Factors influencing recruitment to rheumatology
Attracting suitable candidates to rheumatology is vital to maintaining standards of service. We noted that recently there have been relatively low numbers of applications for rheumatology at specialty training year 3 (ST3) level, and so we decided to undertake a study looking at factors affecting career choices, and doctors' attitudes to rheumatology as a specialty. An online questionnaire was developed using Survey Monkey, and emailed to doctors at foundation year (FY) 1, FY2, core medical training (CMT) and basic specialty training (BST) levels working in two trusts within the Eastern region–Norfolk and Norwich University Hospital and Addenbrooke's Hospital, Cambridge.
Key findings were as follows. Junior doctors are making decisions about which specialty to choose early on in their careers. Rheumatology appears to be on the radar, with nearly 70% of respondents having considered, or who are considering, it as a career. However, reduced exposure to rheumatology inpatients, and less junior doctor posts, limits experience gained. It is vital that we take steps (see Box 1 for ideas) to raise the profile of rheumatology and ensure that we continue to attract strong candidates in order to maintain a high standard of care for patients.
How can we improve recruitment to rheumatology? Emergent themes from qualitative responses.
Background
Attracting suitable candidates to rheumatology is vital to maintaining standards of service. We noted that recently there have been low numbers of applicants to rheumatology at ST3 level, so decided to undertake a study looking at factors affecting career choices, and doctors' attitudes to the specialty.
Method
An electronic questionnaire was emailed to doctors at FY1, FY2, CMT and BST levels working in two trusts within the Eastern region–Norfolk and Norwich University Hospital and Addenbrooke's Hospital, Cambridge. It focused on three areas; anonymous demographic information, reasons behind career choices and attitudes to rheumatology as a specialty.
Results
Out of 270 doctors, 90 (34%) completed the questionnaire; of these 48% were male and 52% female. At the time they responded, 77% of doctors had decided on the specialty in which they wished to work. Asked at which point in their careers they had made this choice responses were as follows: 10% before entering medical school, 26% during medical school, 36% during FY1, 16% during FY2 and 22% during CMT/BST.
Factors most important when choosing a future career were an interest in the specialty and job satisfaction. Less important were opportunities for flexible/part-time training, favourable working hours and good monetary rewards. Of respondents, 67% said that they were considering/had considered choosing rheumatology. Among those who considered it, reasons for doing so included an interest in the specialty, exposure as a medical student and favourable working hours. A free-text box asked for suggestions to improve recruitment to rheumatology. Qualitative responses were analysed and emergent themes are highlighted in Box 1.
Discussion
This study highlights a number of key points. The majority of doctors have decided on which specialty they wish to choose by the time they enter CMT or BST. They are keen to find an interesting specialty with good job satisfaction, and for many rheumatology is on the radar. However, applications at ST3 level are low compared to many other specialties. This is despite the fact that rheumatology compares favourably with other specialties in terms of job satisfaction.1
Administering the survey electronically allowed us to target a large number of doctors. The overall response rate is lower than the mean of 54% seen in other published studies without monetary rewards,2 perhaps reflecting the electronic method of delivery–often response rates for postal questionnaires are higher than that for electronic communications.3 Response bias cannot be excluded as a factor which may have influenced the findings, but there were many responses from doctors who had, and had not, considered rheumatology as a career choice.
Junior doctors are making decisions about which specialty to choose early on in their careers. Reduced exposure to rheumatology inpatients, and less junior doctor posts limit experience gained. It is vital that we take steps (Box 1) to raise the profile of rheumatology and ensure that we continue to attract strong candidates in order to maintain a high standard of care for our patients.
Footnotes
Letters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientific letters should not exceed 500 words and may include one table and up to five references.
- © 2011 Royal College of Physicians
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