Is Medical Specialties A Good Career Path – There are growing concerns about recruitment and retention within general practice. National surveys were conducted among foundation year 2 doctors (FY2), basic medical trainees in year 1 and 2 (CT1 and CT2) and medical registrars (StR/ST3+) regarding their enjoyment of medicine, overall satisfaction, career aspirations, influencing factors and perception. medical registrar examination. The results indicate that many FY2, CT1 and CT2 GPs are discouraged by the perceived unmanageable workload and poor work-life balance of the medical clinic. Registrars themselves are less satisfied in general internal medicine than in their main specialties. Therefore, clarifying the roles and improving the morale of medical registrants must be a priority. If current trends continue, they will have a significant impact on patient safety, patient care and workforce planning.
Recruitment to general medical fields has been declining in recent years. In addition, the retention of key medical trainees in advanced training programs in general medical specialties has become a greater problem. The competitive application ratios for basic medical training (CMT) (approximately 2:1) are significantly lower than in other specialties such as anesthesiology, general health care, and basic surgical training.1 Nationally, a number of vacancies in medical training programs have emerged rota gaps are regularly filled by locum staff.2
Is Medical Specialties A Good Career Path
National surveys carried out by the Health Professionals Unit of the Royal College of Physicians (RCP) have highlighted increasing levels of dissatisfaction among medical clinical assistants and widespread concerns about training and future career prospects. FY2s) in the East Midlands Deanery investigated factors influencing CMT applications (personal communication). The findings of this survey suggest that many potential candidates are put off by the role of medical registrar. If current trends continue, they will have a significant impact on patient safety, patient care and workforce planning.
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Questionnaires were developed through discussion forums with the RCP London (RCPL) New Consultants Committee, the RCPL Regional Advisers Committee, the RCP Trainers Committee, Heads of Medical Schools in England, the RCP Patient Carers Network, Severn Deanery Medical Registrars and RCP Edinburgh representatives.
The surveys explored several topics including: enjoyment of medicine; Overall satisfaction; career plans; deterrent and attraction factors; and perceptions of specialist registrars. The full text of the survey questionnaires is available on the RCP website.5–7
Some questions asked participants to reflect on the previous year of training. Due to the timing of survey distribution, FY2s were asked to reflect on their FY1 year, CT1s on their FY2 year, and CT2s on their CT1 year. In addition to the structured response format, participants were given several opportunities to provide free-text responses.
The results were analyzed individually for each survey. A subset analysis of FY2, CT1/2 and medical registry data was performed and these data are presented where different questions were asked, variation in responses was noted, or factors considered to be significantly different influencing responses between groups. Descriptive statistics of the survey results are presented.
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Returned questionnaires were received from 2,315 registrants (37.2% response rate). Responses came from registrars in all medical departments and from all deans. In total, 49.6% of the respondents were women and 50.4% were men. Of the respondents, 60% were trained in the field of general (internal) medicine (GIM).
Returned questionnaires were received from 728 basic medical trainees (23% response rate). Responses came from both CT1 and CT2 students from all deans.
Returned questionnaires were received from 212 FY2 doctors from Severn, East Midlands and West Midlands deaneries (18% response rate).
When FY2s were asked how much they enjoyed their FY1 general medical jobs compared to their FY1 non-medical jobs, 58% enjoyed them more or much more and 16% enjoyed them less or much less. When CT1s were asked how much they liked their general medical jobs in FY2 compared to their non-medical jobs in FY2, 66% liked it more or much more and 4% liked it less or much less. CT1s were more likely to enjoy their medical experience during basic training than FY2s who had yet to choose a specialty.
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Overall, 96.9% of CT1s reported being satisfied with their choice of medicine as a major, compared to 81.5% of CT2s. When medical registrars were asked about job satisfaction, 85.7% said they were satisfied or very satisfied with their profession, but only 50.1% were satisfied or very satisfied with GIM (Fig. 1). When asked whether they would recommend a career in medicine to school graduates, 63.8% either agreed or strongly agreed (Fig. 2).
When FY2s were asked if they were considering a career in the medical specialty, 27.0% said “yes definitely,” 25.3% “maybe yes,” 16.3% “not sure,” and 31.5% said “no.”
When CMTs were asked if they intended to pursue a career in a medical specialty (ie requiring ST3 RCP membership), 76.5% said yes, 16.6% were unsure, 6.4% “plan to change specialty ” ” and 0.5% “planned to leave the medical profession”.
Of the medical registrars surveyed, 31.2% had considered giving up their GIM training in the previous 6 months, compared to 17.1% who had considered giving up their major.
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When FY2s were asked to select factors that actively influenced their choice of a career in medicine, most felt attracted to the following characteristics: overall case mix (eg, interest or variety; 89.8%), academic challenge (77, 1%), the influence of the role model(s) (67.2%) and the overall type of work (e.g. ward visits, outpatient clinics and procedures; 66.7%).
When CMTs were asked to select factors that actively influenced their choice to pursue a career involving general medicine as a clinical assistant, most of them found the following characteristics attractive: overall case mix (84.3%), teamwork (80.4%) and emergency and/or acute care (74.8%).
When FY2s were asked to select factors that actively influenced their choice to pursue a career in medicine, the majority (81.4%) felt that work-life balance as a medical registrar was a deterrent. There was no significant overall majority effect of work-life balance as a medical consultant in this group (39.0% were discouraged, 33.9% attracted and 27.1% reported no effect).
When CMTs were asked to select factors that actively influenced their choice to pursue a career involving general medicine as a clinical assistant, the majority felt that these deterrent characteristics were: work-life balance (79.9%) and volume and/or workload intensity (74.0%).
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Of the FY2s who were unsure or not considering a career in a medical specialty, 78.0% were intimidated by the prospect of working as a general emergency physician. It had no influence on 16.7% and drew 5.3%. Of those FY2s who were put off by the prospect of working as an emergency GP, 60.2% would “definitely” or “probably” be more likely to consider a career in medicine if they did not have to do the role 47.9% of FY2s years considering medicine would rather not do a medical specialty that involves working as an on-call medical registrar. However, 25.0% were not concerned and 25.0% would like to have a specialty that would include the work of a medical registrar.
Of those CMTs who were unsure or not considering pursuing a career in a medical specialty, 74.3% were discouraged by the prospect of working as an on-call general practitioner. It had no influence on 17.4% and drew 8.3%. Of those CMTs who were put off by the prospect of working as a general emergency physician, 75.5% would “definitely” or “probably” be more likely to consider a career in medicine if they did not have to do this role Of the CMTs considering medicine, 25.4% would she preferred not to do a medical specialty that involved working as an on-call medical registrar. However, 23.6% were not affected by this and 25.4% would like to have a specialization that would include the work of a medical registrar. Finally, 8.5% would not consider a medical specialty that includes working as a medical registrar.
CT2s intending to pursue a career in general medicine were asked to select their first and second choice specialties (Fig. 3). The most popular first-choice specialties were geriatrics (7.6%), respiratory medicine (7.2%), and cardiology, gastroenterology, and hematology (all 5.8%). The most popular second-choice specialty was acute medicine (5.3%), but it was less popular than the first-choice specialty (2.5%). However, 13.7% did not have a second choice specialization.
Of those CT2s considering leaving medicine, 72.1% considered a career in general practice, 18.6% academic medicine and/or research, and 17.4% anesthesiology and/or critical care medicine.
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FY2s, CTs and registrars were asked, ‘In general, what would you consider the workload of the following on-call registrars?’ (Fig. 4).
Perceptions of the 2nd founding year (FY2), general practitioner (CMT) and specialist practitioners (StR) of registrars’ workload. CMT = basic medical trainee; FY2 = Foundation Year 2; GP = general practitioner; ITU = intensive care unit; StR = professional medical registrar.
Physicians in FY2 perceived the medical registrar as having a heavier workload compared to other on-call clinical assistants. Most felt that the registrar’s workload was “heavy”
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