Allocation of training posts to applicants for postgraduate medical education in austria: survey and analysis.

Abstract

To analyze the consequences of the current procedure for allocating training posts to medical graduates in Austria. In this cross-sectional study, a questionnaire was sent in two mailings to 8,127 licensed general practitioners and specialists based on the register of the Vienna Medical Chamber in June 2000. The main outcome measures were the percentage of licensed male and female physicians who did not obtain training in their originally preferred medical specialty and the percentage of physicians who were working in a medical specialty other than their originally preferred specialty. A total of 2,736 respondents (34%) completed the questionnaire in the two mailings: 50.3% of physicians--43.2% of male physicians and 58.6% of female physicians--were not practicing in their originally preferred specialty. An average 9% of physicians changed their minds about their preferred specialty during their training. Twenty-one percent of all physicians completed training in an additional specialty. An average of 11 months of additional training was spent at official training posts in specialties other than those finally practiced. The Austrian allocation procedure is ineffective, uneconomical, and unfair for the applicants. Many medical graduates accept training in a specialty other than the one preferred, not because it is their wish but because Austria's allocation process leaves them no alternative. The authors call the way in which the Austrian training post allocation system governs specialty choice the "musical-chairs effect." This allocation process requires review and the incorporation of recruitment guidelines to ensure equal rights and fair opportunities.