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Lin LO, Huttinger AL, Butler P, Gosman AA, Janis JE. Socioeconomic Disparities in Research Participation: Bias in Plastic Surgery Residency Match. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5565. [PMID: 38313590 PMCID: PMC10836880 DOI: 10.1097/gox.0000000000005565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/11/2023] [Indexed: 02/06/2024]
Abstract
Background Integrated plastic surgery residency applicants have increased at a rate disproportionate to available positions. Research productivity has become a surrogate marker for competitiveness, and many applicants pursue it to distinguish themselves. To date, no study has investigated socioeconomic disparities in extended research experience (ERE) participation. Methods A 35-question cross-sectional survey was distributed to applicants to United States-based integrated plastic surgery residency programs during the 2019-2022 application cycles. Summary tables, student t test, and chi-square tests were used for statistical analysis. Results A total of 161 responses (response rate: 20.9%) were recorded. Fifty-nine (40.7%) respondents participated in an ERE. The most common reason for ERE participation was strengthening one's application. The most common reason against participation was avoiding delays in career progression. A greater percentage of respondents from Northeastern medical schools participated in EREs (P = 0.019). There were no significant differences in debt burden between those who did or did not participate in an ERE. A greater percentage of applicants whose parents had advanced degrees participated in EREs (P = 0.053). Conclusions There may be geographic and socioeconomic biases present in access to ERE for students interested in plastic surgery. The growing popularity of EREs may have unintended consequences for applicant diversity. As most plastic surgeons ultimately practice in nonacademic settings, applicants and plastic surgeons may consider the financial hardships and possible socioeconomic disparities in research opportunities before participating in or recommending them.
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Affiliation(s)
- Lawrence O. Lin
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Allyson L. Huttinger
- Department of Plastic and Reconstructive Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Va
| | - Paris Butler
- Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn
| | - Amanda A. Gosman
- Division of Plastic Surgery, Department of Surgery, University of California San Diego Health, La Jolla, Calif
| | - Jeffrey E. Janis
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Jefferson L, Golder S, Essex H, Dale V, Bloor K. Exploring gender differences in uptake of GP partnership roles: a qualitative mixed-methods study. Br J Gen Pract 2023; 73:e545-e555. [PMID: 37365008 PMCID: PMC10325588 DOI: 10.3399/bjgp.2022.0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/02/2022] [Accepted: 03/05/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The unadjusted gender pay gap in general practice is reported to be 33.5%. This reflects partly the differential rate at which women become partners, but evidence exploring gender differences in GPs' career progression is sparse. AIM To explore factors affecting uptake of partnership roles, focusing particularly on gender differences. DESIGN AND SETTING Convergent mixed-methods research design using data from UK GPs. METHOD Secondary analysis of qualitative interviews and social media analysis of UK GPs' Twitter commentaries, which informed the conduct of asynchronous online focus groups. Findings were combined using methodological triangulation. RESULTS The sample comprised 40 GP interviews, 232 GPs tweeting about GP partnership roles, and seven focus groups with 50 GPs. Factors at individual, organisational, and national levels influence partnership uptake and career decisions of both men and women GPs. Desire for work-family balance (particularly childcare responsibilities) presented the greatest barrier, for both men and women, as well as workload, responsibility, financial investment, and risk. Greater challenges were, however, reported by women, particularly regarding balancing work-family lives, as well as prohibitive working conditions (including maternity and sickness pay) and discriminatory practices perceived to favour men and full-time GPs. CONCLUSION There are some long-standing gendered barriers that continue to affect the career decisions of women GPs. The relative attractiveness of salaried, locum, or private roles in general practice appears to discourage both men and women from partnerships presently. Promoting positive workplace cultures through strong role models, improved flexibility in roles, and skills training could potentially encourage greater uptake.
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Affiliation(s)
| | - Su Golder
- Department of Health Sciences, University of York, York
| | - Holly Essex
- Department of Health Sciences, University of York, York
| | - Veronica Dale
- Department of Health Sciences, University of York, York
| | - Karen Bloor
- Department of Health Sciences, University of York, York
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Muacevic A, Adler JR, Songra L, Salahuddin Z, Pandey G, Chew B, Magill H. The Effect of Sociodemographic Factors on Obtaining a Place in Core Surgical Training. Cureus 2022; 14:e31271. [PMID: 36505122 PMCID: PMC9731932 DOI: 10.7759/cureus.31271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
Competition for Core Surgical Training (CST) is rising, placing a strong emphasis on interview performance. Several interview courses offer to help candidates secure their chosen surgical job but at premium fees. A group of London-based CSTs started a free course offering high-quality mock interview experiences to over 90 applicants in 2022, with the aim of providing an accessible opportunity for financially disadvantaged candidates. Course candidates completed three sets of questionnaires, pre- and post-mock interview, and a final one upon job allocation. Candidates' educational background and schooling history were obtained as well as their self-assessment score, eventual rank after interview and the rank of the job they had accepted. The three sets of questionnaires were completed by 87, 73 and 45 candidates respectively. Overall, there was a statistically significant difference in self-reported confidence scores after the course (P < 0.001). There was no significant difference in the self-assessment score of the 44.2% of candidates who had attended private education in the UK, compared to publicly educated (P = 0.0525), nor was there a difference in their rank after interviews (P = 0.236). Candidates who spent £50 or more had higher self-assessment scores (P = 0.042) but they didn't rank higher in overall scores (P = 0.591). Interview preparation courses are helpful in increasing candidates' confidence, however spending more money does not translate into a better overall interview performance. Our study suggests that candidates from private education backgrounds do not have an advantage in the CST application process.
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Vinnicombe Z, Little M, Super J, Anakwe R. Differential attainment, socioeconomic factors and surgical training. Ann R Coll Surg Engl 2022; 104:577-582. [PMID: 35950509 PMCID: PMC9433186 DOI: 10.1308/rcsann.2021.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION Differential attainment (DA) is the gap in levels of achievement between different groups; socioeconomic factors are thought to play a significant role in DA. The aim of this study was to review and assess the evidence for DA in early surgical training and to examine the potential influence of socioeconomic status. METHODS Data were obtained from the General Medical Council GMC for those taking Membership of the Royal College of Surgeons (MRCS) examinations between 2016 and 2019 and core surgical training annual review of competency progression (ARCP) outcomes between 2017 and 2019. The index of multiple deprivation (IMD) was used as a measure of socioeconomic background. Trainees were then divided into deprivation quintiles (DQ1=most deprived, DQ5=least deprived). MRCS and ARCP outcomes were compared between DQ groups using 95% confidence intervals and chi-square tests. RESULTS Those from lower socioeconomic backgrounds had significantly lower overall MRCS pass rates (DQ1=45.5%, DQ2=48.9% vs DQ4=59.6%, DQ5=61.5%, p<0.05) and 1st time pass rates (DQ1&2=46.6% vs DQ4&5=63.5%, p<0.001). Additionally, they had a significantly higher number of attempts required to pass MRCS (DQ 1&2=1.86 vs DQ 4&5=1.54, p<0.01). Those from lower socioeconomic backgrounds had a significantly greater proportion of unsatisfactory ARCP outcomes (DQ1&2=24.4% vs DQ 4&5=14.2%, p<0.05). CONCLUSIONS There is clear evidence of the influence of socioeconomic background on DA in early surgical training. However, the reasons for this are likely complex and more work is required to investigate this relationship.
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Affiliation(s)
| | | | - J Super
- Maidstone and Tunbridge Wells NHS Trust, UK
| | - R Anakwe
- Imperial College NHS Foundation Trust, UK
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Lagunes-Cordoba E, Maitra R, Dave S, Matheiken S, Oyebode F, O'Hara J, Tracy DK. International medical graduates: how can UK psychiatry do better? BJPsych Bull 2021; 45:299-304. [PMID: 33263275 PMCID: PMC8477154 DOI: 10.1192/bjb.2020.118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The National Health Service (NHS) was created 70 years ago to provide universal healthcare to the UK, and over the years it has relied upon international medical graduates (IMGs) to be able to meet its needs. Despite the benefits these professionals bring to the NHS, they often face barriers that hinder their well-being and performance. In this editorial, we discuss some of the most common challenges and the adverse effects these have on IMGs' lives and careers. However, we also propose practical measures to improve IMGs' experiences of working in psychiatry.
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Affiliation(s)
| | - Raka Maitra
- Tavistock and Portman NHS Foundation Trust, UK
| | - Subodh Dave
- Derbyshire Healthcare NHS Foundation Trust, UK
| | | | | | - Jean O'Hara
- South London and Maudsley NHS Foundation Trust, UK
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Das A, Smith D, Mathew RG. Predictors of ophthalmology career success (POCS) study. BMJ Open Ophthalmol 2021; 6:e000735. [PMID: 34322599 PMCID: PMC8276289 DOI: 10.1136/bmjophth-2021-000735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/07/2021] [Indexed: 11/03/2022] Open
Abstract
Objective Ophthalmology is the busiest outpatient specialty with demand predicted to rise over 40% in the next 20 years. A significant increase in the number of trainee ophthalmologists is required to fill currently vacant consultant posts and meet the UK's workforce demands by 2038. Our aim was to understand what determines success in ophthalmology training, in order to inform future ophthalmologists, refine recruitment and facilitate workforce planning. Methods and Analysis This was a retrospective longitudinal cohort study using routinely collected data available from UK Medical Education Database (UKMED) (https://www.ukmed.ac.uk/). Data were analysed on 1350 candidates who had applied for ophthalmology specialty training (OST) between 2012 and 2018, as well as 495 candidates who had attempted Fellow of the Royal College of Ophthalmologists (FRCOphth) Part 1 between 2013 and 2018. Participants who had not obtained their primary medical qualification from the UK medical schools were excluded. Primary outcome measures included gaining a place on the OST programme and passing the FRCOphth Part 1 examination on first attempt. Results Higher education performance measure decile scores at medical school are strongly predictive in securing an OST post and passing the part 1 examination first time (p<0.001). Candidates who attempt FRCOphth Part 1 prior to their ST1 application are more likely to get a place on OST on first attempt. Socioeconomic factors, gender and ethnicity do not influence success in OST entry. Male trainees are more likely to pass FRCOphth Part 1 on their first attempt. Conclusion This study is the first quantitative assessment of the factors that determine success in OST recruitment and ophthalmology postgraduate examinations in the UK. Similar studies should be undertaken in all other medical and surgical specialties to understand what factors predict success.
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Affiliation(s)
- Aditi Das
- Directorate of Undergraduate Medical Education, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Rashmi G Mathew
- Directorate of Undergraduate Medical Education, Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Vinnicombe Z, Little M, Super J, Anakwe R. Surgical training in the UK: is cost a barrier to entry? Postgrad Med J 2021; 98:281-284. [PMID: 33414177 DOI: 10.1136/postgradmedj-2020-139170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is good quality evidence linking socioeconomic background and the likelihood of a surgical career. Additionally, training in surgery is more expensive than in other specialties. Our aim was to assess the awareness and perceptions of trainees and medical students of the relative costs of surgical training and to determine whether perceptions of cost deter potential surgical trainees. METHODS Medical students, foundation doctors and core trainees in England were surveyed over a 2-week period. χ2 tests of independence were used to assess statistically significant associations between measured variables MAIN FINDINGS: A total of 284 responses were received. More than half of respondents (54%) were not previously aware of the high costs of surgical training. More than a quarter of respondents (27%) did not take out a student loan. There was a significant association (p=0.003) between familial income and being less likely to consider a surgical career due to the costs. Respondents who reported receipt of a student loan were also significantly less likely to consider a surgical career due to the costs (p=0.033). CONCLUSION Our study demonstrates an important relationship between perceived costs of surgical training and future career aspirations. This suggests that access to surgical training may still be difficult for many. This study also highlights a general lack of awareness of high surgical training costs. It is important that surgical training is accessible. Financial status should not be a significant disincentive and widening access to surgical training can only serve to enrich and advance the specialty.
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Affiliation(s)
- Zak Vinnicombe
- Department of Plastic and Reconstructive Surgery, St George's Healthcare NHS Trust, London, UK
| | - Max Little
- Department of Orthopaedic Surgery, Whittington Hospital, London, UK
| | - Jonathan Super
- Department of Gastroenterology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, UK
| | - Raymond Anakwe
- Department of Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London, UK
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Levaillant M, Levaillant L, Lerolle N, Vallet B, Hamel-Broza JF. Factors influencing medical students' choice of specialization: A gender based systematic review. EClinicalMedicine 2020; 28:100589. [PMID: 33134904 PMCID: PMC7588859 DOI: 10.1016/j.eclinm.2020.100589] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Students' choice of medical specialties has evolved throughout year, with a growing interest in quality of life and in technological specialties. We investigated the repartition of such choices in the world and its influencing factors with a focus on the gender's influence, for helping policy-makers to deal with medical shortage and territorial to specialty disconnect. METHODS A systematic search was conducted on MEDLINE and Scopus from January 2010 to January 2020. Data extraction and analysis followed JBI and PRISMA recommendations. The selected articles had to focus on medical students, detail their choice of specialty, and look for factors influencing their choice. Articles were excluded if they only assessed the attractiveness of a specialty, or evaluated a public policy. This review was registered on PROSPERO, CRD 42020169227. FINDINGS 751 studies were screened, and fifty-four were included. Surgery and internal medicine were the most wanted specialties, both in occidental and non-occidental countries. The main factors influencing the choice of specialty were lifestyle, work-life balance and discipline interest, with variation across different countries. Gender clearly affected this choice with 63.7% of men willing radiology and 14.7% of men in obstetrics and gynecology. INTERPRETATION Influential factors vary with specialty and are affected by the country of residence. Gender has a great impact in students' willingness to work in specific specialties. Policymakers should adapt their appealing strategies according to the country and the medical discipline concerned. FUNDING The authors have no support or funding to report.
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Affiliation(s)
- Mathieu Levaillant
- Methodologic and biostatistics department, CHU Angers, University Angers, France
- Corresponding author.
| | - Lucie Levaillant
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, Angers Cedex 9, France
| | - Nicolas Lerolle
- Medical Intensive Care Unit, CHU Angers, Angers University Hospital, Angers, France
| | - Benoît Vallet
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
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Scanlan G, Johnston P, Walker K, Skåtun D, Cleland J. Today's doctors: What do men and women value in a training post? MEDICAL EDUCATION 2020; 54:408-418. [PMID: 32162377 DOI: 10.1111/medu.14151] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Recent studies suggest that traditional male-female differences may be changing in terms of what is valued in a medical career but there have been no studies directly quantifying the relationship between gender and stated career-related preferences. To address this gap, we examined the differences between male and female doctors in terms of the strength of their work-related preferences at the point of eligibility to enter residency or specialty training in the UK. METHODS This was a quantitative study using a survey incorporating a discrete choice experiment (DCE). Respondents were asked a series of questions in which they had to choose between two or more scenarios, differing in terms of attributes. The attributes were: location; familiarity with specialty; culture of the working and learning environment; earnings; working conditions, and opportunities for professional development. The main outcome measure was willingness to accept compensation to forgo a desirable attribute within a training position. Conditional logistic regression models were run separately for males and females. RESULTS A total of 5005 out of 6890 (73%) Foundation Year 2 doctors completed the DCE. The relative value of each attribute was similar for males and females, with location most valued and familiarity with the specialty least valued. There was a pattern of female respondents valuing the move between the best and worst levels of each training attribute more than men, and significantly more than men in respect of the importance of working culture. CONCLUSIONS This study adds to existing knowledge in terms of quantifying gendered values in respect of training or residency preferences. That men value a supportive working culture significantly less than women is well established. However, our findings that location, working conditions and working culture are increasingly important to both men and women, suggests that traditional gender norms may be changing. This intelligence can inform gender-responsive workforce planning and innovation, and future research.
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Affiliation(s)
- Gillian Scanlan
- Centre for Medical Education, University of Dundee, Dundee, UK
| | - Peter Johnston
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
- Scotland Deanery (North), NHS Education for Scotland, Aberdeen, UK
| | - Kim Walker
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK
| | - Diane Skåtun
- Health Economics Research Unit (HERU), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jennifer Cleland
- Medical Education Research and Scholarship Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Cleland J, Prescott G, Walker K, Johnston P, Kumwenda B. Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study. BMJ Open 2019; 9:e032021. [PMID: 31767592 PMCID: PMC6886964 DOI: 10.1136/bmjopen-2019-032021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Knowledge about the career decisions of doctors in relation to specialty (residency) training is essential in terms of UK workforce planning. However, little is known about which doctors elect to progress directly from Foundation Year 2 (F2) into core/specialty/general practice training and those who instead opt for an alternative next career step. OBJECTIVE To identify if there were any individual differences between these two groups of doctors. DESIGN This was a longitudinal, cohort study of 'home' students who graduated from UK medical schools between 2010 and 2015 and completed the Foundation Programme (FP) between 2012 and 2017.We used the UK Medical Education Database (UKMED) to access linked data from different sources, including medical school performance, specialty training applications and career preferences. Multivariable regression analyses were used to predict the odds of taking time out of training based on various sociodemographic factors. RESULTS 18 380/38 905 (47.2%) of F2 doctors applied for, and accepted, a training post offer immediately after completing F2. The most common pattern for doctors taking time out of the training pathway after FP was to have a 1-year (7155: 38.8%) or a 2-year break (2605: 14.0%) from training. The odds of not proceeding directly into core or specialty training were higher for those who were male, white, entered medical school as (high) school leavers and whose parents were educated to degree level. Doctors from areas of low participation in higher education were significantly (0.001) more likely to proceed directly into core or specialty training. CONCLUSION The results show that UK doctors from higher socioeconomic groups are less likely to choose to progress directly from the FP into specialty training. The data suggest that widening access and encouraging more socioeconomic diversity in our medical students may be helpful in terms of attracting F2s into core/specialty training posts.
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Affiliation(s)
- Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen College of Life Sciences and Medicine, Aberdeen, UK
| | - Gordon Prescott
- Lancashire Clinical Trials Unit, University of Aberdeen, Preston, UK
| | - Kim Walker
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen College of Life Sciences and Medicine, Aberdeen, UK
- NHS Education for Scotland, Edinburgh, UK
| | - Peter Johnston
- NHS Education for Scotland, North Deanery, Aberdeen, UK
- NHS Grampian, Aberdeen, UK
| | - Ben Kumwenda
- Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen College of Life Sciences and Medicine, Aberdeen, UK
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Kumwenda B, Cleland J, Prescott G, Walker K, Johnston P. Relationship between sociodemographic factors and specialty destination of UK trainee doctors: a national cohort study. BMJ Open 2019; 9:e026961. [PMID: 30918038 PMCID: PMC6475150 DOI: 10.1136/bmjopen-2018-026961] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Many countries are driving forward policies to widen the socioeconomic profile of medical students and to train more medical students for certain specialties. However, little is known about how socioeconomic origin relates to specialty choice. Nor is there a good understanding of the relationship between academic performance and specialty choice. To address these gaps, our aim was to identify the relationship between socioeconomic background, academic performance and accepted offers into specialty training. DESIGN Longitudinal, cohort study using data from the UK Medical Education Database (https://www.ukmed.ac.uk/). PARTICIPANTS 6065 (60% females) UK doctors who accepted offers to a specialty training (residency) post after completing the 2-year generic foundation programme (UK Foundation Programme) between 2012 and 2014. MAIN OUTCOME MEASURES Χ2 tests were used to examine the relationships between sociodemographic characteristics, academic ability and the dependent variable, specialty choice. Multiple data imputation was used to address the issue of missing data. Multinomial regression was employed to test the independent variables in predicting the likelihood of choosing a given specialty. RESULTS Participants pursuing careers in more competitive specialties had significantly higher academic scores than colleagues pursuing less competitive ones. After controlling for the presence of multiple factors, trainees who came from families where no parent was educated to a degree level had statistically significant lower odds of choosing careers in medical specialties relative to general practice (OR=0.78, 95% CI, 0.67 to 0.92). Students who entered medical school as school leavers, compared with mature students, had odds 1.2 times higher (95% CI, 1.04 to 1.56) of choosing surgical specialties than general practice. CONCLUSIONS The data indicate a direct association between trainees' sociodemographic characteristics, academic ability and career choices. The findings can be used by medical school, training boards and workforce planners to inform recruitment and retention strategies.
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Affiliation(s)
- Ben Kumwenda
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Gordon Prescott
- Medical Statistics Team, University of Aberdeen, Aberdeen, UK
| | - Kim Walker
- Institute of Education for Medical and Dental Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK, Centre for Healthcare Education Research and Innovation (CHERI), Aberdeen, UK
| | - Peter Johnston
- NHS, NHS Grampian and The Scotland Deanery, Aberdeen, UK
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Woolf K, Jayaweera H, Unwin E, Keshwani K, Valerio C, Potts H. Effect of sex on specialty training application outcomes: a longitudinal administrative data study of UK medical graduates. BMJ Open 2019; 9:e025004. [PMID: 30837254 PMCID: PMC6429837 DOI: 10.1136/bmjopen-2018-025004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To examine sex differences in the specialty training recruitment outcomes of UK medical graduates; and whether sex differences were explained by prior academic attainment and previous fitness to practise (FtP) declarations. DESIGN Retrospective longitudinal cohort study. SETTING Administrative data on entrants to all UK medical schools from the UK Medical Education Database. PARTICIPANTS 10 559 doctors (6 155; 58% female) who entered a UK medical school in 2007 or 2008 and were eligible to apply for specialty training by 2015. PRIMARY OUTCOME MEASURE Odds of application, offer and acceptance to any specialty training programme, and on to each of the nine largest training programmes, adjusting for sex, other demographics, prior academic attainment, FtP declaration and medical school. RESULTS Across all specialties, there were no sex differences in applications for specialty training, but women had increased odds of getting an offer (OR=1.40; 95% CI=1.25 to 1.57; p<0.001) and accepting one (OR=1.43; 95% CI=1.19 to 1.71; p<0.001). Seven of the nine largest specialties showed significant sex differences in applications, which remained after adjusting for other factors. In the adjusted models, Paediatrics (OR=1.57; 95% CI=1.01 to 2.46; p=0.046) and general practice (GP) (OR=1.23; 95% CI=1.03 to 1.46; p=0.017) were the only specialties to show sex differences in offers, both favouring women. GP alone showed sex differences in acceptances, with women being more likely to accept (OR=1.34; 95% CI=1.03 to 1.76; p=0.03). Doctors with an FtP declaration were slightly less likely to apply to specialty training overall (OR=0.84; 95% CI=0.71 to 1.00; p=0.048) and less likely to accept an offer to any programme (OR=0.71; 95% CI=0.52 to 0.98; p=0.036), after adjusting for confounders. CONCLUSIONS Sex segregation between medical specialties is due to differential application, although research is needed to understand why men are less likely to be offered a place on to GP and Paediatrics training, and if offered GP are less likely to accept.
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Affiliation(s)
- Katherine Woolf
- Research Department of Medical Education, University College London Medical School, London, UK
| | - Hirosha Jayaweera
- Research Department of Medical Education, University College London Medical School, London, UK
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Crawley, Western Australia, Australia
| | - Emily Unwin
- Research Department of Medical Education, University College London Medical School, London, UK
| | - Karim Keshwani
- Research Department of Medical Education, University College London Medical School, London, UK
- North Middlesex University Hospital NHS Trust, London, UK
| | - Christopher Valerio
- Research Department of Medical Education, University College London Medical School, London, UK
- North Middlesex University Hospital NHS Trust, London, UK
| | - Henry Potts
- Centre for Health Informatics and Multiprofessional Education, UCL, London, UK
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