Mathematics and Statistics, Lancaster University, Lancaster, UK.
Lancaster Medical School, Lancaster University, Lancaster, UK.
BMJ Open. 2024 Feb 29;14(3):e077635. doi: 10.1136/bmjopen-2023-077635.
To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations.
A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data).
All UK medical schools, foundations and specialty training organisation.
All UK medical students from 2002 to 2015, for a total of 97 932 participants.
Individual movements and number of movements by county of students from family home to medical school training, from medical school to foundation training and from foundation to specialty training.
Leslie matrix, principal components analysis, Gini coefficient, χ test, generalised linear models and variable selection methods were employed to explore the different facets of students' and junior doctors' movements from the family home to medical school and for the full pathway (from family home to specialty training).
The majority of the movements between the different stages of the full pathway were restricted to a distance of up to 50 km; although the proportion of movements changed from year-to-year, with longer movements during 2007-2008. At the individual level, ethnicity, socioeconomic class of the parent(s) and the deprivation score of the family home region were found to be the most important factors associated with the length of the movements from the family home to medical school. Similar results were found when movements were aggregated at the county level, with the addition of factors such as gender and qualification at entry (to medical school) being statistically associated with the number of new entrant students moving between counties.
Our findings show that while future doctors do not move far from their family home or training location, this pattern is not homogeneous over time. Distances are influenced by demographics, socioeconomic status and deprivation. These results may contribute in designing interventions aimed at solving the chronic problems of maldistribution and underdoctoring in the UK.
确定和识别医学生和初级医生在培训地点之间的移动距离模式。
一项对 2002 年至 2015 年期间英国医学生的回顾性队列研究（UKMED 数据）。
所有英国医学院、基金会和专业培训组织。
2002 年至 2015 年期间的所有英国医学生，共有 97932 名参与者。
学生从家庭住所到医学院培训、从医学院到基础培训和从基础培训到专业培训的每个县的个人移动次数和移动次数。
使用 Leslie 矩阵、主成分分析、基尼系数、卡方检验、广义线性模型和变量选择方法，探讨学生和初级医生从家庭住所到医学院以及整个路径（从家庭住所到专业培训）移动的不同方面。
大部分不同阶段之间的移动距离都限制在 50km 以内；尽管移动比例逐年变化，2007-2008 年期间的移动距离较长。在个体层面上，种族、父母的社会经济阶层和家庭住所地区的贫困程度被发现是与从家庭住所到医学院的移动距离最相关的最重要因素。当以县为单位汇总移动时，发现了类似的结果，例如性别和入学时（进入医学院）的资格等因素与县际新入学学生的数量存在统计学关联。
我们的研究结果表明，尽管未来的医生不会远离家庭住所或培训地点，但这种模式随着时间的推移并不均匀。距离受人口统计学、社会经济地位和贫困程度的影响。这些结果可能有助于设计旨在解决英国分布不均和医生不足等慢性问题的干预措施。
