts to 21.7% for the 2015 cohort), but not among women (12.3% for the 2005-2009 cohorts and 12.5% for the 2015 cohort). There was an increase in the percentage of first choices for anaesthesia, psychiatry, radiology and careers outside medicine. Anaesthesia, oncology, paediatrics and radiology increased in popularity over time among men, but not among women. CONCLUSIONS: Career choices for general practice remain low. Other current shortage specialties, apart from radiology and psychiatry, are not showing an increase in the number of doctors who choose them. Large gender differences remain in the choices for some specialties. Further work is needed into the determinants of junior doctors' choices for shortage specialties and those with large gender imbalances.

Adequacy of postgraduate medical training: views of different generations of UK-trained doctors.

BACKGROUND: Over the last decade, many changes have taken place in the UK, which have affected the training that doctors receive. AIM: To assess doctors' views on quality and adequacy of postgraduate training. METHODS: Questionnaires about training sent to UK-trained doctors who graduated between 1974 and 2012. RESULTS: Among trainees towards the end of their first year of medical work and training, 36% agreed that in their first year "Training was of a high standard"; 21% disagreed; 43% neither agreed nor disagreed. Only 16% agreed "I had to perform clinical tasks for which I felt inadequately trained".Among doctors 12 years into their careers, 83% agreed "My training has been long enough, and good enough, to enable me to practise adequately when I first become/became a consultant or GP".Among senior hospital doctors aged in their 50s or 60s, 21% agreed that "These days, the training of specialist doctors in the NHS is sufficient to enable them to practise adequately when they first become consultants"; 38% disagreed, and the rest neither agreed nor disagreed. Of senior GPs, 41% agreed "These days, the training of GP trainees in the NHS is sufficient to enable them to practise adequately when they first become GPs"; 28% disagreed. CONCLUSIONS: Views on early career training were mixed, but few felt exposed to clinical situations beyond their ability. Most newly appointed consultants and GPs felt adequately trained for practice, though many senior doctors were unsure that this was the case.