New study looks at factors affecting retention of doctors

A positive working environment and good work/life balance are key factors that medical students take into account when considering their choice of specialty, a new study suggests.

The recruitment of doctors is a major issue facing the health service today. Recruitment into both training and consultant posts has become increasingly problematic in recent years, particularly for some specialties.

This has been blamed on a number of issues, including emigration of trainees, reduced salaries and deteriorating working conditions.

Researchers from the Rotunda Hospital in Dublin and the Royal College of Surgeons in Ireland (RCSI) set out to assess the factors that are important to medical students when considering their career and specialty choice, with particular reference to careers in neonatology.

The paediatric sub-specialty of neonatology is one area that has been found to be severely affected by staff retention and emigration issues. This is a rapidly evolving intensive care specialty with strong links to research.

A national framework published in 2013 found that the number of neonatologists in Ireland “was below what one would expect when compared to international standards of care”.

A neonatology sub-specialty training scheme was subsequently launched in 2017, with its first trainees graduating in 2020.

This study involved a survey of medical students in the Rotunda Hospital between October 2019 and May 2020. The students were in the Rotunda for their clinical placement in neonatology in the academic year 2019/2020.

A total of 149 students completed the survey, 74% of whom were aged 18-25, while 22% were aged 26-30.

The students were asked about the role of mentors in their career choice. Just 25% reported having a mentor, but of these, 79% said that their mentor had influenced their career choice.

The researchers suggested that different specialties “could bolster student interest by developing mentorship programmes”.

When asked about individual factors that influenced their career choice, the most important one overall was found to be “interest in the medical specialty”, with 137 respondents citing the importance of this.

This was followed by “positive experience during clinical post” (109), and “lifestyle/working patterns” (102).

The delivery of training programmes and the availability of future consultant posts were also seen as very important.

The researchers acknowledged that this survey was carried out at one point in time so it is unclear how these factors may change over time. They said that the next stage of this study is to survey doctors at different stages in their career to determine what factors maintain a doctor’s interest in a specialty and what drives them to change career paths.

However, they also said that the findings show that medical students think carefully about their career choice and are influenced by an interest in a specialty, coupled with a positive working environment and the impact of work/life balance.

They added that the needs of medical students and trainee doctors “need to be made a priority by policy makers and training bodies if we want to retain our passionate highly-educated Irish trained doctors”.

This study was published in the Irish Medical Journal.