29th November 2019,
Sam Seleq, Emmanuel Jo, Phillippa Poole, Tim Wilkinson, Fiona Hyland, Joy Rudland, Antonia Verstappen, Warwick Bagg
Understanding when medical students and doctors make choices about their future medical career is of importance to universities, postgraduate colleges and for individual doctors. Choosing a career is influenced by…
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This paper aims to compare New Zealand medical students’ graduate intentions with the health workforce requirements in 2028, where medical graduates are anticipated to have completed training. At graduation, half of medical students were undecided on a career pathway. We found that the career intentions of medical students who had decided on a vocational pathway did not align with workforce requirements, with the main gap existing in general practice. The key limitation is the assumption that medical students career decisions and workforce requirements remain constant.
To determine the career decision intentions of graduating doctors, and the relationship between these intentions and the predicted medical workforce needs in New Zealand in 10 years’ time.
A workforce forecasting model developed by the Ministry of Health (MOH) has been used to predict the proportion of doctors required in each medical specialty in 2028 in New Zealand. The future work intentions of recently graduated doctors at the Universities of Auckland and Otago were collected from the Medical Student Outcomes Data (MSOD), and compared with these predicted needs.
Between 2013 and 2017, 2,292 doctors graduated in New Zealand, of whom 1,583 completed the MSOD preferences section (response rate 69%). Of these only 50.1% had decided on a future medical specialty. The most popular were surgical specialties (26.2%), general practice (20.7%), and internal medicine (11.0%). Compared to the MOH workforce forecast model there appears to be insufficient interest in general practice at the time of graduation.
To shape the medical workforce to meet forecast needs, multiple stakeholders will need to collaborate, with a special focus on the early postgraduate years, as many doctors have yet to decide on specialisation.
- Hauer KE, et al. Factors associated with medical students’ career choices regarding internal medicine. 2008; JAMA 300:1154–64.
- Zarkovic A, Child S, Naden G. Career choices of New Zealand junior doctors. N Z Med J. 2006; 119.
- Boyle V, Shulruf B, Poole P. Influence of gender and other factors on medical student specialty interest. N Z Med J. 2014; 127:78–87.
- Poole P. Nature and nurture: shaping New Zealand’s medical workforce. N Z Med J. 2016; 129:6–8.
- Martin I. Medical workforce development: Challenges and opportunities for the next 25 years. in Procedia - Social and Behavioral Sciences. 2010; 2:6914–6919.
- Health Workforce Australia. Australia’s Future Health Workforce – Doctors. (2014).
- Crettenden IF, et al. How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce. Hum. Resour. Health 2014; 12:7.
- Bloor K. Planning human resources in health care: Towards an economic approach, An international comparative review. (2003).
- Gorman D. Developing health care workforces for uncertain futures. Academic Medicine 2015; 90:400–403.
- Jacobs RL, Hawley JD. The Emergence of ‘Workforce Development’: Definition, Conceptual Boundaries and Implications. in International Handbook of Education for the Changing World of Work. 2009:2537–2552.
- Poole P, Shulruf B. Shaping the future medical workforce: Take care with selection tools. J. Prim. Health Care. 2013; 5:269–275.
- Witzburg, RA, Sondheimer HM. Holistic review—Shaping the medical profession one applicant at a time. N Engl J Med. 2013; 368:1565–1567.
- Weiner JP, Yeh S, Blumenthal D. The impact of health information technology and e-health on the future demand for physician services. Health Aff. 2013; 32:1998–2004.
- Fraher EP, Knapton A, Holmes GM. A Methodology for Using Workforce Data to Decide Which Specialties and States to Target for Graduate Medical Education Expansion. Health Serv. Res. 2017; 52:508–528.
- Jo EC, Mathis K, Goh J. Forecasting future medical specialty workforces supply with age distribution using health workforce annual practicing certificate data (2018).
- Kaur B, Roberton DM, Glasgow NJ. Evidence-based medical workforce planning and education: The MSOD project. Medical Journal of Australia (2013).
- The New Zealand MSOD Steering Group. National report on students graduating medical school in New Zealand in 2013–2017 (2018).
- Moore J, et al. Student debt amongst junior doctors in New Zealand; Part 2: Effects on intentions and workforce. N Z Med J. 2006; 119:21–28.
- West DC, Robins L, Gruppen LD. Workforce, learners, competencies, and the learning environment: Research in medical education 2014 and the way forward. Academic Medicine 2014; 89:1432–1435.
- Petterson SM, et al. Projected primary care physician shortages by 2035. Ann. Fam. Med. 2015; 13, 107–114.
- Martin I, et al. Australia’s Future Health Workforce – Psychiatry. N Z Med J. 2016; 119:107–114.
- Goldacre MJ, Laxton L, Lambert T. Medical graduates’ early career choices of specialty and their eventual specialty destinations: UK prospective cohort studies. BMJ. 2010; 341:3199.
- Svirko E, Goldacre MJ, Lambert T. Career choices of the United Kingdom medical graduates of 2005, 2008 and 2009: questionnaire surveys. Medical Teacher. 2013; 35.
- Grover A, Orlowski JM, Erikson CE. The Nation’s Physician Workforce and Future Challenges. Am J Med Sci. 2016; 351:11–19.
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