Maisonneuve Jenny J, Lambert Trevor W, Goldacre Michael J
BMC Med Educ. 2014 Dec 21;14:270. doi: 10.1186/s12909-014-0270-5.
The UK medical graduates of 2008 and 2009 were among the first to experience a fully implemented, new, UK training programme, called the Foundation Training Programme, for junior doctors. We report doctors' views of the first Foundation year, based on comments made as part of a questionnaire survey covering career choices, plans, and experiences.
Postal and email based questionnaires about career intentions, destinations and views were sent in 2009 and 2010 to all UK medical graduates of 2008 and 2009. This paper is a qualitative study of 'free-text' comments made by first-year doctors when invited to comment, if they wished, on any aspect of their work, education, training, and future.
The response rate to the surveys was 48% (6220/12952); and 1616 doctors volunteered comments. Of these, 61% wrote about their first year of training, 35% about the working conditions they had experienced, 33% about how well their medical school had prepared them for work, 29% about their future career, 25% about support from peers and colleagues, 22% about working in medicine, and 15% about lifestyle issues. When concerns were expressed, they were commonly about the balance between service provision, administrative work, and training and education, with the latter often suffering when it conflicted with the needs of medical service provision. They also wrote that the quality of a training post often depended on the commitment of an individual senior doctor. Service support from seniors was variable and some respondents complained of a lack of team work and team ethic. Excessive hours and the lack of time for reflection and career planning before choices about the future had to be made were also mentioned. Some doctors wrote that their views were not sought by their hospital and that NHS management structures did not lend themselves to efficiency. UK graduates from non-UK homes felt insecure about their future career prospects in the UK. There were positive comments about opportunities to train flexibly.
Although reported problems should be considered in the wider context, in which the majority held favourable overall views, many who commented had been disappointed by aspects of their first year of work. We hope that the concerns raised by our respondents will prompt trainers, locally, to determine, by interaction with junior staff, whether or not these are concerns in their own training programme.
2008年和2009年的英国医学毕业生是首批体验一项全新的、全面实施的英国初级医生培训计划——基础培训计划的人。我们根据作为问卷调查一部分所做的评论，报告医生们对基础培训第一年的看法，该问卷调查涵盖职业选择、计划和经历。
2009年和2010年，通过邮寄和电子邮件向2008年和2009年所有英国医学毕业生发送了关于职业意向、去向和看法的问卷。本文是对第一年医生在被邀请（如果他们愿意）就工作、教育、培训和未来的任何方面发表评论时所做的“自由文本”评论的定性研究。
调查的回复率为48%（6220/12952）；1616名医生自愿发表评论。其中，61%的人写到了他们培训的第一年，35%的人写到了他们所经历的工作条件，33%的人写到了医学院对他们工作的准备情况，29%的人写到了他们未来的职业，25%的人写到了来自同行和同事的支持，22%的人写到了从事医学工作，15%的人写到了生活方式问题。当表达担忧时，通常是关于服务提供、行政工作以及培训和教育之间的平衡，当后者与医疗服务提供的需求发生冲突时，培训和教育往往会受到影响。他们还写道，培训岗位的质量往往取决于个别资深医生的投入。上级的服务支持参差不齐，一些受访者抱怨缺乏团队合作和团队精神。还提到了工作时间过长，以及在必须做出关于未来的选择之前缺乏反思和职业规划的时间。一些医生写道，医院没有征求他们的意见，而且国民保健制度的管理结构不利于提高效率。来自非英国家庭的英国毕业生对他们在英国未来的职业前景感到不安。也有关于灵活培训机会的积极评论。
尽管所报告的问题应在更广泛的背景下考虑，在该背景下大多数人总体上持赞成意见，但许多发表评论的人对他们工作的第一年的某些方面感到失望。我们希望我们的受访者提出的担忧将促使各地的培训人员通过与初级员工互动来确定这些担忧在他们自己的培训计划中是否存在。
