Career intentions of medical students in the UK: a national, cross-sectional study (AIMS study)

Abstract

Objective: To determine current UK medical students' career intentions after graduation and on completing the Foundation Programme (FP), and to ascertain the motivations behind these intentions.

Design: Cross-sectional, mixed-methods survey of UK medical students, using a non-random sampling method.

Setting: All 44 UK medical schools recognised by the General Medical Council.

Participants: All UK medical students were eligible to participate. The study sample consisted of 10 486 participants, approximately 25.50% of the medical student population.

Outcome measures: Career intentions of medical students postgraduation and post-FP, motivations behind these career intentions, characterising the medical student population and correlating demographic factors and propensity to leave the National Health Service (NHS).

Results: The majority of participating students (8806/10 486, 83.98%) planned to complete both years of the FP after graduation, with under half of these students (4294/8806, 48.76%) intending to pursue specialty training thereafter. A subanalysis of career intentions after the FP by year of study revealed a significant decrease in students' intentions to enter specialty training as they advanced through medical school. Approximately a third of surveyed students (3392/10 486, 32.35%) intended to emigrate to practise medicine, with 42.57% (n=1444) of those students not planning to return. In total, 2.89% of students intended to leave medicine altogether (n=303). Remuneration, work-life balance and working conditions were identified as important factors in decision-making regarding emigration and leaving the profession. Subgroup analyses based on gender, type of schooling, fee type and educational background were performed. Only 17.26% of surveyed students were satisfied or very satisfied with the overall prospect of working in the NHS.

Conclusions: The Ascertaining the career Intentions of UK Medical Students study highlights UK students' views and career intentions, revealing a concerning proportion of those surveyed considering alternative careers or emigration. Addressing factors such as remuneration, work-life balance and working conditions may increase retention of doctors and improve workforce planning efforts.

Keywords: health economics; health education; health policy; medical education & training; organisation of health services; qualitative research.

Figure 1

(A) Importance of factors influencing medical students’ intention to emigrate and practise medicine; (B) importance of factors influencing medical students’ intention to leave the medical profession entirely and seek an alternative career; (C) locations cited as potential destinations by students who intend to emigrate to practise medicine; (D) preferred industries to work in by those intending to leave medicine. *Several respondents cited the Middle East or Gulf region rather than specifying which country; these responses were grouped with individual destinations in the region.

Figure 2

Proportions of students by year of study (with 95% CIs) intending to (A) directly enter specialty training after Foundation Year 2 (FY2); (B) emigrate to practise medicine after FY2; (C) enter a non-training clinical post after FY2, for example, as a locum doctor or clinical fellow; (D) leave medicine permanently after FY2 to pursue an alternative career. ‘Year 4’ represents students in their fourth year of study, but not their penultimate year. Percentages in figures reflect the proportion of students in each year group for each intention.

Figure 3

Medical students’ satisfaction levels regarding aspects of working as a doctor in the National Health Service (NHS).