Abstract

BackgroundUnderstanding the influences on healthcare professionals’ career choices and progression can inform interventions to improve workforce retention. Retention of health professionals is a high priority worldwide, in order to maintain expertise and meet the needs of national populations. In the UK, investment in clinical scientists’ pre-registration education is high and the need to retain motivated scientists recognised.MethodsWe conducted a mixed methods study to investigate the career choices and progression of early career clinical scientists. First job sector and salary of trainees who completed the UK pre-registration Scientist Training Programme (STP) between 2014 and 2019 were analysed using descriptive statistics and Chi-Squared tests. Semi-structured interviews conducted with volunteer practising clinical scientists who completed the programme in 2015 or 2016 were analysed thematically and reviewed for alignment with theories for understanding career choice and workforce retention.ResultsMost scientists who completed the STP between 2014 and 2019 obtained a post in the UK National Health Service (NHS) and achieved the expected starting salary. Life scientists were more likely to work in non-NHS healthcare settings than other scientific divisions; and physiological scientists less likely to achieve the expected starting salary. Experiences during training influenced career choice and progression 0–3 years post qualification, as did level of integration of training places with workforce planning. Specialty norms, staff turnover, organisational uncertainty and geographical preferences influenced choices in both the short (0–3 years) and longer term (5 + years). Interviewees reported a strong commitment to public service; and some could foresee that these priorities would influence future decisions about applying for management positions. These factors aligned with the components of job embeddedness theory, particularly that of ‘fit’.ConclusionsTraining experiences, personal values, specialty norms and organisational factors all influence UK clinical scientists’ early career choices and progression. Job embeddedness theory provides a useful lens through which to explore career choice and progression; and suggests types of intervention that can enhance the careers of this essential group. Interventions need to take account of variations between different scientific specialties.

Highlights

  • Understanding the influences on healthcare professionals’ career choices and progression can inform interventions to improve workforce retention

  • Starting salaries of Scientist Training Programme (STP) completers Most completers whose first post was in the National Health Service (NHS) reported receiving the expected Band 7 salary (67 %), whilst a third (31 %) remained on Band 6

  • Salaries for those whose first post was outside the NHS were more variable, with 20 % of those entering non-NHS healthcare settings receiving a Band 8 equivalent and 9 % reporting a decrease in salary

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Summary

Introduction

Understanding the influences on healthcare professionals’ career choices and progression can inform interventions to improve workforce retention. Retention of health professionals is a high priority worldwide, in order to maintain expertise and meet the needs of national populations. High quality patient care depends in large part on the expertise and morale of the health workforce [1]; and health services in many countries, including the UK, find it difficult to recruit and retain motivated professionals to meet the needs of their populations [2, 3]. Understanding the influences on health professionals’ career choice and progression can inform efforts to improve retention [4]. We have investigated the career choice and progression of early career clinical scientists in the UK, with a view to helping educators and workforce managers design interventions that improve recruitment and retention of this necessary healthcare workforce

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