Using qualitative methods, what factors do child & adolescent higher trainees and new consultants (within 1 year of appointment), report in choosing their higher training subspecialty?

Abstract

Aims

This Research aims to identify factors reported by recent and current trainees in choosing Child & Adolescent (C&A) Psychiatry for their higher training/career path. The hypothesis is that via thematic analysis prominent factors will emerge to inform future recruitment and retention.

Background

The need to attract more doctors into Psychiatry has been identified by NHS, Royal College of Psychiatrists and the Media; Health Education England figures show core psychiatry had lowest fill rates of any specialty in 2016,17 &18.

Some subspecialties experience particular difficulties e.g. C&A. Royal College of Psychiatry analysis of workforce in March 2018 showed the numbers of C&A psychiatrists of all grades have fallen by 6.3% in four years and for consultants alone the decrease was 6.9% over the same period.

However, very little research has been completed investigating why trainees might choose C&A Psychiatry with a literature search revealing only one report of C&A trainees views in the UK in 2006.

Method

A qualitative design was chosen to provide insight into the factors affecting participants in choosing their career.

The theoretical framework supporting the study relates to capturing experience via a case study approach, aiming to explore reported issues in a real life context and considering similarities in the cases to inform future recruitment.

The Research was approved by The Health Research Authority and local Research & Development departments.

Purposeful sampling was used with voluntary participation following informed consent and non-identifiable demographic data were collected and analysed quantatively.

Semi-structured interviews to saturation were conducted with fourteen (N = 14) participants asked questions exploring their subspecialty choice. Responses were recorded and transcribed verbatim prior to thematic analysis, including triangulation via a co-coding process to check areas were not over-represented and/or subject to researcher thoughts and possible unconscious biases.

Result

Semi-structured interviews included all North-East C&A trainees and 3 recently qualified Consultants.

Demographics results included 5 male and 6 female participants and 6 non-UK graduates.

Emergent themes were analysed into key findings including:

• – interest in children/specialty

• – specialty experience

• – supportive supervisors/team

• – work-life balance

• – opportunity to impact/intervene early.

Limitations include study of a single geographical area and possible researcher bias.

Conclusion

This Research provides novel findings re factors influencing career choice of C&A Psychiatry to inform future recruitment and retention. Clear themes have emerged re important recruitment/retention factors and the study highlights need for more research to investigate reasons why C&A is not chosen.