Factors affecting recruitment to higher specialty training: a questionnaire study
Aims
Owing to concerns that experiences of general internal medicine are exacerbating the supply problems in specialty training posts, our research aimed to identify what factors are associated with intentions to choose specialties that contain a general internal medicine component in higher training, and to describe those factors.
Methods
Cross sectional survey study of core medical trainees, including analysis of free text comments to investigate experiences of work intensity, burnout, engagement, and factors influencing specialty choice. Factor analysis and logistic regression identified influencers to specialty choice as defined by the presence or absence of general internal medicine (GIM).
Results
We identified five factors that defined trainees’ career intentions: supportive environment; lifestyle controllability; prestige; job security; science and challenge. Of these, only lifestyle controllability was significantly associated with an intention to pursue training in GIM. This factor described features of work scheduling. Free text descriptions corroborated trainee experiences of challenges around scheduling of work and ward rounds, handovers and administration tasks. These experiences created work schedule unpredictability, which may inform decisions about specialties where more control over timing and lifestyle compatibility are perceived.
Conclusions
In a policy context leaning towards the increased provision of generalist medicine, the control over the timing of work may be an important factor to address in order to increase the attractiveness of speciality training posts with general internal medicine, or where perceived lifestyle controllability is low. Upon validation of this study, a broader examination of the compatibility of scheduling processes of work is required, to minimise unpredictability and to increase perceptions of time control.
- © Royal College of Physicians 2016. All rights reserved.
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