What do UK medical students value most in their careers? A discrete choice experiment

Jennifer A Cleland* (Corresponding Author), Peter Johnston, Verity Watson, Nicolas Krucien, Diane Skatun

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)
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CONTEXT: Many individual- and job-related factors are known to influence medical careers decision making. Previous research has extensively studied medical trainees' (residents') and students' views of the factors that are important. However, how trainees and students trade off these factors at times of important careers-related decision making is under-researched. Information about trade-offs is crucial to the development of effective policies to enhance the recruitment and retention of junior doctors.

OBJECTIVES: Our aim was to investigate the strength of UK medical students' preferences for the characteristics of training posts in terms of monetary value.

METHODS: We distributed a paper questionnaire that included a discrete choice experiment (DCE) to final-year medical students in six diverse medical schools across the UK. The main outcome measure was the monetary value of 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: A total of 810 medical students answered the questionnaire. The presence of good working conditions was by far the most influential characteristic of a training position. Medical students consider that, as newly graduated doctors, they will require compensation of an additional 43.68% above average earnings to move from a post with excellent working conditions to one with poor working conditions. Female students value excellent working conditions more highly than male students, whereas older medical students value them less highly than younger students.

CONCLUSIONS: Students on the point of completing medical school and starting postgraduate training value good working conditions significantly more than they value desirable geographical location, unit reputation, familiarity with the unit or opportunities for partners or spouses. This intelligence can be used to address the crisis in workforce staffing that has developed in the UK and opens up fruitful areas for future research across contexts and in terms of examining stated preferences versus actual career-related behaviour.

Original languageEnglish
Pages (from-to)839-851
Number of pages13
JournalMedical Education
Issue number8
Early online date14 Mar 2017
Publication statusPublished - Aug 2017

Bibliographical note

the authors thank Professors Charlotte Rees, at the University of Dundee, UK, at the time of this study, and Karen Mattick, University of Exeter, UK, for their feedback on the original project proposal, the project report and the qualitative survey that informed the DCE, and John Lemon, University of Aberdeen, UK, for his sterling work and endless patience in developing and managing the surveys. The authors also thank their colleagues in the six study medical schools, who facilitated ethics permission, and the distribution and collection of questionnaires. Finally, the authors would like to thank the medical students who participated in this study.

this programme of work was supported by NHS Education for Scotland.


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