Article Text
Abstract
Objectives This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors.
Setting Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors’ career decisions.
Participants Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey.
Results Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.
Junior doctors’ decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.
Events linked with specific specialties influenced doctors’ attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect.
Conclusions Junior doctors’ preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers.
- medical education & training
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Footnotes
Contributors SS led this study, with all authors involved in study design and discussion of data from interviews carried out by EP and SS. All listed authors have directly contributed to writing and finalising the paper.
Funding This paper presents independent research funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR). The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health.
Competing interests SS reports grants from NIHR SPCR, during the conduct of the study, and also works as an NHS General Practitioner. KC reports grants from NIHR School for Primary Care Research, during the conduct of the study, and grants from Department of Health Policy research programme, outside the submitted work. EP reports grants from NIHR School for Primary Care Research, during the conduct of the study; personal fees from additional part-time employment in teaching and research at the University of Manchester, outside the submitted work; JG has nothing to disclose.
Ethics approval University of Manchester Research Ethics Committee 6, Ref: ethics/15370.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Raw transcripts are held by the researchers who will consider requests for further information in line with guidance from funders and/or ethics committee.