Does it matter how much physician trainees work anymore?

Fletcher, Kathlyn E.; Ranji, Sumant R

doi:10.1136/bmjqs-2016-005534

Cited by 1 publication

(2 citation statements)

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“…The relationship between medical education and quality of care is complex and dynamic, and can potentially be influenced by fatigue, supervision or clinical experience [ 36 ]. A study on junior doctors-prescribing mistakes in the UK highlighted a multifaceted problem, including mistakes due to lack of knowledge and training, lack of support, time pressures, working alone without immediate access to support, the wish to appear confident, hierarchical structures and senior doctors being unapproachable or unhelpful [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Inadequate supervision of postgraduate trainee doctors in Ireland is a result of increasing workloads and staff shortages, exacerbated by a decade long recession and cuts to the salaries of new consultants, which has impacted on recruitment [ 38 , 39 ]. Given the UK experience [ 36 ], it is also a cause of concern regarding clinical governance and patient safety.…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing trainee doctor emigration in a high income country: a mixed methods study

Clarke¹,

Crowe²,

Humphries

et al. 2017

Hum Resour Health

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BackgroundThe Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland.MethodsUsing a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey. Of the 523 who responded (58.6% response rate), 423 were still in Ireland and responded to questions on factors influencing intention to practice medicine abroad and are the subjects of this study. Explanatory factors for intention to practice medicine in Ireland in the foreseeable future, the primary outcome, included demographic variables and experiences of working within the Irish health system. Associations were examined using univariable and multivariable logistic regression to estimate odds ratios for factors influencing the primary outcome. Qualitative interviews were conducted with 50 trainee doctors and analysed thematically, exploring issues associated with intention to practice medicine abroad.ResultsThere were high levels of dissatisfaction among trainee doctors around working conditions, training and career progression opportunities in Ireland. However, most factors did not discriminate between intention to leave or stay. Factors that did predict intention to leave included dissatisfaction with one’s work-life balance (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.53–4.10; P < 0.001); feeling that the quality of training in Ireland was poor (OR 1.82; 95% CI 1.09–3.05; P = 0.002) and leaving for family or personal reasons (OR 1.85; 95% CI 1.08–3.17; P = 0.027). Qualitative findings illustrated the stress of doing postgraduate training with inadequate supervision, lack of ring-fenced training time and pressures on personal and family life.ConclusionsLarge-scale dissatisfaction with working, training and career opportunities point to systemic factors that need to be addressed by health workforce planners if Ireland is to retain and benefit from a motivated medical workforce, given trainees’ perceptions that there are better opportunities abroad.Electronic supplementary materialThe online version of this article (10.1186/s12960-017-0239-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%