Extending a Conceptual Framework for Junior Doctors’ Career Decision Making and Rural Careers: Explorers versus Planners and Finding the ‘Right Fit’

Abstract

This study uses data from a Rural Clinical School of Western Australia (RCSWA) and WA Country Health (WACHS) study on rural work intentions among junior doctors to explore their internal decision-making processes and gain a better understanding of how junior doctors make decisions along their career pathway. This was a qualitative study involving junior doctor participants in postgraduate years (PGY) 1 to 5 undergoing training in Western Australia (WA). Data was collected through semi-structured telephone interviews. Two main themes were identified: career decision-making as an on-going process; and early career doctors’ internal decision-making process, which fell broadly into two groups (‘explorers’ and ‘planners’). Both groups of junior doctors require ongoing personalised career advice, training pathways, and career development opportunities that best “fit” their internal decision-making processes for the purposes of enhancing rural workforce outcomes.

Exploring Doctors’ Emerging Commitment to Rural and General Practice Roles over Their Early Career

“…It is highly simplistic to assume that having these rural training experiences or early declarations of a rural intent/preference guarantees large numbers will stay rurally. The high level of uncertainty of their practice location can be seen as both a negative and a positive-there remains a large pool who are continually reassessing their career decisions and this includes those considering rural practice [43]; however, many may be open to the idea of rural practice but eventually decide otherwise, as competing interests, such as family needs, take preference [44]. This large pool of 'fence sitters' thus highlights the ongoing importance of maximising positive experiences amongst junior doctors of factors known to both pull towards and retain them in rural practice, whilst minimising negative experiences of factors known to push them away from rural practice [37,43].…”

“…The high level of uncertainty of their practice location can be seen as both a negative and a positive-there remains a large pool who are continually reassessing their career decisions and this includes those considering rural practice [43]; however, many may be open to the idea of rural practice but eventually decide otherwise, as competing interests, such as family needs, take preference [44]. This large pool of 'fence sitters' thus highlights the ongoing importance of maximising positive experiences amongst junior doctors of factors known to both pull towards and retain them in rural practice, whilst minimising negative experiences of factors known to push them away from rural practice [37,43]. The importance of continued opportunities for postgraduate rural training pathways to support growing the rural workforce has been demonstrated amongst one specialty group (international medicine) [45].…”

Experiences of working as early career allied health professionals and doctors in rural and remote environments: a qualitative systematic review

“…It suited me.” pg 3 [ 58 ] “So, I guess at this point I want to be a generalist. I like a bit of everything, it keeps it interesting, it keeps it fresh” pg 6 [ 37 ] 1.2.2 Career challenges 2.2.2 Career and specialisation challenges “Whilst I enjoy the rural lifestyle and experience. As a new graduate, I am limited with opportunities to further my career … ..…”

“…“So, I guess at this point I want to be a generalist. I like a bit of everything, it keeps it interesting, it keeps it fresh” pg 6 [ 37 ]…”

Selection, training and employment to encourage early‐career doctors to pursue a rural postgraduate training pathway

“…As such, the opinions of early‐career doctors may differ from those of medical students. One qualitative study of 21 Western Australian doctors (mostly limited to 3 years post‐graduation from a rural clinical school) identified that early‐career decision‐making about rural work is complex and dynamic 8 . With this background in mind, we sought to explore the attractors and barriers for early‐career doctors to pursue rural pathways after graduating from medical school.…”