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Cohort study of 2006 medical graduates - Second report

• The BMA cohort study of 2006 medical graduates is a 10-year longitudinal study of the career paths of 435 doctors. This is the second report and provides information on the work and experiences of doctors in the foundation year 1 of training. It also provides insights into their interest in medicine, career choice and future career progress.
• Cohort doctors were asked about their application to foundation school. Most doctors report that they were accepted to their first choice of deanery/foundation school and of those that did not receive their first choice, two in five received their second choice. The main factors influencing their choice of deanery/group include local ties, such as family and friends and geographical proximity to their medical school.
• Cohort doctors were asked to rate the extent to which various factors had influenced their acceptance of their foundation year 1 placements. The most frequently cited factors include the ‘first offer of a placement’, ‘prior knowledge of work’ and ‘working conditions’. However, many cohort doctors explained that they were largely given no choice as to their placement allocation.
• Less than half of cohort doctors report staying in hospital accommodation during their F1 placements and of those doctors who did stay in hospital accommodation the vast majority reported that it was free.
• Three-quarters of cohort doctors are of the view that there were opportunities during their undergraduate course to practise essential clinical and procedural skills/tasks. However, more than a third of cohort doctors report that they had been asked to undertake tasks which they felt to be beyond their capabilities during their F1 placement.
• Three in five cohort doctors report that a medical colleague initially helped them in their work in the wards and a third of cohort doctors received such assistance from nursing colleagues. Of those cohort doctors who received help or assistance from medical colleagues, most of this assistance appears to come from specialist trainees, registrars or SHOs.
• Three-quarters of cohort doctors are of the view that some tasks such as taking bloods, could be undertaken more appropriately by other health professionals, largely appropriately trained nursing colleagues.
• Currently 30 per cent of doctors have a very strong desire to practise medicine and 42 per cent have a strong desire to practise medicine. A fifth have a lukewarm desire to practise medicine, 4 per cent have a weak desire to practise medicine and 2 per cent regret becoming doctors. The cohort’s desire to practise medicine has declined somewhat since graduation in the previous year.
• Around half of cohort doctors prefer a career in hospital medicine and a quarter wish to pursue a career in general practice. Unsurprisingly, almost a fifth are undecided about their preferred career path and many of these doctors have yet to choose between hospital medicine and general practice. The most popular specialty choice among cohort doctors is general practice, followed by general medicine and surgery.
• Around half of cohort doctors aspire to the consultant grade and almost a fifth aspire to become a GP principal. Around one in five are still undecided as to their ultimate career goal. Female cohort doctors are more likely to plan a career in the associate specialist or staff grade or as a salaried or principal GP.
• Three-quarters of cohort doctors envisage working outside the NHS at some point in their career, mainly as part of their medical career. The proportion of doctors who envisage working outside of the NHS has increased from 66 per cent at graduation from medical school to 75 per cent one year later.
• One year after graduation from medical school, less than one in 10 cohort doctors are confident that they will automatically get a job, once they have completed their training and only 4 per cent are confident that they will get a job in their chosen specialty. The proportion of cohort doctors who are confident of automatically getting a job upon completion of training has halved from 16 per cent at graduation from medical school to 8 per cent one year later.
• One year after graduation, three in five cohort doctors plan to practise medicine outside the UK, either temporarily or permanently. This is consistent according to gender and many of those doctors who would like to practise medicine outside the UK, intend to do so either at the completion of their foundation training or early in their specialty training.