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Career choices of United Kingdom medical graduates of 1999 and 2000: questionnaire surveys

Trevor W Lambert, statistician, Michael J Goldacre, director, Gill Turner, research officer. 

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

Correspondence to: T Lambert
trevor.lambert{at}dphpc.ox.ac.uk

The career choices of doctors at the end of their preregistration year have been studied for doctors who qualified in the United Kingdom in 1974, 1977, 1980, 1983, 1988, 1993 and 1996.^1-4 We report here on the graduates of 1999 and 2000.

	Participants, methods, and results

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The survey population comprised all graduates from all medical schools in the United Kingdom in 1999 and 2000. We used graduation lists from each medical school to compile our database. The doctors were sent a questionnaire towards the end of their preregistration year; non-respondents were sent a maximum of four reminders. As in earlier surveys,^1-4 graduates were asked to state up to three choices of long term career in order of preference and to indicate whether they intended to practise medicine in the United Kingdom for the foreseeable future. We grouped career choices specified by the respondents into 14 mainstream specialties based on those defined in the Todd report.⁵ We used ² statistics and adjusted residuals to compare cohorts.¹

The two cohorts consisted of 8661 graduates, of whom 23 were unregistered at the time of the surveys. Of the 8638 who were registered, 20 declined to participate, two were known to be dead, and 122 were untraceable. The remaining 8494 comprised 4104 men and 4390 women, of whom 5702 (67.1%) replied. The proportion of women graduates who responded was significantly higher than that of the men (73.7% v 60.1%, ²=175.9, df=1, P<0.001).

The table shows the junior doctors' first choices of long term mainstream specialty and compares them with the respondents of 1996 (table). We found no difference in the distribution of first choices between the graduates of 1999 and 2000 (²=14.1, df=13, P>0.05) and a significant difference between those of 1999 and 2000 combined and 1996 (²=83.5, df=13, P<0.001). Choices for general practice increased, whereas choices for hospital medical specialties, surgical specialties, paediatrics, and obstetrics and gynaecology decreased (the latter halved). Differences between men and women in choices of specialty remain substantial.

Of the graduates from 1999 and 2000, 10.3% (583) "definitely" or "probably" did not intend to practise medicine in the United Kingdom for the foreseeable future. Including those who were undecided, 25% (1418) had doubts about practising medicine in the United Kingdom. The corresponding figures were 9.0% (263) and 22.2% (648) for the 1996 cohort and 9.7% (251) and 24.3% (631) for the 1993 cohort.

	Comment

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The percentage of newly qualified doctors intending to enter general practice has increased from 20% in 1996, the lowest percentage recorded in our surveys, but remains much lower than the figure of 40-50% of the qualifiers of the 1970s and 1980s.¹ Concerns about career prospects in obstetrics and gynaecology have reduced the numbers choosing this specialty to the lowest ever recorded in our surveys. Changes in choice for other specialties are less striking.

The government is substantially increasing the number of places at medical schools. Knowledge of young doctors' career choices will help planners to anticipate whether future service requirements in different specialties will be met from United Kingdom sources.

	Acknowledgments

We thank our respondents and Karen Hollick, Alison Stockford, and Janet Justice.

Contributors: TWL and MJG designed the study. TWL supervised the surveys and the analysis. MJG wrote the first draft of the paper. GT performed the data analysis. All authors contributed to editing the paper. TWL and MJG are guarantors.

	Footnotes

Funding: Department of Health.

Competing interests: None declared.

	References

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1.	Lambert TW, Goldacre MJ, Edwards C, Parkhouse J. Career preferences of doctors who qualified in the United Kingdom in 1993 compared with those of doctors qualifying in 1974, 1977, 1980, and 1983. BMJ 1996; 313: 19-24[Abstract/Free Full Text].
2.	Lambert TW, Goldacre MJ. Career destinations seven years on among doctors who qualified in the United Kingdom in 1988: postal questionnaire survey. BMJ 1998; 317: 1429-1431[Abstract/Free Full Text].
3.	Goldacre MJ, Davidson JM, Lambert TW. Career choices at the end of the pre-registration year of doctors who qualified in the United Kingdom in 1996. Med Educ 1999; 33: 882-889[CrossRef][Web of Science][Medline].
4.	Lambert TW, Goldacre MJ, Parkhouse J. Intentions of newly qualified doctors to practise in the United Kingdom. BMJ 1997; 314: 1591-1592[Free Full Text].
5.	Royal Commission on Medical Education 1965-8. Report. London: HMSO, 1968. (Cmnd 3569.) (Todd report.)

(Accepted 5 August 2002)