Understanding push-pull factors in medical careers decision making

Understanding push-pull factors in medical careers-decision making

Existing research indicates factors such as the perceived benefits of particular specialities, wish for quality of life, and demographic factors, such as gender, are influential. However, we do not know the most important ‘push-pull’ careers-decision making factors for the current generation of UK medical students and trainees. What drives medical students and trainees away from a place or a speciality? What draws them to a new location or a different speciality? To what extent are specific factors important at different transitions?

This project used anonymous, online surveys to gather contemporary UK data on these issues from medical trainees and students. A Discrete Choice Experiment was used to identify the most important push-pull factors in medical careers-decision making.

Outcome and Translation

Our results suggest organisations could focus on improving working conditions for trainees to a minimum standard, promote linked training positions for medical couples, and provide access to career support for non-medical partners. Alternatively, organisations might provide monetary incentives to trainees for accepting posts that do not meet their preferred conditions. Medical students were also found to value good working conditions more than they value geographical location. 

HERU researchers involved in this research project: Diane Skåtun, Verity Watson and Nicolas Krucien

External collaborators: J Cleland (University of Aberdeen), C Rees (University of Dundee), K Mattick (University of Exeter) and P Johnston (NHS Education for Scotland (NES))

Publications

Cleland, J., Johnston, P., Mattick, K., Rees, C., Skåtun, D.,Watson, V. and Krucien, N. (2013) Understanding push-pull factors in medical careers decision making. Final report, NHS Education for Scotland.

Cleland, J., Johnston, P., Watson, V., Krucien, N. and Skatun, D. (2016) 'What do UK doctors in training value in a post? A discrete choice experiment', Medical Education, 50(2), 189-202.

Skåtun, D., Watson, V., Krucien, N., Johnston, P. and Cleland, J.  (2016) 'Junior doctors training: is it really location, location, location?', HERU Policy Brief, University of Aberdeen, September 2016.

Cleland, J.A., Johnston, P., Watson, V., Krucien, N. and Skåtun, D. (2017) 'What do UK medical students value most in their careers? A discrete choice experiment', Medical Education, 51(8), 839-851.

Presentations

Cleland, J., Skåtun, D., Watson, V., Krucien, N. and Johnston, P. (2014) 'Novel use of a Discrete Choice Experiment (DCE) in medical education', General Practice and Primary Care (NADEGS) National Conference, Carnoustie, 23-24 January 2014.