Stability and change in career choices of junior doctors: postal questionnaire surveys of the United Kingdom qualifiers of 1993

Objective To report on stability and change in career choices of doctors, b etween 1 and 3 years after qualification. Design Postal questionnaire surveys. Setting United Kingdom. All doctors who qualified in the United Kingdom in 1993. Main outcome measures Choices of eventual career expressed 1 and 3 years af ter qualifying. Results The overall pattern of career choices at year 3 differed a little f rom that at year 1. For example, choices for general practice increased fro m 26% to 29%, choices for medical specialties fell from 22% to 18%, and for surgical specialties they fell from 17% to 14%. However, because changes o f choice between specialties tended to 'cancel out', the aggregated data ma sked much larger changes when considered at the level of individual doctors . Overall, 74% of respondents retained their year 1 career choice in year 3 (78% of men, 70% of women). Of doctors who chose a hospital specialty in y ear 1, 71% chose the same specialty in year 3, 18% had switched choice to a nother hospital specialty, and 9% had switched choice to general practice. The percentage who changed choice from hospital specialties to general prac tice between years 1 and 3 was lower in the 1993 cohort than in all previou s cohorts. Of those whose year 1 choice of long-term career was general pra ctice, 89% retained that choice in year 3 and 11% switched to other branche s of medicine. Even by year 3, less than half of all respondents (and a sma ller percentage of women than men) signified that their long-term choice of specialty was definite. In year 3, 78% of all respondents, and 79% of doct ors from homes in the United Kingdom, intended definitely or probably to pr actise medicine in the United Kingdom for the foreseeable future, which rep resented little change from the figures in year 1. Conclusions About a quarter of doctors change their career choice between y ears 1 and 3 after qualification, and less than half regard their choice in year 3 as definite. Flexibility is therefore needed, well beyond the first post-qualification year, to accommodate changes of choice. Where training opportunities in a hospital specialty are limited, doctors are now inclinin g, more than in the past, to switch to an alternative hospital specialty ra ther than to general practice.