What do UK doctors in training value in a post? A discrete choice experiment

Jennifer Cleland*, Peter Johnston, Verity Watson, Nicolas Krucien, Diane Skåtun

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)
14 Downloads (Pure)


CONTEXT: Many individual and job-related factors are known to influence medical careers decision making. Medical trainees' (residents) views of which characteristics of a training post are important to them have been extensively studied but how they trade-off these characteristics is under-researched. Such information is crucial for the development of effective policies to enhance recruitment and retention. Our aim was to investigate the strength of UK foundation doctors' and trainees' preferences for training post characteristics in terms of monetary value.

METHODS: We used an online questionnaire study incorporating a discrete choice experiment (DCE), distributed to foundation programme doctors and doctors in training across all specialty groups within three UK regions, in August-October 2013. The main outcome measures were monetary values for training-post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic, calculated from regression coefficients.

RESULTS: The questionnaire was answered by 1323 trainees. Good working conditions were the most influential characteristics of a training position. Trainee doctors would need to be compensated by an additional 49.8% above the average earnings within their specialty to move from a post with good working conditions to one with poor working conditions. A training post with limited rather than good opportunities for one's spouse or partner would require compensation of 38.4% above the average earnings within their specialty. Trainees would require compensation of 30.8% above the average earnings within their specialty to move from a desirable to a less desirable locality. These preferences varied only to a limited extent according to individual characteristics.

DISCUSSION: Trainees place most value on good working conditions, good opportunities for their partners and desirable geographical location when making career-related decisions. This intelligence can be used to develop alternative models of workforce planning or to develop information about job opportunities that address trainees' values.

Original languageEnglish
Pages (from-to)189-202
Number of pages14
JournalMedical Education
Issue number2
Early online date26 Jan 2016
Publication statusPublished - Feb 2016

Bibliographical note

Acknowledgements: our thanks first to the following colleagues (in alphabetical order) for their support: Professor Phillip Cachia, East of Scotland Deanery; Professor Jacky Hayden, CBE, North Western Deanery; Professor Stewart Irvine, NHS Education for Scotland; Dr Namita Kumar, Health Education North East England; Professor Alastair McLellan, West of Scotland Deanery; Professor Gillian Needham, North of Scotland Deanery; Professor William Reid, South East of Scotland Deanery; and Ms Jayne Scott, NHS Education for Scotland. Our thanks also go to the START Core Group: Professor Alastair McLellan, Professor Rowan Parks, Dr Ronald MacVicar and Ms Anne Dickson. We also thank Professor Charlotte Rees and Dr Karen Mattick for their feedback on the project proposal, the project report and the qualitative survey that informed the DCE. Our thanks to John Lemon for his sterling work and endless patience when developing and managing the online surveys. Finally, we would like to thank all the doctors in training who participated in the DCE.

Funding: our thanks go to NHS Education for Scotland for funding this programme of work.




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