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      Junior doctors’ aspirations for careers in ophthalmology: 40 years of surveys of UK medical graduates

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          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.

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          Most cited references19

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            Women in surgical residency training programs.

            Increasing numbers of women are entering surgical fields. The purpose of this study was to assess whether orthopaedic surgery is significantly different from other surgical fields in the recruitment of women to training programs. We analyzed data from the American Association of Medical Colleges as reported in annual issues on medical education in the Journal of the American Medical Association for the years 1970 to 2001, excluding 1975. Using linear regression models, we analyzed two factors: changes in the percentage of women within orthopaedic residencies (i.e., the ratio of men to women) and changes in the percentage of all female residents who choose to enter orthopaedics compared with other types of surgical residencies. The percentage of women in the entering classes of medical school has increased from 11.1% in 1970 to 47.8% in 2001, while the percentage of women in orthopaedics has increased from 0.6% in 1970 to 9.0% in 2001. Orthopaedic residencies have the lowest percentage of women compared with all other primary surgical specialties. Only thoracic surgery, a field entered secondarily after the completion of general surgical training, has a lower percentage. The increases in the percentage of women in orthopaedics over the past thirty years have been significantly lower than those in every other primary surgical field (including general surgery, obstetrics and gynecology, ophthalmology, otolaryngology, and urology), except neurosurgery, and are markedly different from the percentages of women in the entering classes of medical school. The percentage of all female residents who choose an orthopaedic residency is 0.6%, a number that has not changed over the past twenty years. Orthopaedic surgery has not had the same success in recruiting female trainees that other surgical fields have had. Furthermore, there appears to be a leveling of the recruitment rate over the past two decades, indicating that the higher numbers of women entering medicine will not be sufficient to improve gender representation in orthopaedic surgery training.
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              Career progression and destinations, comparing men and women in the NHS: postal questionnaire surveys

              Objective To study the career progression of NHS doctors, comparing men and women. Design Postal questionnaire surveys. Participants and setting Graduates of 1977, 1988, and 1993 from all UK medical schools. Results The response rate was 68% (7012/10 344). Within general practice, 97% (1208/1243) of men, 99% (264/267) of women who had always worked full time throughout their career, and 87% (1083/1248) of all women were principals. Median times from qualification to principal status were 5.8 (95% confidence interval 5.6 to 6.0) years for men, 5.6 (5.4 to 5.8) years for women who had worked full time during training, and 6.8 (6.5 to 7.0) years for all women. Of the 1977 and 1988 graduates in hospital practice, 96% (1293/1347) of men were consultants, compared with 92% (276/299) of women who had always worked full time throughout their career and 67% (277/416) of women who had not. Median time to first consultant post was 11.7 (11.5 to 11.9) years for men, 11.3 (11.0 to 11.6) years for women who worked full time during training, and 12.3 (12.0 to 12.6) years for all women. Women who had not always worked full time throughout their career were over-represented in general practice and under-represented in most hospital specialties, substantially so in the surgical specialties and anaesthetics. Women who had always worked full time were under-represented not only in the surgical specialties but also in general practice. Conclusions Women not progressing as far and as fast as men was, generally, a reflection of not having always worked full time rather than their sex. The findings suggest that women do not generally encounter direct discrimination; however, the possibility that indirect discrimination, such as lack of opportunities for part time work, has influenced choice of specialty cannot be ruled out.
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                Author and article information

                Journal
                JRSM Open
                JRSM Open
                SHR
                spshr
                JRSM Open
                SAGE Publications (Sage UK: London, England )
                2054-2704
                6 May 2020
                May 2020
                : 11
                : 5
                : 2054270419892155
                Affiliations
                [1-2054270419892155]UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
                Author notes
                [*]Trevor W Lambert. Email: trevor.lambert@ 123456dph.ox.ac.uk
                Author information
                https://orcid.org/0000-0001-9688-3036
                Article
                10.1177_2054270419892155
                10.1177/2054270419892155
                7236578
                32523702
                925e2169-1374-40a7-b50d-e9668517aae0
                © The Author(s) 2020

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: National Institute for Health Research, FundRef https://doi.org/10.13039/501100000272;
                Award ID: 016/0118
                Categories
                Research Paper
                Custom metadata
                corrected-proof
                ts2

                ophthalmology career,medical education,specialty choice,uk workforce

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