Table 2

Organisational perspective

SubthemeDetailsIllustrative quote
Staffing and compensation policies 
Location of jobs**Current staffing policies result in F2s not necessarily working in the region of the UK in which they would prefer to live.‘As much as I love being here, I feel it is not a very attractive region within the UK. It’s probably the bottom of the pile.’ (P6)
Rota gaps**Most of the F2s had worked in jobs in which there were rota gaps, and most had been asked to increase their hours to fill these gaps.‘All my previous rotas, they’ve never been fully staffed… we were three down at one point, and we just had to cover the bulk of that. And we sent emails saying, this is so unsafe, but you don’t really get very far with that.’ (P4)
Rota policies**In Australia, it was possible to pair rotas with a partner.‘One perk of Australia, the pairing, or more consideration to the rota. They’re not fully linking mine, but they’re going to match when we’re working weekends.’ (P15)
PerksAustralian organisations were thought to have good perks compared with the NHS, which contributed to the sense of feeling valued. Having somewhere to go to during breaks, such as a doctor’s mess, was felt to be important.‘It’s kind of hard to take a break and dissociate yourself from work when there’s nowhere to go.’ (P2)
Working environment
Feeling valuedMany of the F2s felt that Australian and New Zealand organisations valued their staff more than the NHS did.‘How often have you stayed overtime and got no…no one thanks you for it. You get upset because you’re hungry, tired, haven’t gone to the toilet and you’re never getting paid for it.’ (P10)
‘Non-handoverable jobs’**F2s described staying late at work for jobs that were ‘non-handoverable’. These were jobs that were not urgent but they did not feel they could hand over to the next shift.‘It’s things like ordering bloods for tomorrow. Things you know that should have been done during the day. But sometimes, you’re just so busy, it doesn’t get done.’ (P10)
Working atmosphereThe working atmosphere within the NHS was felt to be very negative. The working atmosphere in Australia was thought to be more relaxed than in the UK.‘The Australian people’s personalities are very relaxed and very chilled, so a lot of people have said that that it’s a nice environment to work in. In that sense I think it could differ between that and the UK.’ (P11)
Raising concerns**F2s were unsure about how to raise concerns and were worried that they might be penalised for doing so.‘How are you supposed to give any of this feedback to the top people, because where on earth are they? I think also sometimes you’re worried if you had a concern and you expressed it, that number one, it would fall on deaf ears, and also would you be getting into trouble for expressing concerns?’ (P9)
Learning environment
Learning on the job**F2s enjoyed being challenged, and this was viewed as a positive part of the learning process. Going abroad was viewed by the F2s as good for on-the-job training.‘You can tell people who have been away, and have come back. Just, they’re much more confident, they’ve got much more experience.’ (P4)
Formal teaching**Australia had a reputation for providing more formal teaching than that which is offered in the UK.‘One of my friends who is working out in Perth [Australia], has said actually she has like hourly sessions kind of every other week where she’ll get bedside teaching. That’s way above and beyond what I’ve had. I don’t think I’ve had bedside teaching beyond what happens on a ward round.’ (P13)
Mentorship**Most of the F2s would have liked to have a mentor, had that been available to them.‘My consultant [in a previous job] was very good in encouraging and looking at options and she was probably the person who gave me the most advice about careers. I found that immensely useful, so I think to have some kind of continuity with someone who could be a mentor would have been probably very helpful.’ (P8)
Career advice**Some F2s stated that they had received little or no career advice. Others were satisfied with the career advice that they had been given.‘I think most of the time people expect you to just figure out on our own what you want to do and get the advice that you want on your own.’ (P12)
Balance of service provision versus learning**Some of the F2s felt that there was a greater emphasis on service provision than on training.‘When I was in gen med, there could have been opportunities to observe lumbar punctures, do more pleural taps and things. But we just had to do so many discharge letters and referral forms. And I mean, it just wasn’t helpful for our training.’ (P10)
  • F2s, foundation year two doctors; NHS, National Health Service.