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      Career decision difficulties post foundation training – the medical student perspective

      research-article
      JRSM Short Reports
      Royal Society of Medicine Press

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          Abstract

          Objectives

          Since 2005, newly qualified doctors in the UK have had their time to prepare for career subspecialization application cut short to 16 months. To have enough time to become a competitive applicant, the choice of specialization may now have to be made as early as in medical school. This study aimed to assess how prepared medical students are towards committing to a specialty while in medical school, and their opinion about having to make such a decision.

          Design

          A cross-sectional questionnaire. A list of all career specialties available to doctors at the point of specialization was provided and asked students to rank their top choice. An assessment of the certainty of their choice was then determined.

          Setting

          Questionnaires were distributed at the end of an optional final year medical student academic meeting held at a leading London medical school university.

          Participants

          One hundred and thirty final year students attended the meeting. Questionnaires were distributed to all attenders; 115 responses were collected.

          Main outcome measures

          The certainty of career specialization choice was assessed in qualitative form, with responses ranging from ‘not likely’, ‘maybe’, ‘probably’, ‘almost certainly’ and ‘definitely’. Their feelings in having to decide upon career specialty while in medical school was assessed through either a ‘yes’ or ‘no’ response.

          Results

          A total of 115 responses were collected. The second most common selection was the ‘undecided’ option at 15%. The highest certainty factor occurred at ‘maybe’ with 41% and progressively fewer responses occurred as the certainty factor increased, with only 10% at ‘definitely’; 95% voted ‘no’ to having to decide what they want to specialize in by the end of medical school.

          Conclusions

          The majority of students have yet to commit to a specialty and almost all agree that they should not have to decide what they want to specialize in by the end of medical school. There is thus greater responsibility from medical schools to incorporate more career discussions into their syllabus.

          Related collections

          Most cited references8

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          Career destinations, job satisfaction and views of the UK medical qualifiers of 1977.

          To study the career destinations, job satisfaction and views of UK-trained senior doctors. Postal questionnaire. All doctors who qualified from all UK medical schools in 1977; and Department of Health employment data. Career destinations of medical qualifiers from 1977. 72% responded to the questionnaire. Using all available evidence, including that on non-responders, 76% of the cohort, comprising 77% of the men and 74% of the women, were working in the NHS 27 years after qualification. Approximately 18% were in medical jobs either overseas or outside the NHS. Of respondents in the NHS, 89% of men and 51% of women had full-time contracts. NHS doctors rated their job satisfaction highly, with a median score of 19.5 on a scale from 5 (very low satisfaction) to 25 (very high satisfaction). Satisfaction with time off for leisure was much lower, with a median score of 4.6 on a scale from 1 (low) to 10 (high). Of those in the NHS, 67% agreed that they worked longer hours than they thought they should; and 40% agreed that their working conditions were satisfactory. 27 years after qualification, the percentage of women who were working in the NHS was similar to that of men. Although these senior doctors had high levels of satisfaction with the content of their jobs, they were not so satisfied with their working hours and working conditions. Our results can be used as benchmarks, against which the career pathways and satisfaction levels of more recently qualified doctors can be compared.
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            Modernising medical careers and factors influencing career choices of medical students.

            This article details medical students' views towards future career choices and factors that may influence this choice. The role of gender in career choice and the importance of structured career advice and management is highlighted and discussed.
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              Career choices made for the hospital medical specialties by graduates from UK medical schools, 1974-2005.

              This article summarises findings from studies of career choices made for the hospital medical specialties by medical graduates one, three and five years after qualifying from UK medical schools in selected years from 1974 to 2005. The percentage of doctors who, early in their careers, expressed a preference for the hospital medical specialties declined between the 1970s and 1980s, increased during the 1990s, and has stabilised since then. The percentage of women medical graduates who want a career in the hospital medical specialties is now similar to that of men. Compared with doctors who choose other specialties, a higher percentage of doctors who choose the hospital medical specialties are uncertain about their specialty choice in the early years after qualification. This uncertainty needs to be considered by those planning postgraduate medical education for the hospital medical specialties, particularly now that postgraduate training in the UK has become much more structured.
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                Author and article information

                Journal
                JRSM Short Rep
                SHORTS
                rsmshorts
                JRSM Short Reports
                Royal Society of Medicine Press
                2042-5333
                May 2011
                17 May 2011
                : 2
                : 5
                : 39
                Affiliations
                simpleWhittington Hospital , London Deanery, UK
                Author notes
                Article
                SHORTS-11-023
                10.1258/shorts.2011.011023
                3105460
                21637400
                d71ba5cd-4d59-4ccb-900a-c4cbfc9ac891
                © 2011 Royal Society of Medicine Press

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc/2.0/), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

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