Doctoral Career Research Articles

Balance between career and family life among female doctors in King Abdul- Aziz Medical City, Riyadh, Saudi Arabia

Background: The balance between career and family life of women doctors is a topic of research worldwide. This relation has a significant impact on both work and family obligations. Aims & Objective: To determine the reported effect of career on family life and vice versa among Saudi female physicians. Material and Methods: A cross sectional study was conducted included all Saudi women doctors who ever married and in current clinical practice at KAMC, Riyadh, between 1 January and 28 February 2013. A self-administrated questionnaire has been used for data collection containing: demographic data, impact of career on family life, common obstacles and suggested solution. Pearson’s chi-square was used to analyze the relationship between variables. Results: The study included 174 Saudi female doctors. More than half of them (56.3%) reported discrimination from colleagues because of their marital status. Seventy-five Saudi female physicians (43.1%) were unsatisfied in balancing their career and family life. More than half of the participants (51.7%) thought their work has a negative impact on their relationship with their spouses/children. Type of job (on call status) was significantly associated with difficulty in transportation to the hospital (p=0.006). Providing childcare in medical centers (79.9%) and more days off for maternity leave (75.3%) were most reported solutions suggested. Conclusion: Poor satisfaction of Saudi female physicians in balancing career and family life is a common problem among those working in KAMC.

Doctoral career path studies:exchanging paradigms across international borders

This paper explores four doctoral education studies in the United States of America, the Organisation for Economic Co-operation and Development (OECD), the United Kingdom and France which were presented at the 2012 European Alliance on Research Career Development workshop. These studies were directed towards research funding agencies elaborating new theoretical and methodological insights in this emerging field of doctoral career path studies. What questions do these studies choose to foreground? The studies reveal a general silence about matters of power, hierarchy and marginalisation of doctoral education instead highlighting more pragmatic operational and institutional considerations. The paper generates a set of expanding questions to ask about how the agendas of doctoral career path studies are being constructed and in whose interests they are designed and supported. The paper also offers alternate conceptions of the notion of development, freedoms and significance when evaluating such research agendas, especially for developing world contexts. Key words: doctoral career path studies, career tracking, career outcomes

The role of anatomy demonstrating in a doctor's career

The role of anatomy demonstrating in a doctor's career

Teaching mindfulness in medical school: where are we now and where are we going?

Mindfulness has the potential to prevent compassion fatigue and burnout in that the doctor who is self-aware is more likely to engage in self-care activities and to manage stress better. Moreover, well doctors are better equipped to foster wellness in their patients. Teaching mindfulness in medical school is gaining momentum; we examined the literature and related websites to determine the extent to which this work is carried out with medical students and residents. A literature search revealed that 14 medical schools teach mindfulness to medical and dental students and residents. A wide range of formats are used in teaching mindfulness. These include simple lectures, 1-day workshops and 8-10-week programmes in mindfulness-based stress reduction. Two medical schools stand out because they have integrated mindfulness into their curricula: the University of Rochester School of Medicine and Dentistry (USA) and Monash Medical School (Australia). Studies show that students who follow these programmes experience decreased psychological distress and an improved quality of life. Although the evidence points to the usefulness of teaching mindful practices, various issues remain to be considered. When is it best to teach mindfulness in the trajectory of a doctor's career? What format works best, when and for whom? How can what is learned be maintained over time? Should mindfulness training be integrated into the medical school core curriculum?

How to ... be an Active Appraiser

Being an active appraiser is very challenging in terms of knowing a doctor's work well enough to appraise them effectively. It also requires a set of skills that need to be developed and applied well in a complex system and in the context of an individual doctor's career development. Being 'active' means bringing these skills and principles together.

8. New Faculty Perceptions of Supervision and Mentoring: The Influence of Graduate School Experiences

This study examined new faculty members’ perceptions and approaches to student supervision and mentoring as related to their own experiences as doctoral students. Previous research has examined the graduate student-supervisor/mentor relationship but has yet to examine its impact on subsequent graduate student practices when they enter academic positions. Fourteen Canadian faculty members participated in a study on the experiences and expectations of doctoral candidates and early career academics. As a group, these new faculty members perceived that ideally a supervisor would also be a mentor. They perceived that a mentor shares professional and personal experience, functions as a ‘sounding board,’ provides guidance and advice, and helps prepare students for the work they are currently doing and for their career responsibilities in the future. A majority of these new faculty members reported that their graduate supervisors were not their only mentor or did not function as a mentor. Furthermore, all participants reported that they consciously made an effort to include mentorship as part of their supervisory role. These findings indicated that graduate students’ own experiences of being supervised and/or mentored informed approaches with their own students. This research shows the apparent value in studying the influences of these important graduate school relationships and demonstrates the way in which our perspectives on supervisory relationships may influence subsequent practice.

Bad apples spoil the barrel: Addressing unprofessional behaviour

Given the changes in society we are experiencing, the increasing focus on patient-centred care and acknowledgement that medical education including professionalism issues needs to continue not only in the residency programmes but also throughout the doctors career, is not surprising. Although most of the literature on professionalism pertains to learning and teaching professionalism issues, addressing unprofessional behaviour and related patient safety issues forms an alternative or perhaps complementary approach. This article describes the possibility of selecting applicants for a medical school based on personality characteristics, the attention to professional lapses in contemporary undergraduate training, as well as the magnitude, aetiology, surveillance and methods of dealing with reports of unprofessional behaviour in postgraduate education and CME.

Development of the Murdoch Chiropractic Graduate Pledge

This paper reviews the origins of the learned professions, the foundational concepts of professionalism, and the common elements within various healer's oaths. It then reveals the development of the Murdoch Chiropractic Graduate Pledge. A committee comprised of three Murdoch academics performed literature searches on the topic of professionalism and healer's oaths and utilized the Quaker consensus process to develop the Murdoch Chiropractic Graduate Pledge. The committee in its deliberations utilized over 200 relevant papers and textbooks to formulate the Murdoch Chiropractic Graduate Pledge that was administered to the 2010 Murdoch School of Chiropractic and Sports Science graduates. The School of Chiropractic and Sports Science included professionalism as one of its strategic goals and began the process of curriculum review to align it with the goal of providing a curriculum that recognizes and emphasizes the development of professionalism. The reciting of a healer's oath such as the Hippocratic Oath is widely considered to be the first step in a new doctor's career. It is seen as the affirmation that a newly trained health care provider will use his or her newfound knowledge and skill exclusively for the benefit of mankind in an ethical manner. Born from the very meaning of the word profession, the tradition of recitation of a healer's oath is resurgent in health care. It is important for health care instructors to understand that the curriculum must be such that it contributes positively to the students' professional development.

Portfolio Development for Foundation Doctors – Step® Foundation Day 1

The careers of foundation-year doctors since the advent of Modernising Medical Careers (MMC) have significantly differed from those of our predecessors. Long gone are the days when doctors could spend a few years plying their trade as senior house officers in different subspecialties, taking their time to develop an extensive skill set before finally settling on the area in which they wished to forge their career.

Career satisfaction and professional accomplishments

Research on doctor career satisfaction has often focused on factors such as income, specialty, gender, work hours, autonomy, patient load, lifestyle preferences, work environment, and insurance regulations. Other educational, personal and professional factors have not received sufficient empirical attention. This study was designed to test the following five hypotheses that doctors' career satisfaction is associated with: (i) Higher satisfaction with their undergraduate medical education; (ii) Greater academic and clinical competence; (iii) More involvement in teaching and research activities; (iv) Higher orientation toward lifelong learning; and (v) Increased professional accomplishments. A survey was mailed in 2006 to a national sample of 5349 doctors in the United States who graduated from Jefferson Medical College between 1975 and 2000; 3170 (59%) returned completed surveys. Based on responses to a career satisfaction question, doctors were classified into three groups: Highly satisfied (top third, n=1078); moderately satisfied (middle third, n=1031); and least satisfied (bottom third, n=1061). These groups were compared on a number of variables. All five research hypotheses were confirmed. Additionally, no significant association was observed between career satisfaction, age, years in practice, gender, or ethnicity; however, career satisfaction was associated with doctors' specialties. The findings suggest that factors such as satisfaction with medical education, medical school class rank, assessments of clinical competence, teaching, and research activities, orientation toward lifelong learning, and professional accomplishments should be considered for a more comprehensive understanding of doctors' career satisfaction.

Fatherhood and medicine

Having children will inevitably, to a greater or lesser degree, have a negative impact on a woman doctor's career progression. It is a major challenge to create a working environment which optimises her career progression, and at the same time enables optimal parental care for her children. This is a multi-faceted issue, but the quality of childcare is rarely discussed, except in terms of nursery places and tax deductions. The perspective of the father, and his potential contribution to the sustenance of his wife's career and the welfare of his children, are rarely considered. The woman doctor's perspective as a mother is also put to one side. The major burden of childcare for the foreseeable future will fall on the mother, but the key issue (for parents and administrators) is that the period of intensive childcare is limited and, once complete, both careers can proceed at full pace.

Professionalism beyond medical school: An educational continuum?

Given the changes in society we are experiencing, the increasing focus on patient centred care and acknowledgment that medical education needs to continue not only in the residency programmes but throughout the doctors career, is not surprising. This article describes the attention currently paid to professionalism in the residency programmes, differences in perception of professionalism between patients, faculty, students and residents, differences in professionalism issues in the different educational phases, as well as their consequences for training and assessment regarding professionalism. Continuous medical education in professionalism is thereafter briefly discussed.

The under-performing trainee - concerns and challenges for medical educators

Although difficulties can occur at any stage of a doctor's career, they often appear early.

Determinants of career aspirations of medical students in southern China

BackgroundWith recent changes in both the Chinese medical system and compensation of medical doctors, the career aspirations of Chinese medical students have become more diverse. Shantou University Medical College has conducted evaluations and instituted programs to enhance student preparedness to enter a variety of medical careers.MethodsA survey was conducted with 85 students to evaluate medical career aspirations and their association with family background, personal skills, English language proficiency, and interest in biomedical research, which were considered as possible factors affecting their career interest.ResultsChinese students aspire to traditional as well as nontraditional medical careers. A significant minority of students are now interested in nontraditional careers such as medical teaching or research. However, poor proficiency in the English language and lack of computer skills may limit their academic and career opportunities.ConclusionCareer aspirations have changed among medical undergraduates. Although many wish to pursue a traditional clinical doctor career, many are interested in research and teaching careers. Factors such as family background, personal characteristics, school mentoring, and extracurricular support may play a role.

Competition ratios for different specialties and the effect of gender and immigration status

Some specialties have always been very competitive. Careers advice for medical students and junior doctors is often patchy.1–3 The Medical Schools Council reported ‘an urgent need’ for medical schools to provide more comprehensive information regarding careers.4 Competition ratios have been published, but these were only to be found in obscure human resources publications5 until Shelley Heard's recent paper in the BMJ Career Focus.6 None of these previous studies mentioned the immigration status of applicants, or the extreme gender differences in applications for different specialties. There has always been a career-defining moment when a junior doctor obtains a training post in his/her chosen specialty with a National Training Number (NTN). Until 2007, an NTN was only awarded with a Specialist Registrar (SpR) post in the chosen specialty, often following several years in the Senior House Officer (SHO) grade. Modernising Medical Careers (MMC) was an initiative to streamline training and move the career-defining moment to an earlier point in a doctor's career.3,7 There has been little mention of how to select candidates for those popular specialties where 90% of applicants currently do not get a post. With selection occurring earlier, there is even less to choose between candidates. The Tooke report into MMC has recommended moving the career-defining moment two years later, but this is still much earlier than occurred in many specialties prior to 2007.8

Why do we choose rheumatology? Implications for future recruitment—results of the 2006 UK Trainee Survey

Against changes to junior doctor career structure under MMC (Modernizing Medical Careers), and uncertainty about the future place of rheumatology, we explored critical factors in choice of rheumatology as a speciality, and asked what factors might govern choices of prospective trainees. Using these data, we developed suggestions to enhance future recruitment. A postal survey was sent to rheumatology specialist registrars (SpRs) on the Joint Committee for Higher Medical Training (JCHMT) database between December 2005 and January 2006, and concurrently by e-mail to the Rheumatologists at Training e-mail list. Seventy-three percent (165/227) of trainees responded. Of them, 89.1% had previous senior house officer (SHO) experience in rheumatology and 81.8% made a career decision in favour of rheumatology during their SHO post. The top four ranked factors influencing choice of rheumatology were SHO experience, subject matter, inspirational consultants and lifestyle aspects; 89.1% would still choose rheumatology now. Factors felt to be negatively influencing future trainees came under three key themes: poor student or postgraduate exposure, employment and service delivery issues (including concern over the future place of rheumatology in primary vs secondary care), and perceived poor profile of rheumatology. Factors positively influencing future candidates were subject matter, work/life balance and prior exposure to the speciality. Early postgraduate experience is key to choice of speciality. An overwhelming majority of trainees decide speciality during SHO experience. With ongoing changes in career structure, it is critical that rheumatology is incorporated into foundation and speciality training programmes and essential that continued measures are taken to improve the image of rheumatology.

Graduate education and community engagement

AbstractWindows of opportunity for integrating community engagement throughout the doctoral career are offered in this chapter along with a description of the knowledge, skills, and value orientations needed for future faculty to become engaged scholars.

Safe prescribing by junior doctors

Tobaiqy et al. in a recent study have reported that Foundation Year 1 (FY 1) doctors lack confidence in prescribing several groups of drugs [1]. The majority of the FY 1 doctors felt that undergraduate education in clinical pharmacology and therapeutics (CPT) had not prepared them adequately for prescribing duties. CPT of drugs that are commonly prescribed across specialties, e.g. analgesics, anti-inflammatories, antacids, antibiotics, antihypertensives and anticoagulant drugs, should be adequately taught to medical students because they are likely to be encountered on a doctor's first day on the ward after graduation. However, it is not possible to teach the whole formulary in depth to medical students, and drugs that are more specific to certain specialties are probably best taught during specialty postings. Moreover, there are considerable differences in local formularies between NHS hospital trusts in the UK. This poses a challenge in terms of what drugs should be taught and in how much detail, as students may move to a new region for FY training following graduation. Confidence in prescribing comes from practice and familiarity with a particular drug on the ward. CPT is taught in most medical school curricula, but students have difficulty translating the theory into practice until they are faced with the responsibility of making prescribing decisions [2, 3]. Even though medical students may be taught to write prescriptions which are countersigned by a doctor, confidence only comes with practice, responsibility and adequate supervision. Aronson [4] has rightly noted that the writing of the prescription is a late event in the prescribing process and describes four preceding steps: (i) making an accurate diagnosis, (ii) assessing the balance of benefit to harm, (iii) choosing the right drug among a range of alternatives and the right dose regimen, and (iv) discussion with the patient about the proposed treatment and potential beneficial and adverse effects. It would be difficult to teach medical students all of these steps for all the drugs in the formulary and it is not time efficient to attempt to do so. More focus should be placed on teaching the principles of writing a proper prescription, which applies to any drug being prescribed. This is relevant to medical students as well as practising doctors, and should be a core part of continuous professional development programmes. Many doctors who are able to prescribe drugs confidently are unfortunately unable actually to write clear legible prescriptions that can be dispensed or administered without confusion [5, 6]. These findings are in keeping with unpublished audits done by the authors in two District General Hospitals in the north and south of England. A snap-shot of prescribing practices in the orthopaedic directorate of both hospitals was done at the beginning of the audit cycle. The percentage of inpatient prescription charts with errors in both hospitals was 54% and 60%, respectively. Most of the drugs were analgesics, anti-inflammatory drugs and antibiotics. There were no FY 1 doctors working in either of the units, so all the prescriptions had been done by doctors who had been prescribing for >1 year. The doctors frequently did not know the local prescribing guidelines or how to obtain them. We think that these audits suggest that prescription writing is poor even among doctors who are confident about the CPT of the prescribed drugs, and that knowing what drug to prescribe to which patient does not necessarily translate to a good prescription. Various reasons have been identified for doctors writing wrong prescriptions [7], but it is an issue that needs to be addressed continuously throughout a doctor's professional career. We do not believe all drug-prescribing issues can be adequately and sufficiently addressed during undergraduate medical training.

Leaking Pipelines: Doctoral Student Family Formation

Balancing the demands of an academic career and those of a family are a great challenge, especially for women. Women pursuing a tenure-track position, or while on the tenure-track, often find themselves in a position of choosing between advancing their academic careers or having children; as a result, women, more so than men, leak out of the academic pipeline. The primary focus of this study is to explore, using secondary data from the "UC Berkeley Doctoral Career and Life Survey," and interviews with doctoral students, how family formation affects the life and career paths of men, and particularly women, while they are in graduate school. Secondly, recommendations are made for university sponsored policies, programs, and services for doctoral students with children.

The compatibility of future doctors' career intentions with changing health care demands

In the Netherlands the medical education system is in the process of being transformed to establish a more demand-oriented health care system. This transformation may entail the occupational restructuring of the medical profession. Meanwhile, on the supply side, the career intentions of future doctors are also changing. We aimed to categorise medical students' prevailing career intentions and to examine to what extent newly proposed medical occupations that may be part of the transformation process correspond with these career intentions. We carried out expert interviews and a feedback round to gain input for a survey among students. From the demand perspective, 11 experts proposed non-traditional medical occupations and evaluated these on the basis of job characteristics relevant to a doctor's career choice. Subsequently, students from 5 universities filled out a questionnaire to rate these job characteristics by their importance and the proposed occupations' attractiveness. Results Four different clusters of career intentions were categorised as patient-oriented expert, career-oriented specialist, lifestyle-oriented generalist, and balance-seeking realist. These clusters differ in terms of the ways in which students feel attracted to the proposed occupations. The career-oriented specialists feel least attracted and the lifestyle-oriented generalists most attracted to the occupations. The experts' call for shorter postgraduate programmes to educate patient-oriented doctors partly matches students' career intentions. Most students share the intention of obtaining a direct care position that provides ample task variation, which may explain the appeal of the occupations 'emergency doctor' and 'basic specialist'. The limited interest in specific patient groups suggests a need for more exposure to the occupations linked to these groups.