Junior doctors' aspirations for careers in ophthalmology: 40 years of surveys of UK medical graduates.
ABSTRACT: Objective:Using data from 40 years of national surveys of UK medical graduates, we report on ophthalmology as a career choice. Design setting and participants:Self-administered questionnaire surveys of all graduates from all UK medical schools in selected years of qualification between 1974 and 2015. Main outcome measures:Career specialty preferences of doctors one, three, and five years after graduation; career specialty destinations 10 years after graduation. Results:One year after graduation, ophthalmology was the first career preference of 1.6% of the qualifiers of 1974-83, 2.2% of 1993-2002, and 1.8% of 2005-15. The corresponding percentages three years after graduation were 1.5, 1.8, and 1.2%. Men were more likely than women to choose ophthalmology: among graduates of 2005-15, 2.4% of men and 1.4% of women did so at one year, as did 1.7% of men and 0.7% of women at five years. Seventy per cent of doctors practising as ophthalmologists 10 years after qualification had told us in their first post-qualification year that ophthalmology was their first choice of career. Conclusions:There has been no systematic change in recent years in the proportion of recent medical graduates intending to have a career in ophthalmology when surveyed one year after graduation. However, the proportion at three and five years after graduation was lower than that at year 1. Suggestions for maintaining interest in the specialty include improved career advice, greater early clinical exposure to ophthalmology, and improved access to flexible training. Most practising ophthalmologists had made early decisions that this was their intended career.
Project description:BACKGROUND: Cardiology is one of the most popular of the hospital medical specialties in the UK. It is also a highly competitive specialty in respect of the availability of higher specialty training posts. Our aims are to describe doctors' early intentions about seeking careers in cardiology, to report on when decisions about seeking a career in cardiology are made, to compare differences between men and women doctors in the choice of cardiology, and to compare early career choices with later specialty destinations. METHODS: Questionnaire surveys were sent to all UK medical graduates in selected qualification years from 1974-2009, at 1, 3, 5, 7 and 10 years after graduation. RESULTS: One year after graduation, the percentage of doctors specifying cardiology as their first choice of long-term career rose from the mid-1990s from 2.4% (1993 cohort) to 4.2% (2005 cohort) but then fell back to 2.7% (2009 cohort). Men were more likely to give cardiology as their first choice than women (eg 4.1% of men and 1.9% of women in the 2009 cohort). The percentage of doctors who gave cardiology as their first choice of career declined between years one and five after qualification: the fall was more marked for women. 34% of respondents who specified cardiology as their sole first choice of career one year post-graduation were later working in cardiology. 24% of doctors practising as cardiologists several years after qualification had given cardiology as their sole first choice in year one. The doctors' 'domestic circumstances' were a relatively unimportant influence on specialty choice for aspiring cardiologists, while 'enthusiasm/commitment', 'financial prospects', 'experiences of the job so far' and 'a particular teacher/department' were important. CONCLUSIONS: Cardiology grew as a first preference one year after graduation to 2005 but is now falling. It consistently attracts a higher percentage of men than women doctors. The correspondence between early choice and later destination was not particularly strong for cardiology, and was less strong than that for several other specialties.
Project description:BACKGROUND:The rapidly rising rates of brain diseases due to the growing ageing population and the explosion in treatment options for many neurological conditions increase the demand for neurologists. We report trends in doctors' career choices for neurology; investigate factors driving their choices; and compare doctors' original choices with their specialty destinations. METHODS:A multi-cohort, multi-purpose nation-wide study using both online and postal questionnaires collected data on career choice, influencing factors, and career destinations. UK-trained doctors completed questionnaires at one, three, five, and ten years after qualification. They were classified into three groups: graduates of 1974-1983, graduates of 1993-2002, and graduates of 2005-2015. RESULTS:Neurology was more popular among graduates of 2005-2015 than earlier graduates; however, its attraction for graduates of 2005-2015 doctors reduced over time from graduation. A higher percentage of men than women doctors chose neurology as their first career choice. For instance, among graduates of 2005-2015, 2.2% of men and 1.1% of women preferred neurology as first choice in year 1. The most influential factor on career choice was "enthusiasm for and commitment to the specialty" in all cohorts and all years after graduation. Only 39% who chose neurology in year 1 progressed to become neurologists later. Conversely, only 28% of practicing neurologists in our study had decided to become neurologists in their first year after qualification. By year 3 this figure had risen to 65%, and by year 5 to 76%. CONCLUSIONS:Career decision-making among UK medical graduates is complicated. Early choices for neurology were not highly predictive of career destinations. Some influential factors in this process were identified. Improving mentoring programmes to support medical graduates, provide career counselling, develop professionalism, and increase their interest in neurology were suggested.
Project description:Changes to the structure of medical training worldwide require doctors to decide on their career specialty at an increasingly early stage after graduation. We studied trends in career choices for surgery, and the eventual career destinations, of UK graduates who declared an early preference for surgery.Postal questionnaires were sent, at regular time intervals after qualification, to all medical qualifiers from all UK medical schools in selected qualification years between 1974 and 2005. They were sent in the first year after qualification, at year three and five years after qualification, and at longer time intervals thereafter.Responses were received from 27,749 of 38,280 doctors (73%) at year one, 23,468 of 33,151 (71%) at year three, and 17,689 of 24,870 (71%) at year five. Early career preferences showed that surgery has become more popular over the past two decades. Looking forward from early career choice, 60% of respondents (64% of men, 48% of women) with a first preference for a surgical specialty at year one eventually worked in surgery (p < 0.001 for the male-female comparison). Looking backward from eventual career destinations, 90% of responders working in surgery had originally specified a first choice for a surgical specialty at year one. 'Match' rates between eventual destinations and early choices were much higher for surgery than for other specialties. Considering factors that influenced early specialty choice 'a great deal', comparing aspiring surgeons and aspiring general practitioners (GPs), a significantly higher percentage who chose surgery than general practice specified enthusiasm for the specialty (73% vs. 53%), a particular teacher or department (34% vs. 12%), inclinations before medical school (20% vs. 11%), and future financial prospects (24% vs. 13%); and a lower percentage specified that hours and working conditions had influenced their choice (21% vs. 71%). Women choosing surgery were influenced less than men by their inclinations before medical school or by their future financial prospects.Surgery is a popular specialty choice in the UK. The great majority of doctors who progressed in a surgical career made an early and definitive decision to do so.
Project description:To report on doctors' early choices of specialty at selected intervals after qualification, and eventual career destinations.Questionnaire surveys.United Kingdom.Total of 15 759 doctors who qualified in 1974, 1977, 1983, 1993, and 1996, and their career destinations 10 years after graduation.15 759 doctors were surveyed one and three years after graduation and 12 108 five years after graduation. Career preferences at years 1, 3, and 5, and destinations at 10 years, were known for, respectively, 64% (n=10 154), 62% (n=9702), and 61% (n=7429) of the survey population. In the 1993 and 1996 cohorts, career destinations matched with year 1 choices for 54% (1890/3508) of doctors in year 1, 70% (2494/3579) in year 3, and 83% (2916/3524) in year 5. Corresponding results for the earlier cohorts (1974-83) were similar: 53% (3310/6264), 74% (4233/5752), and 82% (2976/3646). The match rates varied by specialty; for example, the rates were consistently high for surgery. Career destinations matched with year 1 choices for 74% (722/982) of doctors who specified a definite (rather than probable or uncertain) specialty choice in their first postgraduate year. About half of those who chose a hospital specialty but did not eventually work in it were working in general practice by year 10.Ten years after qualification about a quarter of doctors were working in a specialty that was different from the one chosen in their third year after graduation. This stayed reasonably constant across graduation cohorts despite the changes in training programmes over time. Subject to the availability of training posts, postgraduate training should permit those who have made early, definite choices to progress quickly into their chosen specialty, while recognising the need for flexibility for those who choose later.
Project description:Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as 'somewhat satisfied' or 'very satisfied' by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.
Project description:Specialty choices among medical graduates have undergone changes over time. We aimed to analyze status of otorhinolaryngology as specialty of choice among female medical graduates and factors affecting it. A total of 123 female medical graduates were surveyed during their internship over a period of 1 year in a tertiary-care hospital. Each intern was assessed using a questionnaire at the end of otorhinolaryngology rotation. The survey included nine questions about future career choices with special focus on ENT as a choice for specialization. Questions on choice of specialty, reason for choice, quality of undergraduate teaching and clinical postings were included. The post graduation specialty choices in descending order are Medicine, Pediatrics, Surgery, Obstetrics and Gynecology, Dermatology, Ophthalmology, Radiology, ENT, Anesthesia, Psychiatry followed by Physiology, Anatomy and Biochemistry. Among surgical branches most popular choice was General Surgery followed by Obstetrics and Gynecology, Ophthalmology, ENT and Orthopedics in descending order. Reason for the choice included advice from family and friends. Forty two interns (34.2%) followed advice of senior colleagues, 42 (34.2%) followed advice of relatives in the medical field, 25 (20.3%) took advice of non-medico parents while 14 (11.3%) followed their peer group. Regarding the opinion on the quality of undergraduate teaching and clinical postings, both were rated good by the majority. Otorhinolaryngology is less preferred than other general surgery, Obstetrics and Gynecology and ophthalmology by female medical graduates among surgical disciplines. Possible reasons and ways to improve status of Otorhinolaryngology are discussed.
Project description:It is important to inform medical educators and workforce planners in Anaesthesia about early career choices for the specialty, factors that influence them and to elucidate how recent choices of men and women doctors relate to the overall historical trends in the specialty's popularity.We analysed longitudinal data on career choice, based on self-completed questionnaires, from national year-of-qualification cohorts of UK-trained doctors from 1974 to 2012 surveyed one, three and 5 years post-qualification. Career destination data 10 years post-qualification were used for qualifiers between 1993 and 2002, to investigate the association between early choice and later destinations.In years 1, 3 and 5 post-qualification, respectively, 59.9% (37,385), 64.6% (31,473), and 67.2% (24,971) of contactable doctors responded. There was an overall increase, from the early to the later cohorts, in the percentage of medical graduates who wished to enter anaesthesia: for instance year 1 choices rose from 4.6 to 9.4%, comparing the 1974 and 2012 cohorts. Men were more likely than women to express an early preference for a career in anaesthesia: for example, at year 3 after qualification anaesthesia was the choice of 10.1% of men and 7.9% of women. There was a striking increase in the certainty with which women chose anaesthesia as their future career specialty in recent compared to earlier cohorts, not reflected in any trends observed in men choosing anaesthesia. Sixty percent of doctors who were anaesthetists, 10 years after qualifying, had specified anaesthesia as their preferred specialty when surveyed in year 1, 80% in year 3, and 92% in year 5. Doctors working as anaesthetists were less likely than those working in other hospital specialties to have specified, as strong influences on specialty choice, 'experience of the subject' as students, 'inclinations before medical school', and 'what I really want to do'. Men anaesthetists were more influenced in their specialty choice than men in other hospital specialties by 'wanting a career with acceptable hours'; the corresponding difference among women was not significant.We suggest a focus on inspirational teaching of anaesthesia in medical school and on greater exposure to the specialty in the foundation programme. Factors which may discourage women from entering anaesthesia should be explored and addressed.
Project description:Objective:To report doctors' early career preferences for emergency medicine, their eventual career destinations and factors influencing their career pathways. Design:Self-administered questionnaire surveys. Setting:United Kingdom. Participants:All graduates from all UK medical schools in selected graduation years between 1993 and 2015. Main outcome measures:Choices for preferred eventual specialty; eventual career destinations; certainty about choice of specialty; correspondence between early specialty choice for emergency medicine and eventually working in emergency medicine. Results:Emergency medicine was chosen by 5.6% of graduates of 2015 when surveyed in 2016, and 7.1% of graduates of 2012 surveyed in 2015. These figures represent a modest increase compared with other recent cohorts, but there is no evidence of a sustained long-term trend of an increase. More men than women specified emergency medicine - in 2016 6.6% vs. 5.0%, and in 2015 7.9% vs. 6.5%. Doctors choosing emergency medicine were less certain about their choice than doctors choosing other specialties. Of graduates of 2005 who chose emergency medicine in year 1, only 18% were working in emergency medicine in year 10. Looking backwards, from destinations to early choices, 46% of 2005 graduates working in emergency medicine in 2015 had specified emergency medicine as their choice of eventual specialty in year 1. Conclusions:There was no substantial increase across the cohorts in choices for emergency medicine. Policy should address how to encourage more doctors to choose the specialty, and to create a future UK health service environment in which those who choose emergency medicine early on do not later change their minds in large numbers.
Project description:Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates' intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ' Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would 'definitely or probably' practise medicine in the UK in the surveys of 1977-1986, 81% in 1996-2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977-1986, 8% in 1996-2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys.
Project description:Purpose:To evaluate how well the training residency program prepared recent graduates to practice comprehensive ophthalmology with special focus on surgical competency. Methods:This is a cross-sectional study that included Ophthalmologists who graduated from Riyadh ophthalmology residency program between the years 2002-2012. A total of 126 graduates were invited through e-mails and electronic social media platforms to anonymously complete an electronic survey. The survey included questions that aim to assess the surgical competency of graduated ophthalmologists in doing various surgical procedures that were among the requirements of residency training. Results:Ninety participants in the mean age of 38.7?years completed the survey. The majority of respondents (93%) joined fellowship programs and around half of them sub-specialized in anterior segment. More than half (55.6%) of the respondents reported that the acquired surgical skills during residency training were adequate. By the end of the residency period, the respondents' competency in doing extra capsular cataract extraction was better than phacoemulsification while 52% of them reported incompetence in both glaucoma and strabismus surgeries whereas the majority were incompetent in oculoplastics' procedures (e.g. entropion repair). However, the majority felt competent in doing primary repair, minor and laser procedures. Lack of exposure was the major cause of such incompetency. Conclusion:This self-reported survey showed that the lack of adequate surgical exposure during residency training was the main reason of incompetency. This resulted in reduction of ophthalmologists' future practice of surgical procedures outside the scope of their sub-specialty. This emphasizes that physicians mainly practice what they surgically acquire during their fellowship training.