Doctors currently in jobs with academic content and their future intentions to pursue clinical academic careers: questionnaire surveys

Barriers and facilitators to primary care research: views of GP trainees and trainers

Background

Primary care plays an important role in the conception and delivery of transformational research but GP engagement is lacking, prompting calls for the promotion of academic opportunities in primary care.

Aim

To identify potential barriers and facilitators among GP trainees and trainers in primary care research to inform support given by Local Clinical Research Networks (LCRNs).

Design & setting

A cross-sectional online survey was developed and distributed by the CRN to GP trainees and trainers in the North East and North West.

Method

The survey covered areas including demographics, career intentions, current and potential engagement with research, as well as their general understanding of research in primary care, which included barriers and facilitators to primary care research.

Results

Trainees had low intentionality to pursue research and half of trainees did not engage with any research activity. Despite one in five trainees reporting intentions to include research in their career, only 1% would undertake a solely academic career. Medical school region was the only strongly associated factor with academic career intention. Just under 30% of trainers reported engagement in research, but far fewer (8.6%) were interested in contributing to research, and only 10% felt prepared to mentor in research.

Conclusion

Among trainees, there is limited engagement in and intentionality to pursue research, and this was crucially reflected by responses from trainers. This study identified the need for LCRNs to assist with training in research mentoring and skills, funding opportunities, and to develop resources to promote research in primary care.

Clinical Audit Platform for Students (CAPS): a pilot study

BACKGROUND

A clinical audit measures specific clinical outcomes or processes against a predefined standard. However, many clinicians are unable to carry out audits given their time constraints. Alternatively, medical students may often wish to complete audits early in their career to strengthen their portfolios. As such, the student clinical audit platform was designed to connect willing supervisors and these medical students.

METHODS

Project supervisors were members of a regional trainee-led network. Interested students were familiarised with the various aspects of an audit and allocated to supervisors with similar interests. There was regular communication to track progress and anonymised feedback forms were distributed to all students and supervisors after a year.

RESULTS

A total of 17 responses were received from the 19 students who were involved in a project. Based on a 5-point Likert scale, students displayed a mean improvement in their understanding of a clinical audit (1.18±1.07, p<0.001), the confidence to approach a supervisor (1.29±1.21, p<0.001) and the ability to conduct an audit by themselves in the future (1.77±1.15, p<0.001). Of the seven affiliated supervisors, five provided feedback with 80% indicating they had projects which remained inactive and all happy with the quality of work produced by their students.

CONCLUSION

Despite limitations to this programme, the platform produced projects which were disseminated both locally and nationally, demonstrating positive collaboration between medical students and clinicians. We present our findings and evaluations to encourage similar audit platforms to be adopted at other locations.

Consent to discuss participation in research: a pilot study

Background

Equitable access to research studies needs to be increased for all patients. There is debate about which is the best approach to use to discuss participation in research in real-world clinical settings.

Objective

We aimed to determine the feasibility of asking all clinical staff within one hospital Trust (an organisation that provides secondary health services within the English and Welsh National Health Service) to use a newly created form on the Trust’s electronic patient records system, as a means of asking patients to consent to discuss participation in research (the opt-in approach). We also aimed to collect feedback from patients and clinicians about their views of the opt-in approach.

Methods

Four pilot sites were selected in the Trust: two memory clinics, an adult mental health team and an acute adult ward. Data were collected in three phases: (1) for 6 months, pilot site staff were asked to complete a consent to discuss participation in research form with patients; (2) staff feedback on the form was collected through an online survey; and (3) patient feedback was collected through focus groups.

Findings

Of 1779 patients attending services during the pilot period, 197 (11%) had a form completed by staff and 143 (8%) opted-in to finding out about research. Staff cited limited time, low priority and poor user experience of the electronic patient records system as reasons for low uptake of the form. Patients generally approved of the approach but offered suggestions for improvement.

Conclusions

There were mixed results for adopting an opt-in approach; uptake was very low, limiting its value as an effective strategy for improving access to research.

Clinical implications

Alternative strategies to the opt-in approach, such as transparent opt out approaches, warrant consideration to maximise access to research within routine clinical care.

Effect of a national focused course on academic medicine for UK candidates applying for a Clinical Academic Programme

Background Academic medicine is crucial for healthcare advancement. However, recruitment of junior doctors into academia remains an area of concern globally. In the UK, a national integrated clinical academic pathway was developed to address these issues, with the Academic Foundation Programme as the 'first opportunity for research'. We aimed to evaluate whether a focused course on academic medicine could enhance knowledge, confidence and preparedness of candidates wishing to apply for an academic programme. Methods UK medical students attended a national course conducted by current UK Academic Foundation Programme doctors that comprised lectures on academic medicine and various aspects of the Academic Foundation Programme. An online questionnaire-based cross-sectional study was conducted with participants rating measures including knowledge, preparedness and confidence related to Academic Foundation Programme applications. Outcomes were measured using Likert scales (1=low; 5=high). Results In total, 103 out of 155 attendees from 11 different UK medical schools responded to the survey (66% response rate). Pre and post-course data showed increase in participants' knowledge (median score 2 vs 4, p < 0.0001), understanding of the application process (median score 2 vs 4, p < 0.0001), confidence (median score 2 vs 4, p < 0.0001) and preparedness (median score 2 vs 4, p < 0.0001) in applying for the Academic Foundation Programme. Conclusion To our knowledge this is the first study in the available literature that demonstrates a focused course on academic medicine may enhance UK medical students' knowledge, confidence and preparedness in applying for a clinical academic programme. Further research will ascertain whether such courses can augment trainee numbers undertaking and remaining within academic medicine.

The Uk Academic Foundation Programmes: Are the Objectives Being Met?

Background

Since the Academic Foundation Programme was established in the UK in 2005 a number of trainees have participated in this programme; however, there are few published national data on the experiences of these academic trainees. We aimed to assess the perceived value and challenges of training on the AFP.

Methods

In March 2017, an anonymous electronic questionnaire was distributed to all Academic Foundation Programme trainees in the UK, via their local foundation school administrators.

Results

Fifty-six respondents completed the survey from 9 out of the 15 Academic Units of Application. Of these, 82% were undertaking a research based Academic Foundation Programme; however, 41% reported not having access to any training on research methods and governance. Sixty-six percent reported they were aware of the aims and expected outcomes of the Academic Foundation Programme, but the self-reported achievement of academic compendium outcomes was relatively low. Sixty-three percent rated the quality of their experience on the Academic Foundation Programme as excellent or good and 75% reported that they intended to continue in academia. Most trainees (64%) reported that the completion of a postgraduate qualification as part of their Academic Foundation Programme would improve the programme.

Conclusion

The Academic Foundation Programme plays a valuable role in trainees’ development and preparing them for a career in academia. However, the objectives of the programme are currently not being uniformly achieved. Furthermore, trainees feel there remains room for improvement in the design of the Programme.

Women in senior post-graduate medicine career roles in the UK: a qualitative study

Objectives

This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression.

Design

In-depth semi-structured telephone interviews.

Setting

UK.

Participants

Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK.

Main outcome measures

Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine.

Results

Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women’s chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper.

Conclusion

Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education.

Factors important in the choice of a medical career: a Finnish national study

BACKGROUND

Applying for medical school is the first and also one of the most important career choices a physician makes. It is important to understand the reasons behind this decision if we are to choose the best applicants for medical schools and enable them to pursue satisfying careers.

METHODS

Respondents to the Finnish Junior Physician 88, Physician 1998 and Physician 2008 studies were asked: "To what extent did the following factors influence your decision to apply for medical school?" In 1998 and 2008 the respondents were also asked: "If you were starting your studies now, would you start studying medicine?" and had to answer "Yes" or "No". The odds ratios for the answer "No" were tested using logistic regression models.

RESULTS

"Interest in people" was the main motive for starting to study medicine. "Good salary" and "Prestigious profession" were more important motives for males and "Vocation" and "Interest in people" for females. There were some significant changes in the motives for entering medicine in the 20-year period between studies. "Vocation" and "Wide range of professional opportunities" as important motives for entering medicine predicted satisfaction with the medical profession.

DISCUSSION

Strong inner motivation may indicate the ability to adapt to the demands of work as a physician.

CONCLUSIONS

Medical schools should try to select those applicants with the greatest vocational inclination towards a medical career.