Career destinations seven years on among doctors who qualified in the United Kingdom in 1988: postal questionnaire survey

BMJ 1998;317:1429-1431 ( 21 November )

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Career destinations seven years on among doctors who qualified in the United Kingdom in 1988: postal questionnaire survey

Trevor W Lambert, statistician, Michael J Goldacre, director.

UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford OX3 7LF

Correspondence to: Mr Lambert trevor.lambert{at}public-health.oxford.ac.uk

Objective: To report the career choices and career destinationsin 1995 of doctors who qualified in the United Kingdom in 1988.
Design: Postalquestionnaire.
Setting: UnitedKingdom.
Subjects: All doctors who qualified in the United Kingdomin1988.
Main outcome measures: Currentemployment.
Results: Of the 3724 doctors who were sent questionnaires,eight had died and three declined to participate. Of the remaining3713 doctors, 2885 (77.7%) replied. 16.9% (608/3593; 95% confidenceinterval 16.1% to 17.8%) of all 1988 qualifiers from medical schoolsin Great Britain were not working in the NHS in Great Britainin 1995 compared with 17.0% (624/3674; 16.1% to 17.9%) of the1983 cohort in 1990. The proportion of doctors working in generalpractice was lower than in previous cohorts. The percentage ofwomen in general practice (44.3% (528/1192)) substantially exceededthat of men (33.1% (443/1340)). 53% (276/522) of the women ingeneral practice and 20% (98/490) of the women in hospital specialtiesworked part time.
Conclusions: Concerns about recruitment difficulties ingeneral practice are justified. Women are now entering generalpractice in greater numbers than men. There is no evidence ofa greater exodus from the NHS from the 1988 qualifiers than fromearliercohorts.

Key messages

This study reports the career progress to September 1995 of doctors who qualified in 1988
Loss from the British NHS, at 16.9% (95% confidence interval, 16.1% to 17.8%), was no greater than among earlier qualifiers at the same time after qualification
The proportion of doctors working in general practice (38%) was lower than in earlier cohorts studied
In this generation of doctors, women in general practice now outnumber men
Fifty three per cent of the women in general practice and 20% of the women in hospital specialties were working on a part time or flexible basis

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