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Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977.

ABSTRACT: OBJECTIVE:To report attitudes to retirement of late-career doctors. DESIGN:Questionnaires sent in 2014 to all UK medical graduates of 1974 and 1977. SETTING:United Kingdom. PARTICIPANTS:3695 medical graduates. MAIN OUTCOME MEASURES:Factors which influenced doctors' decisions to retire and factors which encouraged doctors to remain in work. RESULTS:The response rate was 85% (3695/4369). 55% of respondents overall were still working in medicine (whether they had not retired or had retired and returned; 61% of men, 43% of women). Of the retirees, 67% retired when they had originally planned to, and 28% had changed their retirement plans. Fifty per cent of retired doctors cited 'increased time for leisure/other interests' as a reason; 43% cited 'pressure of work'. Women (21%) were more likely than men (11%) to retire for family reasons. Women (27%) were more likely than men (9%) to retire because of the retirement of their spouse. General practitioners (GPs) were more likely than doctors in other specialties to cite 'pressure of work'. Anaesthetists and GPs were more likely than doctors in other specialties to cite the 'possibility of deteriorating skill/competence'. Radiologists, surgeons, obstetricians and gynaecologists, and anaesthetists were most likely to cite 'not wanting to do out-of-hours work'.Doctors who were still working were asked what would encourage them to stay in medicine for longer. Factors cited most frequently were 'reduced impact of work-related bureaucracy' (cited by 45%) and 'workload reduction/shorter hours' (42%). Men (30%) were more motivated than women (20%) by 'financial incentivisation'. Surgeons were most motivated by 'reduction of on-call or emergency commitments'. CONCLUSIONS:Retention policy should address ways of optimising the clinical contribution of senior doctors while offering reduced workloads in the areas of bureaucracy and working hours, particularly in respect of emergency commitments.

SUBMITTER: Smith F

PROVIDER: S-EPMC5695300 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977.

Smith Fay F Lachish Shelly S Goldacre Michael J MJ Lambert Trevor W TW

BMJ open 20171031 9

<h4>Objective</h4>To report attitudes to retirement of late-career doctors.<h4>Design</h4>Questionnaires sent in 2014 to all UK medical graduates of 1974 and 1977.<h4>Setting</h4>United Kingdom.<h4>Participants</h4>3695 medical graduates.<h4>Main outcome measures</h4>Factors which influenced doctors' decisions to retire and factors which encouraged doctors to remain in work.<h4>Results</h4>The response rate was 85% (3695/4369). 55% of respondents overall were still working in medicine (whether t ...[more]

PMID: 29089347

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Project description:OBJECTIVES:This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. SETTING:Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors' career decisions. PARTICIPANTS:Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. RESULTS:Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.Junior doctors' decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.Events linked with specific specialties influenced doctors' attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. CONCLUSIONS:Junior doctors' preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers.

Dataset Information

Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977.

Publications

Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977.

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