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Your recent report titled “Career specialty choices of UK medical graduates of 2015 compared with earlier cohorts: questionnaire surveys”(1) provided a thought-provoking read.
As highlighted in your report, the uptake in training for specialties such as general practice continues to remain low. I strongly agree that in order to address this it is necessary to identify the factors that determine career choice in junior doctors. Furthermore, to encourage doctors to peruse undersubscribed specialties, it may be useful to identify the stage in training that the foundations of career choice are made. This may provide an opportunity to spark interest about these low uptake specialties in doctors who are still open minded about their future career.
Your report demonstrates that even very early on in training, many doctors have a definite choice about their future specialty (1). Data collected from students at Brighton and Sussex medical school demonstrated that specialty choice is highly influenced by student’s experiences at medical school (2). I am a fourth year medical student, currently rotating through these various specialty placements and beginning to realistically consider my own personal career options. I too believe that the clinical phase of medical school may hold a unique window to motivate students to become interested in those undersubscribed specialties.
Earlier this year a cohort study at the University of Dundee showed t...
Earlier this year a cohort study at the University of Dundee showed that positive experience in medical school was the biggest influencer in career choice and that almost half of students were following the career consistent with their first choice at final year, highlighting the longevity of these positive experiences (3).
Therefore, in order to encourage uptake for training in specialties such as general practice, targeting students who have not yet left medical school (and therefore are more likely to be more open minded about career choice) may be an effective recruitment strategy. Furthermore, this strategy could focus on establishing a positive experience for medical students whilst on clinical placements.
Considering this, whilst current recruitment strategies such as salary supplements for GP trainees in low-recruitment areas are no doubt important, they may be missing some of their most impressionable audience. By developing a broader interest in GP specialty during medical school through positive clinical experiences, students may be more motivated to tackle the issues within general practice and therefore more likely to take up in training in areas where historically recruitment has been low.
Taking a broader, grass-roots approach to recruitment of low uptake specialties may result in more final-year students with realistic and long-standing career aspirations within these specialties. Building on the conclusions in the report discussed here, medical school experience is a known determining factor in the career choice of junior doctors. Therefore, it may be important to identify the factors that make clinical placement experience positive or negative, in order to improve placement experience and ultimately promote uptake of specific specialties, such as general practice.
1. Lambert TW, Smith F, Goldacre MJ. Career specialty choices of UK medical graduates of 2015 compared with earlier cohorts: questionnaire surveys. Postgrad Med J [Internet]. 2018;postgradmedj – 2017–135309.
2. 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.
3. McNaughton E, Riches J, Harrison G, Mires G, MacEwen C. What factors influenced the choice of medical specialty for doctors surveyed in the final year at medical school and again having entered their specialty training destination? Postgrad Med J [Internet]. 2018;0(0):postgradmedj – 2017–135370.