Medical Edurarion, 1976, 10,480-482
A follow-up of career preferences J. P A R K H O U S E Department of Anaesthetics. University of Manchester
summary
traceable. Of the remaining 111, replies were received from 101 (91 %). The original career choices of those who responded to the follow-up, and those who for the various reasons did not, are shown in Table 1. There appeared to be a better than average
Of 146 pre-registration house officers in 1972 who answered an enquiry about career preferences, 111 were written to again in 1974. The enquiry yielded 101 comparisons, out of which 65 doctors retained their original first choice of career, 15 opted for their previous second or third choice and 21 gave a completely new first choice. Reappraisal of abilities, additional experience of the new choice of career and additional knowledge of promotion prospects were the commonest reasons given for change of career choice.
TABLE1. Comparison of first choice of career in 1972 of respondents and non-respondents to the follow-up survey 1974 First choice career 1972 responders
Medicine Surgery Obstetrics General practice Psychiatry Community medicine Pathology Anaesthetics Radiology Other Total
Key words : *CAREER CHOICE; SPECIALTIES, MEDICAL/ *man; FOLLOW-UP STUDIES; ATTITUDE OF HEALTH PERSONNEL; QUESTIONNAIRES; GREAT BRITAIN
1974 nonresponders
23 20 4 40 I 1 3 5 I 3
12 9 4 7 1 2 2 7 0
101
45
I
Total 35
29 8 47 2 3 5
12 1 4 I46
Introduction re-response from those who, in 1972, had favoured a career in general practice; this may be because they tended to be less mobile, but the numbers involved are too small to draw firm conclusions.
In 1972, 146 young doctors who had graduated from Sheffield and Manchester medical schools the previous summer completed a questionnaire about their career preferences (McLaughlin & Parkhouse, 1972). Two years later, as many as possible of these responders were traced, and asked the same questions as before. They were also asked about the reasons for any changes in their aspirations.
Results Table 2 gives the 1974 career intentions of the 101 respondents to the follow-up survey. There was some increase in the firmness with which career choices had been made; in response to the question ‘have you made up your mind about your future career?’, 11 replied ‘not really’, 35 ‘probably’ and 55 ‘definitely’. There was a marked increase in the estimated chance of succeeding in the first choice of career, with 79 of the 101 responders assessing their chances
Response Of the original 146 responders, 36 could not be written to again, either because they had replied anonymously or because they were no longer Correspondence : Professor J. Parkhouse, Department of Anaesthetics, University Hospital of South Manchester, Withington Hospital, Manchester M20 8LR.
480
A follow-up of career preferences TABLE2. 1974 career intentions (ties in choices not allowed for)
Medicine Surgery Obstetrics General practice Psychiatry Community medicine Pathology Anaesthetics Radiology Other medical Other non-medical Total
First choice
Second choice
Third choice
20 13 3 42
10 1 1
0 0 I 2 I
1
4 4 10 1
3 0 101
22 I 6
Regional Health Manchester Sheffield Authority graduates graduates
1
3
0 2 2 49
0 3 2 11
as better than 75%. Several responders noted that they were now principals in general practice and hence had succeeded in achieving their career choice. There was very little alteration, after 2 years, in declared intentions with regard to practising in the United Kingdom or emigrating. The actual overall distributions of career preferences given in 1972 and in 1974 were similar. There were, however, many individual changes; Table 3 gives an analysis, and shows that 36% of re-responders indicated an altered first choice. TABLE 3. Breakdown of changes in career preferences First choice 1974 = First choice in 1972 First choice 1974 = Second or third choice 1972 New first choice 1974 Total
65 15
21 101
Table 4 shows the frequency with which each of a list of suggested reasons was given as a cause for change in career preference. In addition, 10 reresponders commented on their dissatisfaction with the pay and conditions of N.H.S. hospital posts, and there were several references to incompatibility with satisfactory family life. TABLE 4. Some reasons for change of career preference I. 2. 3. 4. 5.
Table 5 shows the geographical location of the re-responders, 33 years after graduation, according to the Regional Health Authority of their address. TABLE 5 . 1974 location of responders
0 I
1
481
Altered domestic circumstances 16 Altered financial circumstances 6 Additional exuerience of urevious choice of career 17 Additional experience of new choice of career 26 Additional knowledge of promotion/career prospects and difficulties 27 6. Re-appraisal of aptitudes and abilities 21 7. Advice or influence from others
North Yorkshire Trent East Anglia N.W. Thames N.E. Thames S.E. Thames S.W. Thames Wessex Oxford South West West Midlands Merseyside North West Wales Scotland Other Total
3 3
0 2 26
0
1
3 2 0 1
I 2 0 2 2
1
0 0
0 I 8 23 2 3
2 52
0
0 2 2 3 2 1
2
48
Total 1
5 29 1 4 4
0 3 2 0 0 3 10
26 4 4 4 100
Discussion
Relatively few graduates would be expected to persist with working in a specialty in which they felt they had very little chance of success. This was reflected in the improved self-rating of career prospects. Over one-third of the re-responders had changed their choice of career and in 20 cases the new first choice had not featured previously as a second or third choice. Only 55% of this sample of 101 graduates were definite about their career choices 33 years after qualifying. Gains and losses to and from individual specialties could not adequately be assessed in all cases because of the failure to trace some original responders. For example, of the 12 graduates who gave anaesthetics as a first choice in 1972, it was only possible to follow up 5. In general practice, however, 40 of the original 47 were followed up, and of these 26 still gave general practice as their first choice. The mere presentation of numbers of doctors choosing various specialties at different times can give a misleading of stability. - impression . - Specific . changes of career preference in one direction can easily be offset by others in the reverse direction. This argues for the importance of continuing cohort studies, in which the progress of individual doctors
482
J . Parkhouse
can be followed. A virtually complete follow-up is needed, however, if trends are to be analysed fully. The commonest reasons given for change of career preference were improved knowledge of promotion prospects, additional experience of the newly-chosen specialty and reappraisal of aptitudes. Altered domestic circumstances also came high on the list, but altered financial circumstances were mentioned only six times. Advice from others was by no means a prominent reason. Additional experience of the specialty originally chosen was a fairly common reason for change. These findings tend to confirm the fact that at the pre-registration stage many graduates are quite uncertain about what various careers have to offer, and about their own aptitudes and chances of success. The opportunity to obtain experience in a
specialty may lead to either enthusiasm or disenchantment but a good deal would need to be known about the qualitative nature of this experience before further conclusions could be drawn. Forty-four per cent of Manchester graduates and 54% of Sheffield graduates who responded to the follow-up were still working within their own N.H.S. Region 3: years after graduation. This is an interesting cross-sectional indication of mobility; further studies of movement during training are in progress.
Reference MCLAUGHLIN, C. & PARKHOUSE, J. (1972) Career preferences of 1971 graduates of two British medical schools. Lancet, ii, 1018.
A follow-up of career preferences J. P A R K H O U S E Department of Anaesthetics. University of Manchester
summary
traceable. Of the remaining 111, replies were received from 101 (91 %). The original career choices of those who responded to the follow-up, and those who for the various reasons did not, are shown in Table 1. There appeared to be a better than average
Of 146 pre-registration house officers in 1972 who answered an enquiry about career preferences, 111 were written to again in 1974. The enquiry yielded 101 comparisons, out of which 65 doctors retained their original first choice of career, 15 opted for their previous second or third choice and 21 gave a completely new first choice. Reappraisal of abilities, additional experience of the new choice of career and additional knowledge of promotion prospects were the commonest reasons given for change of career choice.
TABLE1. Comparison of first choice of career in 1972 of respondents and non-respondents to the follow-up survey 1974 First choice career 1972 responders
Medicine Surgery Obstetrics General practice Psychiatry Community medicine Pathology Anaesthetics Radiology Other Total
Key words : *CAREER CHOICE; SPECIALTIES, MEDICAL/ *man; FOLLOW-UP STUDIES; ATTITUDE OF HEALTH PERSONNEL; QUESTIONNAIRES; GREAT BRITAIN
1974 nonresponders
23 20 4 40 I 1 3 5 I 3
12 9 4 7 1 2 2 7 0
101
45
I
Total 35
29 8 47 2 3 5
12 1 4 I46
Introduction re-response from those who, in 1972, had favoured a career in general practice; this may be because they tended to be less mobile, but the numbers involved are too small to draw firm conclusions.
In 1972, 146 young doctors who had graduated from Sheffield and Manchester medical schools the previous summer completed a questionnaire about their career preferences (McLaughlin & Parkhouse, 1972). Two years later, as many as possible of these responders were traced, and asked the same questions as before. They were also asked about the reasons for any changes in their aspirations.
Results Table 2 gives the 1974 career intentions of the 101 respondents to the follow-up survey. There was some increase in the firmness with which career choices had been made; in response to the question ‘have you made up your mind about your future career?’, 11 replied ‘not really’, 35 ‘probably’ and 55 ‘definitely’. There was a marked increase in the estimated chance of succeeding in the first choice of career, with 79 of the 101 responders assessing their chances
Response Of the original 146 responders, 36 could not be written to again, either because they had replied anonymously or because they were no longer Correspondence : Professor J. Parkhouse, Department of Anaesthetics, University Hospital of South Manchester, Withington Hospital, Manchester M20 8LR.
480
A follow-up of career preferences TABLE2. 1974 career intentions (ties in choices not allowed for)
Medicine Surgery Obstetrics General practice Psychiatry Community medicine Pathology Anaesthetics Radiology Other medical Other non-medical Total
First choice
Second choice
Third choice
20 13 3 42
10 1 1
0 0 I 2 I
1
4 4 10 1
3 0 101
22 I 6
Regional Health Manchester Sheffield Authority graduates graduates
1
3
0 2 2 49
0 3 2 11
as better than 75%. Several responders noted that they were now principals in general practice and hence had succeeded in achieving their career choice. There was very little alteration, after 2 years, in declared intentions with regard to practising in the United Kingdom or emigrating. The actual overall distributions of career preferences given in 1972 and in 1974 were similar. There were, however, many individual changes; Table 3 gives an analysis, and shows that 36% of re-responders indicated an altered first choice. TABLE 3. Breakdown of changes in career preferences First choice 1974 = First choice in 1972 First choice 1974 = Second or third choice 1972 New first choice 1974 Total
65 15
21 101
Table 4 shows the frequency with which each of a list of suggested reasons was given as a cause for change in career preference. In addition, 10 reresponders commented on their dissatisfaction with the pay and conditions of N.H.S. hospital posts, and there were several references to incompatibility with satisfactory family life. TABLE 4. Some reasons for change of career preference I. 2. 3. 4. 5.
Table 5 shows the geographical location of the re-responders, 33 years after graduation, according to the Regional Health Authority of their address. TABLE 5 . 1974 location of responders
0 I
1
481
Altered domestic circumstances 16 Altered financial circumstances 6 Additional exuerience of urevious choice of career 17 Additional experience of new choice of career 26 Additional knowledge of promotion/career prospects and difficulties 27 6. Re-appraisal of aptitudes and abilities 21 7. Advice or influence from others
North Yorkshire Trent East Anglia N.W. Thames N.E. Thames S.E. Thames S.W. Thames Wessex Oxford South West West Midlands Merseyside North West Wales Scotland Other Total
3 3
0 2 26
0
1
3 2 0 1
I 2 0 2 2
1
0 0
0 I 8 23 2 3
2 52
0
0 2 2 3 2 1
2
48
Total 1
5 29 1 4 4
0 3 2 0 0 3 10
26 4 4 4 100
Discussion
Relatively few graduates would be expected to persist with working in a specialty in which they felt they had very little chance of success. This was reflected in the improved self-rating of career prospects. Over one-third of the re-responders had changed their choice of career and in 20 cases the new first choice had not featured previously as a second or third choice. Only 55% of this sample of 101 graduates were definite about their career choices 33 years after qualifying. Gains and losses to and from individual specialties could not adequately be assessed in all cases because of the failure to trace some original responders. For example, of the 12 graduates who gave anaesthetics as a first choice in 1972, it was only possible to follow up 5. In general practice, however, 40 of the original 47 were followed up, and of these 26 still gave general practice as their first choice. The mere presentation of numbers of doctors choosing various specialties at different times can give a misleading of stability. - impression . - Specific . changes of career preference in one direction can easily be offset by others in the reverse direction. This argues for the importance of continuing cohort studies, in which the progress of individual doctors
482
J . Parkhouse
can be followed. A virtually complete follow-up is needed, however, if trends are to be analysed fully. The commonest reasons given for change of career preference were improved knowledge of promotion prospects, additional experience of the newly-chosen specialty and reappraisal of aptitudes. Altered domestic circumstances also came high on the list, but altered financial circumstances were mentioned only six times. Advice from others was by no means a prominent reason. Additional experience of the specialty originally chosen was a fairly common reason for change. These findings tend to confirm the fact that at the pre-registration stage many graduates are quite uncertain about what various careers have to offer, and about their own aptitudes and chances of success. The opportunity to obtain experience in a
specialty may lead to either enthusiasm or disenchantment but a good deal would need to be known about the qualitative nature of this experience before further conclusions could be drawn. Forty-four per cent of Manchester graduates and 54% of Sheffield graduates who responded to the follow-up were still working within their own N.H.S. Region 3: years after graduation. This is an interesting cross-sectional indication of mobility; further studies of movement during training are in progress.
Reference MCLAUGHLIN, C. & PARKHOUSE, J. (1972) Career preferences of 1971 graduates of two British medical schools. Lancet, ii, 1018.
