Abstract
BackgroundIn the UK and many other countries, many specialties have had longstanding problems with recruitment and have increasingly relied on international medical graduates to fill junior and senior posts. We aimed to determine what specialties were the most popular and desirable among candidates for training posts, and whether this differed by country of undergraduate training.MethodsWe conducted a database analysis of applications to Modernising Medical Careers for all training posts in England in 2008. Total number of applications (as an index of popularity) and applications per vacancy (as an index of desirability) were analysed for ten different specialties. We tested whether mean consultant incomes correlated with specialty choice.ResultsIn, 2008, there were 80,949 applications for specialty training in England, of which 31,434 were UK graduates (39%). Among UK medical graduates, psychiatry was the sixth most popular specialty (999 applicants) out of 10 specialty groups, while it was fourth for international graduates (5,953 applicants). Among UK graduates, surgery (9.4 applicants per vacancy) and radiology (8.0) had the highest number of applicants per vacancy and paediatrics (1.2) and psychiatry (1.1) the lowest. Among international medical graduates, psychiatry had the fourth highest number of applicants per place (6.3). Specialty popularity for UK graduates was correlated with predicted income (p = 0.006).ConclusionBased on the number of applicants per place, there was some consistency in the most popular specialties for both UK and international medical graduates, but there were differences in the popularity of psychiatry. With anticipated decreases in the number of new international medical graduates training in the UK, university departments and professional associations may need to review strategies to attract more UK medical graduates into certain specialties, particularly psychiatry and paediatrics.
Highlights
In the UK and many other countries, many specialties have had longstanding problems with recruitment and have increasingly relied on international medical graduates to fill junior and senior posts
Using Modernising Medical Careers (MMC) data for applications for training posts in 2008, we examined the specialty choices of UK compared with international medical graduates (IMGs)
We hypothesised that specialty choice would be associated with predicted income, as it has been demonstrated for all specialties in the US [6], if candidates perceived no need for strategic applications for less attractive disciplines
Summary
In the UK and many other countries, many specialties have had longstanding problems with recruitment and have increasingly relied on international medical graduates to fill junior and senior posts. We aimed to determine what specialties were the most popular and desirable among candidates for training posts, and whether this differed by country of undergraduate training. A number of countries have increased medical school places to address shortages in the amount of graduates training in certain specialties [1,2,3]. Our hypotheses were related to the known preferences of medical students for specialty training [5], but as the national market in training places is subject to international competition, we predicted that the choice of specialty would depend on country of origin, leading to predictable trends in the relative contribution of overseas graduates to different specialties in the National Health System. We hypothesised that specialty choice would be associated with predicted income, as it has been demonstrated for all specialties in the US [6], if candidates perceived no need for strategic applications for less attractive disciplines
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