Royal college reports attrition and dissatisfaction among paediatrics trainees

One in 10 trainees in paediatric medicine drops out by specialty training year 3 (ST3), and over 40% have seriously considered leaving the specialty, the Royal College of Paediatrics and Child Health has found.

The findings come from a pair of surveys conducted by the college.12

A cohort study of 354 paediatric trainees (81% response rate) who began training in the specialty in 2007 found that 11% were training in another specialty or working in another career.1 This indicates an attrition rate of 5% a year between ST1 and ST3, the college said.

Half (51%) of the trainees no longer in paediatrics had moved to a career in general practice, and 13% had left medicine. Nevertheless, 71% of respondents said that they were happy that they chose paediatrics as a career.

A second online survey of 2037 paediatric trainees, representing a response rate of 56%, found that 41% had seriously considered leaving paediatrics.2

Daniel Lumsden, chairman of the college’s Trainees’ Committee, said that the surveys’ findings were not surprising, as paediatrics had always had a high level of attrition and traditionally lost trainees to general practice. “The issue tends to be work-life balance and people finding the out of hours and on-call work that they do in paediatric training rather difficult, so some trainees see general practice training as being a more attractive option,” he said.

Shortages in middle grade rotas that result in trainees doing more out of hours work than they would if rotas were fully staffed might also be affecting trainees’ job satisfaction, he added.

The two surveys also found that more than a 10th of trainees were working less than full time (13% and 16%) and that around half in both surveys (48% and 49%) hoped to work less than full time as a consultant.

Paediatrics as a specialty has always supported less than full time working, but trainees should be aware that a lower proportion of consultants currently work part time, Lumsden said. The college’s most recent workforce census found that only 18% of consultants work less than full time (fewer than 10 programme activities a week).3

“People need to be realistic when going into paediatrics, because the vast majority of paediatricians don’t do 9 to 5 office hours,” he said. “I think for us what is important is that that is very clear when we are recruiting into the specialty, so that people are aware of what a job as a paediatrician involves.”