Wakeling J, McGregor J R, Bagnall G
NHS Education for Scotland (NES), 2 Central Quay, 89 Hydepark Street, Glasgow, G3 8BW.
Scott Med J. 2007 May;52(2):10-3. doi: 10.1258/rsmsmj.52.2.10.
NHS Scotland loses approximately one-third of Specialist Registrars (SpRs) it trains to consultant posts elsewhere. This has considerable resource and service implications and is the cause of intense political frustration. This study sought to gather data about the career intentions of SpRs and to discover what factors influence their career decisions.
All SpRs in Scotland due to gain their Certificate of Completion of Specialist Training (CCST) between April 2005 and March 2006 were approached to take part in an interview about their career aspirations. Interviews, using a structured interview schedule, took place in spring 2005.
198 SpRs were interviewed--75% of the target population. Almost three-quarters would prefer to stay in Scotland if possible, but when asked to realistically predict where they would take up a consultant post, this proportion had dropped to 64%. Perceived barriers to working in Scotland included the large number of District General Hospital (DGH) posts (often with onerous on-call rotas). A further problem concerned poor information flow between NHS Boards and trainees, with trainees being lost to Scotland who might have stayed if a job had been advertised in time.
The majority of SpRs would prefer to stay in Scotland for their consultant career. There is a need to improve information flow between NHS Boards and trainees. NHS Boards need to know more about the career intentions of trainees and training committees and trainees need to be informed as to when and where posts will be advertised. Posts in DGHs might be made more appealing by having some sessions in larger teaching hospitals (although split-site working is not always popular). Flexibility and part-time options need to be promoted.
苏格兰国民医疗服务体系（NHS Scotland）培训的专科住院医师（SpRs）中，约有三分之一到其他地方担任顾问职位。这带来了相当大的资源和服务问题，也是引发强烈政治挫败感的原因。本研究旨在收集有关专科住院医师职业意向的数据，并找出影响其职业决策的因素。
邀请2005年4月至2006年3月期间将获得专科培训结业证书（CCST）的苏格兰所有专科住院医师参加关于其职业抱负的访谈。2005年春季采用结构化访谈提纲进行了访谈。
对198名专科住院医师进行了访谈，占目标人群的75%。近四分之三的人表示如果可能更愿意留在苏格兰，但当被要求实际预测他们将在何处担任顾问职位时，这一比例降至64%。在苏格兰工作的感知障碍包括大量地区综合医院（DGH）的职位（通常值班轮班繁重）。另一个问题是NHS各委员会与受训人员之间信息流通不畅，一些本可能因及时发布招聘信息而留在苏格兰的受训人员流失了。
大多数专科住院医师希望在苏格兰担任顾问职位。有必要改善NHS各委员会与受训人员之间的信息流通。NHS各委员会需要更多了解受训人员的职业意向，培训委员会和受训人员需要被告知职位发布的时间和地点。通过在大型教学医院安排一些时段（尽管分地点工作并非总是受欢迎），地区综合医院的职位可能会更具吸引力。需要推广灵活性和兼职选择。
