Abstract:
BACKGROUND:Workforce studies show a declining proportion of UK junior doctors proceeding directly to specialist training, with many taking career breaks. Doctors may be choosing to delay this important career decision. AIM:To assess doctors' views on the timing of choosing a clinical specialty. METHODS:Surveys of two cohorts of UK-trained doctors 3 years after qualification, in 2011 and 2015. RESULTS:Presented with the statement 'I had to choose my career specialty too soon after qualification', 61% agreed (27% strongly) and 22% disagreed (3% strongly disagreed). Doctors least certain about their choice of specialty were most likely to agree (81%), compared with those who were more confident (72%) or were definite regarding their choice of long-term specialty (54%). Doctors not in higher specialist training were more likely to agree with this statement than those who were (72% vs 59%). Graduate medical school entrants (ie, those who had completed prior degrees) were less likely to agree than non-graduates (56% vs 62%). Qualitative analysis of free text comments identified three themes as reasons why doctors felt rushed into choosing their future career: insufficient exposure to a wide range of specialties; a desire for a greater breadth of experience of medicine in general; and inadequate career advice. CONCLUSIONS:Most UK-trained doctors feel rushed into choosing their long-term career specialty. Doctors find this difficult because they lack sufficient medical experience and adequate career advice to make sound choices. Workforce trainers and planners should enable greater flexibility in training pathways and should further improve existing career guidance.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Lachish S,Goldacre MJ,Lambert TWdoi
10.1136/postgradmedj-2017-135460subject
Has Abstractpub_date
2018-11-01 00:00:00pages
621-626issue
1117eissn
0032-5473issn
1469-0756pii
postgradmedj-2017-135460journal_volume
94pub_type
杂志文章abstract::Some antifungal agents have been tested qualitatively in various associations against species of Candida, Cryptococcus and Torulopsis. The method used was the channel test and the results are confirmed by comparison with the serial dilution test in agar. The antagonism in vitro with the combination of amphotericin B i...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.647.683
更新日期:1979-09-01 00:00:00
abstract::Primary gastric lymphoma is a rare tumour. It is thought that low grade gastric mucosa associated lymphoid tissue lymphoma has not been previously reported to occur in a patient with gastrojejunostomy. This report describes such a case. The patient presented with bleeding from non-healing stomal ulcers. The ulcers hea...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.020164
更新日期:2005-02-01 00:00:00
abstract::We report the development of synchronous bilateral carpal tunnel syndrome in a woman with metastatic colorectal cancer, undergoing treatment with recombinant interleukin 2. A carpal tunnel decompression was carried out on the hand which was more severely affected, with a gradual recovery in median nerve function. To t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.801.587
更新日期:1992-07-01 00:00:00
abstract::Although there is good evidence that D-penicillamine can induce polymyositis, the exact pathogenic mechanism remains unclear. We report two patients with psoriatic arthritis and primary biliary cirrhosis respectively, who developed polymyositis while receiving D-penicillamine treatment for their primary diseases. Whet...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.793.1018
更新日期:1991-11-01 00:00:00
abstract::A young woman with a previous history of anorexia nervosa presented with severe finger clubbing. Urine samples intermittently contained significant amounts of aspartylglucosamine. Liver biopsy showed abnormal cytoplasmic inclusions in phagocytic cells. The patient was found to be abusing senna laxative. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.662.862
更新日期:1980-12-01 00:00:00
abstract::Herpes simplex encephalitis may be underdiagnosed in Britain. We report eight patients treated at one hospital over three years. Fever, impaired consciousness or focal neurological signs were seen in all patients at presentation but herpes simplex encephalitis was rarely considered as the initial diagnosis. The electr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.746.1037
更新日期:1987-12-01 00:00:00
abstract::In 114 patients (52 males and 62 females) with long-standing pernicious anaemia, hypoferritinaemia was found in 27 (23.7%) and hypochromic microcytic anaemia in 19 (16.6%). Our findings indicate that iron deficiency is a common yet neglected complication of long-standing pernicious anaemia and warrants greater diagnos...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.748.110
更新日期:1988-02-01 00:00:00
abstract::A high proportion (40%) of patients with definite myocardial ischaemia who were questioned on admission to a Cardiac Monitoring Unit had experienced preceding chest pain which had been misinterpreted by both the patients themselves and doctors as 'indigestion' and which had often been inappropriately treated. 'Indiges...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.703.338
更新日期:1984-05-01 00:00:00
abstract::An audit of the introduction of a protocol for thromboprophylaxis at caesarean section revealed over treatment of low risk women and the under treatment of high risk women. A routine computer generated risk assessment profile was introduced as part of a maternity information system. Reaudit showed a significant improv...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.896.354
更新日期:2000-06-01 00:00:00
abstract::The Wolff-Parkinson-White syndrome can rarely present with pre-excited atrial fibrillation. In this condition the short refractory period of the accessory pathway can lead to rapid atrioventricular conduction. There is then a danger that at high heart rates the irregular broad complex tachycardia that results can dete...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.931.297
更新日期:2003-05-01 00:00:00
abstract::We report a case of persistent chorea as a manifestation of thyrotoxicosis. The chorea was severe and persisted after the patient was rendered euthyroid. Dopamine antagonists only partially suppressed the involuntary movements during the first few months. It was eventually controlled with haloperidol, but whenever she...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.756.789
更新日期:1988-10-01 00:00:00
abstract::A patient presented with retroperitoneal fibrosis but without any ureteric obstruction. The diagnosis was made by an abdominal CT scan and also at laparotomy. Post-operatively, she developed hypertensive encephalopathy. An isotope renogram with captopril was abnormal but not diagnostic of renal artery stenosis. The pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.890.730
更新日期:1999-12-01 00:00:00
abstract::Both the quality and the quantity of food ingested are relevant to the genesis of risk factors for coronary heart disease and the two are inseparable. Nevertheless they have a major common pathway through hypertension, which may well be the most important consequence of a high-protein, high-carbohydrate, high-fat, hig...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.629.171
更新日期:1978-03-01 00:00:00
abstract::Percutaneous endoscopic gastrostomy (PEG) was performed on 28 elderly patients (mean age 82 years) who were dysphagic and intolerant of naso-gastric feeding. Twenty-six patients were recovering from a stroke; the interval between the onset of stroke and PEG averaged 63 days. The procedure was successful and well toler...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.786.371
更新日期:1991-04-01 00:00:00
abstract::Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. Patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.713.251
更新日期:1985-03-01 00:00:00
abstract::Shaken baby syndrome is the most common cause of death or serious neurological injury resulting from child abuse. It is specific to infancy, when children have unique anatomic features. Subdural and retinal haemorrhages are markers of shaking injury. An American radiologist, John Caffey, coined the name whiplash shake...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.78.926.732
更新日期:2002-12-01 00:00:00
abstract::The effective training of facilitator/ tutors is crucial to the success of a problem-based learning approach to medical education. New skills are needed to accomplish the change from giver of information to facilitator of learning, coach, and guide. This paper outlines considerations for the design of a tutor training...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.850.474
更新日期:1996-08-01 00:00:00
abstract::Postgraduate medical education (PME) quality assurance at Health Education England (HEE) currently relies upon survey data. As no one metric can reflect all aspects of training, and each has its limitations, additional metrics should be explored. At HEE (West Midlands), we explored the use of learner outcomes, special...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2020-138669
更新日期:2020-11-12 00:00:00
abstract::The anaesthetic properties of propofol ('Diprivan') have been described previously. This report summarizes additional studies designed to investigate some aspects of the general pharmacology of propofol. Following recovery from anaesthesia with propofol there was no evidence of any central anticholinergic or anticonvu...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1985-01-01 00:00:00
abstract::Repeated pneumonia and hypogammaglobulinaemia was associated with long term low dose steroid therapy. Clinical improvement with restoration of antibody levels followed substitution of aerosol for oral therapy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.716.523
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:The post mortem examination or autopsy is a trusted method of identifying the cause of death. Patients and their families may oppose an autopsy for a variety of reasons, including fear of mutilation or owing to religious and personal beliefs. Imaging alternatives to autopsy have been explored, which may prov...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析,评审
doi:10.1136/postgradmedj-2017-134945
更新日期:2017-11-01 00:00:00
abstract::The interpretation of gastrin release is confused because of variation in the technique of the radioimmuoassay of gastrin, the lack of a standard stimulus for the release of gastrin and diversity in the method used to express the results. These problems have been analysed (a) by examining the cross-reactivity of three...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.52.612.645
更新日期:1976-10-01 00:00:00
abstract::A well documented sporadic case of multiple endocrine adenomatosis (MEA) type I, with the pituitary tumour presenting as a prolactinoma, is described in a 28-year-old female. Primary amenorrhoea, resulting from hyperprolactinaemia, was the first symptom of the polyglandular neoplasia. A gastrinoma was removed from the...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.635.618
更新日期:1978-09-01 00:00:00
abstract::Patients with acquired von Willebrand disease may present with severe bleeding, which is usually difficult to manage. Adequate haemostasis in acquired von Willebrand disease may be achieved with the infusion of factor VIII/von Willebrand factor concentrates or with the administration of desmopressin. We report a case ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.70.830.916
更新日期:1994-12-01 00:00:00
abstract::Primary choriocarcinoma of the ovary arising, presumably, from a germ cell is extremely rare. The patient, a 16 year old girl who presented with dysuria and frequency of micturition developed fatal haemoperitoneum due to rupture of a pure primary nongestational ovarian choriocarcinoma. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.718.757
更新日期:1985-08-01 00:00:00
abstract::This paper reviews the development of cerebral scintigraphy from its early days of planar imaging with simple technetium-99m labelled compounds to the recent revival of the technique in the form of positron-emission and single-photon emission tomography. A short explanation of instrumentation and radiopharmaceuticals ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.64.747.4
更新日期:1988-01-01 00:00:00
abstract::Granulomatous disorders comprise a large family sharing the histological denominator of granuloma formation. A granuloma is a focal compact collection of inflammatory cells, mononuclear cells predominating, usually as a result of the persistence of a non-degradable product and of active cell mediated hypersensitivity....
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.76.898.457
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Physicians can come across patients who are exposed to certain prescription drugs or toxins that can result in adverse effects and complications which have high rates of morbidity and mortality. OBJECTIVE:To summarise the key clinical features and management of the common movement disorder toxidromes releva...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2016-134254
更新日期:2017-06-01 00:00:00
abstract::We describe two cases of digoxin toxicity presenting with clinical and electroencephalographic evidence of encephalopathy without other features of digoxin toxicity. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.848.367
更新日期:1996-06-01 00:00:00
abstract::Quantitative lipoprotein level data was obtained from healthy subjects and patients with ischaemic heart disease or peripheral vascular disease in four European communities. Hypertriglyceridaemia, due mainly to an increase in VLDL triglyceride, was commoner in London and Uppsala than in Naples and Geneva. In three com...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00