Beckwith Hannah, Kingsbury Martyn, Horsburgh Jo
Nephrology Registrar, MRC London Institute of Medical Science, Imperial College London, London, UK.
Centre for Higher Education Research and Scholarship, Imperial College London, London, UK.
Clin Kidney J. 2018 Oct;11(5):599-604. doi: 10.1093/ckj/sfy076. Epub 2018 Aug 31.
Increasing concerns about recruitment and retention of junior doctors have led to renewed interest in how and when trainees choose their specialties. To our knowledge, no study has yet reported what attracts UK applicants to nephrology nor how clinicians develop vocational interests or make occupational choices. With this in mind, we sought to explore the motivation behind current nephrologist's career choices in the UK. We interviewed 11 nephrologists using a semi-structured face-to-face approach and used interpretative phenomenological analysis to conduct and analyse the interviews. We found role models were pivotal in encouraging specialization in nephrology, particularly those encountered in early postgraduate training. The diversity, diagnostic challenge and cross-specialty knowledge was highlighted as well as the ability to 'make a difference to patients' lives'. Nephrologists enjoyed the challenge of managing very sick, acutely unwell patients as well as the holistic continuity of long-term care offered to dialysis patients and their families. Academic and procedural components were attractive motivators to the specialty and the flexibility to have multiple interests was noted, with many nephrologists having 'portfolio' careers. Based on these results, we suggest strategies the specialty can use to aid policy decision making, promote recruitment and improve educational experiences within current training programmes.
对初级医生招聘和留用问题的日益关注，引发了人们对实习医生如何以及何时选择专业的新兴趣。据我们所知，尚无研究报告是什么吸引英国申请者选择肾病学，也没有研究报告临床医生如何培养职业兴趣或做出职业选择。考虑到这一点，我们试图探究英国当前肾病学家职业选择背后的动机。我们采用半结构化面对面访谈的方式，对11位肾病学家进行了访谈，并运用解释现象学分析方法来开展和分析这些访谈。我们发现榜样在鼓励选择肾病学专业方面起着关键作用，尤其是在研究生培训早期遇到的榜样。多样性、诊断挑战和跨专业知识以及“对患者生活产生影响”的能力都得到了强调。肾病学家喜欢管理病情严重、急性不适患者的挑战，也喜欢为透析患者及其家属提供长期护理的整体连续性。学术和操作方面的内容对该专业具有吸引力，而且注意到有多种兴趣的灵活性，许多肾病学家都拥有“组合式”职业。基于这些结果，我们提出了该专业可用于协助政策决策、促进招聘以及改善当前培训项目中教育体验的策略。
