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Factors influencing the choice of specialty of Australian medical graduates

Mary G Harris, Paul H Gavel and Jeannette R Young
Med J Aust 2005; 183 (6): 295-300.

Summary

Objective: To identify the relative importance of extrinsic determinants of doctors’ choice of specialty.

Design: A self-administered postal questionnaire.

Setting: Australian vocational training programs.

Participants: 4259 Australian medical graduates registered in September 2002 with one of 16 Australian clinical colleges providing vocational training programs.

Main outcome measures: Choice of specialist vocational training program; extrinsic factors influencing choice of program, and variation by sex, age, marital status and country of birth.

Results: In total, 79% of respondents rated “appraisal of own skills and aptitudes” as influential in their choice of specialty followed by “intellectual content of the specialty” (75%). Extrinsic factors rated as most influential were “work culture” (72%), “flexibility of working arrangements” (56%) and “hours of work” (54%). We observed variation across training programs in the importance ascribed to factors influencing choice of specialty, and by sex, age and marital status. Factors of particular importance to women, compared with men, were “appraisal of domestic circumstances” (odds ratio [OR], 1.9), “hours of work” (OR, 1.8) and “opportunity to work flexible hours” (OR, 2.6). Partnered doctors, compared with single doctors, rated “hours of work” and “opportunity to work flexible hours” as more important (OR, 1.3), while “domestic circumstances” was more important to doctors with children than those without children (OR, 1.7). In total, 80% of doctors had chosen their specialty by the end of the third year after graduation.

Conclusions: Experience with discipline-based work cultures and working conditions occurs throughout medical school and the early postgraduate years, and most doctors choose their specialty during these years. It follows that interventions to influence doctors’ choice of specialty need to target these critical years.

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  • Mary G Harris1
  • Paul H Gavel2
  • Jeannette R Young3

  • 1 National Health Workforce Secretariat, North Sydney, NSW.
  • 2 Sydney South West Area Health Service, Liverpool, NSW.
  • 3 Australian Medical Workforce Advisory Committee, North Sydney, NSW.

Correspondence: 

Acknowledgements: 

Financial support for the study was provided by the Australian Government Department of Health and Ageing.

Competing interests:

None identified.

  • 1. Cohen M. Women in medicine — the Canadian perspective. Paper presented at the Fourth International Medical Workforce Conference November 4–7; San Francisco. Sydney: AMWAC, 1999.
  • 2. Schmittdiel J, Grumbach K. Women in medicine in the United States: progress and challenges on the road to gender parity. Paper presented at the Fourth International Medical Workforce Conference November 4–7; San Francisco. Sydney: AMWAC, 1999.
  • 3. Australian Medical Workforce Advisory Committee. Toward gender balance in the Australian medical workforce: some planning implications. Aust Health Rev 2000; 23 (4): 27-42.
  • 4. Medical Training Review Panel. Medical Training Review Panel, 8th report. Canberra: Australian Department of Health and Ageing, 2004.
  • 5. Australian Medical Association. Opportunities and impediments to flexibility. Canberra: AMA, 2003.
  • 6. Tolhurst HM, Stephen MS. Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students’ attitudes. Med J Aust 2004; 181: 361-364. <MJA full text>
  • 7. Australian Medical Workforce Advisory Committee. Annual Report 2003-04. Sydney: AMWAC, 2004. (AMWAC Report 2004.5.)
  • 8. Australian Medical Workforce Advisory Committee. Innovations in medical education to meet workforce challenges. Aust Health Rev 2000; 23 (4): 43-59.
  • 9. Van Der Weyden MB. The medical time bomb [From the editor’s desk]. Med J Aust 2005; 182: 433. <MJA full text>
  • 10. Prideaux D, Saunders N, Scholfield K, et al. Country report: Australia. Med Educ 2001; 35: 495-504.
  • 11. Lawson KA, Armstrong RM, Van Der Weyden MB. A sea change in Australian medical education. Med J Aust 1998; 169: 653-658. <MJA full text>
  • 12. Australian Medical Workforce Advisory Committee. Career decision making by doctors in vocational training. Sydney: AMWAC, 2003. (AMWAC Report 2003.2.)
  • 13. Goldacre MJ, Lambert TW. Stability and change in career choices of junior doctors: postal questionnaire surveys of the United Kingdom qualifiers of 1993. Med Educ 2000; 34: 700-707.
  • 14. Goldacre MJ, Turner G, Lambert TW. Variation by medical school in career choices of UK graduates of 1999 and 2000. Med Educ 2004; 38: 249-258.
  • 15. Lambert TW, Goldacre MJ, Parkhouse J, Edwards C. Career destinations in 1994 of United Kingdom medical graduates of 1983: results of questionnaire survey. BMJ 1996; 312: 893-897.
  • 16. Davidson JM, Lambert TW, Goldacre MJ. Career pathways and destinations 18 years on among doctors who qualified in the United Kingdom in 1977: postal questionnaire survey. BMJ 1998; 317: 1425-1428.
  • 17. Australian Medical Workforce Advisory Committee. Career decision making by doctors in their postgraduate years — a literature review. Sydney: AMWAC, 2002. (AMWAC Report 2002.1.)
  • 18. Medical Training Review Panel. Medical Training Review Panel, 6th report. Canberra: Australian Government Department of Health and Ageing, 2002.
  • 19. Bryman A. Social research methods, 2nd ed. London: Oxford University Press, 2004.

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