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The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study.
BMC Med Educ. 2015 Mar 13; 15:46.BM

Abstract

BACKGROUND

Since 2007 junior doctors in the UK have had to make major career decisions at a point when previously many had not yet chosen a specialty. This study examined when doctors in this new system make specialty choices, which factors influence choices, and whether doctors who choose a specialty they were interested in at medical school are more confident in their choice than those doctors whose interests change post-graduation.

METHODS

Two cohorts of students in their penultimate year at one medical school (n = 227/239) were asked which specialty interested them as a career. Two years later, 210/227 were sent a questionnaire measuring actual specialty chosen, confidence, influence of perceptions of the specialty and experiences on choice, satisfaction with medicine, personality, self-efficacy, and demographics. Medical school and post-graduation choices in the same category were deemed 'stable'. Predictors of stability, and of not having chosen a specialty, were calculated using bootstrapped logistic regression. Differences between specialties on questionnaire factors were analysed.

RESULTS

50% responded (n = 105/277; 44% of the 239 Year 4 students). 65% specialty choices were 'stable'. Factors univariately associated with stability were specialty chosen, having enjoyed the specialty at medical school or since starting work, having first considered the specialty earlier. A regression found doctors who chose psychiatry were more likely to have changed choice than those who chose general practice. Confidence in the choice was not associated with stability. Those who chose general practice valued lifestyle factors. A psychiatry choice was associated with needing a job and using one's intellect to help others. The decision to choose surgical training tended to be made early. Not having applied for specialty training was associated with being lower on agreeableness and conscientiousness.

CONCLUSION

Medical school experiences are important in specialty choice but experiences post-graduation remain significant, particularly in some specialties (psychiatry in our sample). Career guidance is important at medical school and should be continued post-graduation, with senior clinicians supported in advising juniors. Careers advice in the first year post-graduation may be particularly important, especially for specialties which have difficulty recruiting or are poorly represented at medical school.

Authors+Show Affiliations

University College London Medical School (UCLMS), Room GF/664, Royal Free Hospital, London, NW3 2PF, UK. k.woolf@ucl.ac.uk.London Deanery, The Careers Unit, Room ST201, Stewart House, 32 Russell Square, London, WC1B 5DN, UK. drcarolineelton@gmail.com.Brighton & Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, East Sussex BN1 9PX, UK. M.J.Newport@bsms.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25889968

Citation

Woolf, Katherine, et al. "The Specialty Choices of Graduates From Brighton and Sussex Medical School: a Longitudinal Cohort Study." BMC Medical Education, vol. 15, 2015, p. 46.
Woolf K, Elton C, Newport M. The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study. BMC Med Educ. 2015;15:46.
Woolf, K., Elton, C., & Newport, M. (2015). The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study. BMC Medical Education, 15, 46. https://doi.org/10.1186/s12909-015-0328-z
Woolf K, Elton C, Newport M. The Specialty Choices of Graduates From Brighton and Sussex Medical School: a Longitudinal Cohort Study. BMC Med Educ. 2015 Mar 13;15:46. PubMed PMID: 25889968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study. AU - Woolf,Katherine, AU - Elton,Caroline, AU - Newport,Melanie, Y1 - 2015/03/13/ PY - 2012/11/06/received PY - 2015/02/25/accepted PY - 2015/4/19/entrez PY - 2015/4/19/pubmed PY - 2015/12/30/medline SP - 46 EP - 46 JF - BMC medical education JO - BMC Med Educ VL - 15 N2 - BACKGROUND: Since 2007 junior doctors in the UK have had to make major career decisions at a point when previously many had not yet chosen a specialty. This study examined when doctors in this new system make specialty choices, which factors influence choices, and whether doctors who choose a specialty they were interested in at medical school are more confident in their choice than those doctors whose interests change post-graduation. METHODS: Two cohorts of students in their penultimate year at one medical school (n = 227/239) were asked which specialty interested them as a career. Two years later, 210/227 were sent a questionnaire measuring actual specialty chosen, confidence, influence of perceptions of the specialty and experiences on choice, satisfaction with medicine, personality, self-efficacy, and demographics. Medical school and post-graduation choices in the same category were deemed 'stable'. Predictors of stability, and of not having chosen a specialty, were calculated using bootstrapped logistic regression. Differences between specialties on questionnaire factors were analysed. RESULTS: 50% responded (n = 105/277; 44% of the 239 Year 4 students). 65% specialty choices were 'stable'. Factors univariately associated with stability were specialty chosen, having enjoyed the specialty at medical school or since starting work, having first considered the specialty earlier. A regression found doctors who chose psychiatry were more likely to have changed choice than those who chose general practice. Confidence in the choice was not associated with stability. Those who chose general practice valued lifestyle factors. A psychiatry choice was associated with needing a job and using one's intellect to help others. The decision to choose surgical training tended to be made early. Not having applied for specialty training was associated with being lower on agreeableness and conscientiousness. CONCLUSION: Medical school experiences are important in specialty choice but experiences post-graduation remain significant, particularly in some specialties (psychiatry in our sample). Career guidance is important at medical school and should be continued post-graduation, with senior clinicians supported in advising juniors. Careers advice in the first year post-graduation may be particularly important, especially for specialties which have difficulty recruiting or are poorly represented at medical school. SN - 1472-6920 UR - https://www.unboundmedicine.com/medline/citation/25889968/The_specialty_choices_of_graduates_from_Brighton_and_Sussex_Medical_School:_a_longitudinal_cohort_study_ L2 - https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-015-0328-z DB - PRIME DP - Unbound Medicine ER -