Abstract
BackgroundThe UK faces geographical variation in the recruitment of doctors. Understanding where medical graduates choose to go for training is important because doctors are more likely to consider practicing in areas where they completed postgraduate training. The wider literature also suggests that there is a relationship between origin and background, and where doctors wish to train/work. Thus, the purpose of this paper is to investigate the geographical mobility of UK medical graduates from different socio-economic groups in terms of where they wish to spend their first years of postgraduate training.MethodsThis was an observational study of Foundation Programme (FP) doctors who graduated from 33 UK medical schools between 2012 and 2014. Data was accessed via the UK medical education database (UKMED: https://www.ukmed.ac.uk/). Chi-square tests were used to examine the relationships between doctor’s sociodemographic characteristics and the dependent variable, average driving time from parental home to foundation school/region. Generalised Linear Mixed Models (GLMM) were used to estimate the effects of those factors in combination against the outcome measure.ResultsThe majority of doctors prefer to train at foundation schools that are reasonably close to the family home. Those who attended state-funded schools, from non-white ethnic groups and/or from lower socio-economic groups were significantly more likely to choose foundation schools nearer their parental home. Doctors from disadvantaged backgrounds (as determined by entitlement to free school meals, OR = 1.29, p = 0.003 and no parental degree, OR = 1.34, p < 0.001) were associated with higher odds of selecting a foundation schools that were closer to parental home.ConclusionThe data suggests that recruiting medical students from lower socioeconomic groups and those who originate from under-recruiting areas may be at least part of the solution to filling training posts in these areas. This has obvious implications for the widening access agenda, and equitable distribution of health services.
Highlights
The UK faces geographical variation in the recruitment of doctors
UK medical students spend between four and 6 years at medical school before they enter foundation training, the generic two-year training programme which bridges the gap between finishing medical school and becoming eligible to apply for specialty training
The first choice of foundation school with less than two-hours driving time from the parental home was selected by 61.9% of the trainees, between two and 4 h by slightly above quarter (26.4%) and the remaining 11.7% chose a foundation school that was more than 4 h from the parental home
Summary
The UK faces geographical variation in the recruitment of doctors. Understanding where medical graduates choose to go for training is important because doctors are more likely to consider practicing in areas where they completed postgraduate training. In UK, there have been policy drives to address the shortage of doctors in certain geographical areas [7, 14]. These policies are often supported by the emerging evidence that doctors tend to go back and work in areas. Kumwenda et al BMC Medical Education (2018) 18:314 where their training was undertaken [6, 7, 15,16,17]. This is an issue for several reasons. Because of where UK medical schools are located, for some people there is no medical school that they could attend while staying at home
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