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ObjectivesTo explore trainee doctors’ experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors’ successful transition experiences? (3) What is the impact of MMTs on trained doctors?DesignA qualitative longitudinal study underpinned by MMT theory.SettingFour training areas (health boards) in the UK.Participants20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews.MethodsData were analysed cross-sectionally and longitudinally using thematic Framework Analysis.ResultsParticipants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee–trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees’ children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees’ new roles).ConclusionsPriority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for several years into the trained doctor role.

OBJECTIVES Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students' medical training. Year 1 (2009Year 1 ( -2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors. METHODS RESULTSThe response rate was 87.9% (883 ⁄ 1005). No significant differences were found among medical schools with regard to first-choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work-life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job-related factors by most respondents. Few differences were found among schools in terms of the impact of jobrelated factors on future career preferences. Students for whom the work-life balance was extremely important (odds ratio [OR] = 0.6) were less likely to prefer surgery. Students for whom the work-life balance (OR = 2.2) and continuity of care (OR = 2.1) were extremely important were more likely to prefer general practice.CONCLUSIONS Students' early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work-life balance is very important to tomorrow's doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students' career preferences change as they progress through medical school and training.

Objective To examine the strength of hospital consultants' preferences for various aspects of their work.