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Cohort study 2006 medical graduates - first report

• identify doctors who leave medicine as a career, or who choose to work in another country, to assess the magnitude of this loss and the factors which influence it;
• identify patterns of workforce participation and specialty choice of doctors who remain in the UK, and the factors which influence them;
• investigate career progression, especially those factors which influence variation between doctors.

• The BMA cohort study of 2006 medical graduates is a 10-year longitudinal study of the career paths of 435 doctors. This is the first report and provides baseline information on interest in medicine, career choice and future career progress.

• A central aim of the cohort study is to reflect the future profile of the medical workforce and track their career development over a 10 year period. Almost three in five respondents are female and two in five are male. The majority of respondents are of white ethnic origin and are UK-born. The average age is 27 years. The majority of cohort doctors are single and very few have children.

• A fifth of the cohort have at least one medically qualified parent and those from non-white ethnic backgrounds are more likely to come from a medical background. Four in five respondents have non-medically qualified parents and these are more likely to be working in professional and managerial occupations.

• The average age when cohort members made the decision to become a doctor is 14 years and the most popular reason for choosing to study medicine is because they thought it would be an ‘interesting career’, followed by the ‘desire to work with and help people’.

• Almost a quarter of the cohort had obtained a higher or professional qualification before entering medical school and 15 per cent of the cohort have been in full-time permanent employment before entering medical school.

• Cohort doctors were asked about the main influences on their choice of medical school and most reported ‘location’ as a key influence, followed by the ‘reputation’ and the ‘prospectus’ of the medical school.

• Most of the cohort report graduating from medical school with some form of student debt. The average amount of reported student debt is £20,798 and those with some form of student debt envisage that it will take an average of 11 years to pay it off.

• While the majority of cohort doctors report a strong desire to practise medicine, at graduation, more than one in 10 cohort doctors report a lukewarm or weak desire to practise medicine. The desire to practise medicine has declined somewhat since entry to medical school, particularly among females.

• At graduation, general practice is the most popular specialty choice among cohort doctors, followed by general medicine and surgery. While females are more likely to indicate a preference towards general practice, among male cohort doctors, similar numbers express a preference towards both general practice and surgery.

• Around three in five cohort doctors aspire to the consultant grade and 14 per cent aspire to become a GP principal. Almost a fifth of cohort doctors are undecided as to their ultimate career goal. Male cohort doctors are more likely to aspire to the consultant grade, compared with female cohort doctors who are more likely to plan a career as a non-principal GP.

• ‘Hours of work and working conditions’ is seen as being an important factor influencing carer choice by almost three-quarters of the cohort, followed by ‘a sense of vocation’, ‘domestic circumstances’ and ‘personal appraisal of their own skills and aptitude’.

• At graduation, a third of cohort doctors indicate a desire to train flexibly. Almost half of female cohort doctors desire some degree of flexible training, compared with males. Key reasons given for the desire to train flexibly include family commitments, work-life balance and the pursuit of nonmedical work/interests.

• At graduation, less than a fifth of the cohort are confident that they will automatically get a job, once they have completed their training and less than 10 per cent are confident that they will get a job in their chosen specialty. Two – thirds of cohort doctors envisage working outside of the NHS at some point in their career, mainly as part of their medical career.

• At graduation, three in five cohort doctors plan to practise medicine outside the UK, either temporarily or permanently. This is consistent according to gender and many cohort doctors who intend to practise medicine outside the UK, intend to do so either at the completion of their foundation training or early in their specialty training.
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  © British Medical Association 2008