Abstract
BackgroundNegative comments from senior colleagues about specialties, such as general practice and psychiatry, are known to influence trainees’ career choice, but little is known about the extent of this influence or the mechanism by which it works. There have been calls to ban these disparaging comments, also known as ‘banter’. This study explored how recently qualified doctors make sense of banter in the context of other experiences and information.MethodsSemi-structured telephone interviews were conducted with 24 trainee doctors in their second postgraduate year in South West England. Thematic Analysis was used to code the data and organise them into themes.ResultsTrainees are commonly exposed to banter about the merits of different specialties and those who work in them, but these messages are not received uncritically and are not perceived to be decisive in determining career choice. The views of senior doctors are assimilated with other experiences and information, as trainees strive to assess their ‘fit’ with a specialty. While banter is seen as positioning specialties in a status hierarchy, other factors such as work-life balance and feeling ‘at home’ in a specialty are often believed to be more significant factors in career choice. We posited two theories of banter; the ‘propaganda model’ and the ‘person-specialty fit model,’ and found the latter to provide a better understanding of how banter informs career choice.ConclusionsBanter often comprises stereotypes and caricatures, but despite its biases and distortions, it may still aid career choice. The challenge is not to ban banter, but to provide more accurate and reliable knowledge and experiences of what working life is like in different specialties.
Highlights
Negative comments from senior colleagues about specialties, such as general practice and psychiatry, are known to influence trainees’ career choice, but little is known about the extent of this influence or the mechanism by which it works
Wainwright et al BMC Medical Education (2019) 19:104 disparaging and negative comments about some specialities, with 17–24% of students reporting that ‘badmouthing’ had influenced their career choices. [7, 9] While this occurs across all specialities [9, 10], it is reportedly a particular problem for general practice [7, 10, 11] and psychiatry [7, 10, 12, 13]
A study of UK medical students identified the low status of general practice, linked to a prevailing medical school culture, as one of the factors putting them off considering general practice as a career
Summary
Twenty of 24 participants (83%) were female; nationally, 57.4% of FY2 doctors were female in 2014/5. [27]. The rivalry between surgeons and hospital medical specialists has a long history reflecting their different professional origins [28] Both parties had disparaging caricatures of the other, and these were used to suggest that a particular student or trainee was ‘too good’ for other specialties, in the following example, too good for surgery:. While there were aspects of the job that participants liked or did not like, the dilemma over person-specialty fit seemed different to that for most other specialties For some it was seen as the ‘default’ or ‘fall-back’ career choice – what one chose in the absence of a strong identification with another specialty, or if entry to more competitive specialist training programmes were unsuccessful. I’ll probably just become a GP.” [...] if you don’t know what to do it’s almost the default kind of job. (#2)
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