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What leads Psychiatric trainees to choose a particular higher training speciality? A qualitative study of trainees’ decision making

Lookup NU author(s): Dr Iain McKinnonORCiD


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AIMS AND HYPOTHESIS To describe the current attitudes of trainees in order to understand the recruitment difficulties in the field of Psychiatry and its subspecialties. BACKGROUND Attracting more doctors into hard to fill specialties such as Psychiatry has been well documented. There is little research into factors influencing core trainee subspecialty choices. Further understanding of these factors is important for future workforce planning. A literature search found no published research exploring all six higher training subspecialties. METHODS Interview questions were developed to explore which factors influence trainees’ choices of specialty and decisions to continue in that specialty. Additionally demographic questions were asked. 38 higher trainees from Health Education North East Higher Specialist Training Schemes were contacted and telephone interviews were carried out between June and October 2017. Responses were typed in real-time by NW. Descriptive data were analysed quantitatively. The telephone interviews were analysed qualitatively using Thematic Analysis. Initial comments, coding and co-coding was performed within the research team. Emerging themes were developed and finally higher level themes were identified. RESULTS The overall response rate was 71%. 52% of the participants stated they’d had sufficient exposure to all specialties prior to their decision to specialise. 70% felt that their core training experience had played a significant part in their decision. 55% believed that lifestyle factors were important. Overall 93% of participants were happy with their choice of specialty. From the qualitative analysis, higher level themes common to both trainees’ decisions to apply to and continue in higher training were “supervisory experience,” “perceived work/life balance,” “career prospects” and “training/working environment.” With respect to specialty choice, additional themes of “interest in subspecialty” and “previous experience in subspecialty” were identified. The impact of adequate supervision, perceived changes to models of care delivery and changes to longer term contractual arrangements were amongst the most striking emerging issues of concern to trainees. CONCLUSIONS Whilst the majority of psychiatric trainees interviewed were happy with their choice of specialty, this study highlighted the importance of a broad and enjoyable core training experience, particularly as many trainees used a process of elimination to choose a specialty. A positive supervisory experience is vital throughout training, as is supervisor modelling, and the ability to have a work-life balance in all specialties. The findings of this study should inform planning and delivery of training with a view to workforce planning and further exploration of themes raised.

Publication metadata

Author(s): Wolstenholme N, McKinnon I, Lloyd A

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Royal College of Psychiatrists International Congress

Year of Conference: 2019

Acceptance date: 09/04/2019

Publisher: Royal College of Psychiatrists