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What factors are critical to attracting NHS foundation doctors into specialty or core training? A discrete choice experiment
  1. Gillian Marion Scanlan1,
  2. Jennifer Cleland1,
  3. Peter Johnston2,
  4. Kim Walker2,
  5. Nicolas Krucien3,
  6. Diane Skåtun3
  7. NHS Education for Scotland
  1. 1 Centre for Healthcare Education Research and Innovation (CHERI), Institute of Education for Medical and Dental Sciences, School of Medicine, Dentistry and Nutrition, University of Aberdeen, Aberdeen, UK
  2. 2 NHS Education for Scotland, Scotland Deanery, Aberdeen, UK
  3. 3 Health Economics Research Unit (HERU), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
  1. Correspondence to Gillian Marion Scanlan; r01gms15{at}


Objectives Multiple personal and work-related factors influence medical trainees’ career decision-making. The relative value of these diverse factors is under-researched, yet this intelligence is crucially important for informing medical workforce planning and retention and recruitment policies. Our aim was to investigate the relative value of UK doctors’ preferences for different training post characteristics during the time period when they either apply for specialty or core training or take time out.

Methods We developed a discrete choice experiment (DCE) specifically for this population. The DCE was distributed to all Foundation Programme Year 2 (F2) doctors across Scotland as part of the National Career Destination Survey in June 2016. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo additional potential income and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients.

Results 677/798 F2 doctors provided usable DCE responses. Location was the most influential characteristic of a training position, followed closely by supportive culture and then working conditions. F2 doctors would need to be compensated by an additional 45.75% above potential earnings to move from a post in a desirable location to one in an undesirable location. Doctors who applied for a training post placed less value on supportive culture and excellent working conditions than those who did not apply. Male F2s valued location and a supportive culture less than female F2s.

Conclusion This is the first study focusing on the career decision-making of UK doctors at a critical careers decision-making point. Both location and specific job-related attributes are highly valued by F2 doctors when deciding their future. This intelligence can inform workforce policy to focus their efforts in terms of making training posts attractive to this group of doctors to enhance recruitment and retention.

  • health economics

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  • Contributors JC, PJ and KW had the original idea for this project and obtained the funding for GMS’s doctorate. The development of the DCE was led by GMS in collaboration with JC, PJ, KW and DS. GMS prepared the ethics application. She lead on the literature review. DS and NK supervised the analysis, which was carried out by GMS. JC, PJ and KW contributed throughout the analysis of the DCE. GMS drafted the paper guidance from DS and NK for the methods, analysis and results sections, with JC revising drafts. All authors contributed to the final paper. The study is guaranteed by the University of Aberdeen.

  • Funding NHS Education for Scotland funded this programme of work.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was granted for all components of this work by the College of Life Sciences and Medicine Ethical Research Board (CERB/2015/12/1269, approval granted 22 April 2016), University of Aberdeen, and the study was also approved by National Health Service Research Scotland (NHS R&D).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All available data can be obtained by contacting the corresponding author (GMS).

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