Jean M Davidson

Career choices at the end of the pre‐registration year of doctors who qualified in the United Kingdom in 1996

To report the career intentions one year after qualification of doctors who qualified in the United Kingdom (UK) in 1996, and to compare their intentions with those of 1993 qualifiers at the same stage.

Doctors' reasons for rejecting initial choices of specialties as long-term careers

Objectives  To report on rejected choices of specialty as long‐term careers and reasons for rejection.

Country of training and ethnic origin of UK doctors: database and survey studies.

Abstract Objectives To report on the country of training and ethnicity of consultants in different specialties in the NHS, on trends in intake to UK medical schools by ethnicity, and on the specialty choices made by UK medical graduates in different ethnic groups. Design Analysis of official databases of consultants and of students accepted to study medicine; survey data about career choices made by newly qualified doctors. Setting and subjects England and Wales (consultants), United Kingdom (students and newly qualified doctors). Results Of consultants appointed before 1992, 15% had trained abroad; of those appointed in 1992-2001, 24% had trained abroad. The percentage of consultants who had trained abroad and were non-white was significantly high, compared with their overall percentage among consultants, in geriatric medicine, genitourinary medicine, paediatrics, old age psychiatry, and learning disability. UK trained non-white doctors had specialty destinations similar to those of UK trained white doctors. The percentage of UK medical graduates who are non-white has increased substantially from about 2% in 1974 and will approach 30% by 2005. White men now comprise little more than a quarter of all UK medical students. White and non-white UK graduates make similar choices of specialty. Conclusions Specialist medical practice in the NHS has been heavily dependent on doctors who have trained abroad, particularly in specialties where posts have been hard to fill. By contrast, UK trained doctors from ethnic minorities are not over-represented in the less popular specialties. Ethnic minorities are well represented in UK medical school intakes; and white men, but not white women, are now substantially under-represented.

Graduate status and age at entry to medical school as predictors of doctors’ choice of long-term career

To determine whether graduate entry to medical school, taking an intercalated degree during medical school, and age at entry to medical school are related to choice of eventual career.

Loss of British-trained doctors from the medical workforce in Great Britain

To summarize trends over time in the percentage of British medical graduates who subsequently practise in Great Britain in the National Health Service (NHS), in Great Britain outside the NHS, outside Great Britain, or do not practise medicine.

Career preferences of graduate and non-graduate entrants to medical schools in the UK.

Objective  Recent UK policy has been to increase substantially the number of graduate entrants to medical schools. Our aim was to study whether graduate and non‐graduate entrants have different long‐term career preferences.

Doctors' views of their first year of medical work and postgraduate training in the UK: questionnaire surveys

Objective  The first year of postgraduate work for newly qualified doctors in the UK, the pre‐registration year, is spent working intensively in training posts under supervision. Our aim was to report the views of pre‐registration doctors on these posts.

Retention in the British National Health Service of medical graduates trained in Britain: cohort studies

Objective To report the percentage of graduates from British medical schools who eventually practise medicine in the British NHS. Design Cohort studies using postal questionnaires, employment data, and capture-recapture analysis. Setting Great Britain. Subjects 32 430 graduates from all British medical schools in nine graduation cohorts from 1974 to 2002, subdivided into home based medical students (those whose homes were in Great Britain when they entered medical school) and those from overseas (whose homes were outside Great Britain when they entered medical school). Main outcome measures Working in the NHS at seven census points from two to 27 years after qualification. Results Of home based doctors, 88% of men (6807 of 7754) and 88% of women (7909 of 8985) worked as doctors in the NHS two years after qualification. The corresponding values were 87% of men (7483 of 8646) and 86% of women (7364 of 8594) at five years; 86% (6803 of 7872) and 86% (5407 of 6321) at 10 years; 85% (5404 of 6331) and 84% (3206 of 3820) at 15 years; and 82% (2534 of 3089) and 81% (1132 of 1395) at 20 years. Attrition from the NHS had not increased in recent cohorts compared with older ones at similar times after graduation. Of overseas students, 76% (776 of 1020) were in the NHS at two years, 72% (700 of 972) at five years, 63% (448 of 717) at ten years, and 52% (128 of 248) at 20 years. Conclusions The majority of British medical graduates from British medical schools practise in the NHS in both the short and long term. Differences between men and women in this respect are negligible. A majority of doctors from overseas homes remain in Britain for their years as junior doctors, but eventually about half leave the NHS.

The first house officer year: views of graduate and non-graduate entrants to medical school

Objective  To determine whether graduate and non‐graduate entrants to medical school differ in their views on the first year spent in medical practice as a pre‐registration house officer.

Doctors' age at domestic partnership and parenthood: cohort studies.

Objective To report on doctors’ family formation. Design Cohort studies using structured questionnaires. Setting UK. Participants Doctors who qualified in 1988, 1993, 1996, 1999, 2000 and 2002 were followed up. Main Outcome Measures Living with spouse or partner; and doctors’ age when first child was born. Results The response to surveys including questions about domestic circumstances was 89.8% (20,717/23,077 doctors). The main outcomes – living with spouse or partner, and parenthood – varied according to age at qualification. Using the modal ages of 23–24 years at qualification, by the age of 24–25 (i.e. in their first year of medical work) a much smaller percentage of doctors than the general population was living with spouse or partner. By the age of 33, 75% of both women and men doctors were living with spouse or partner, compared with 68% of women and 61% of men aged 33 in the general population. By the age of 24–25, 2% of women doctors and 41% of women in the general population had a child; but women doctors caught up with the general population, in this respect, in their 30s. The specialty with the highest percentage of women doctors who, aged 35, had children was general practice (74%); the lowest was surgery (41%). Conclusions Doctors are more likely than other people to live with a spouse or partner, and to have children, albeit typically at later ages. Differences between specialties in rates of motherhood may indicate sacrifice by some women of family in favour of career.