Changes in job aspirations during physician training in Australia.
BACKGROUND
There is uncertainty regarding the effects of physician training on planned practice features of Australian physician trainees, for example plans for urban or rural, full-time or part-time and academic/research or purely clinical practice. These plans may differ between male and female trainees and between generalists and sub-specialists.


OBJECTIVE
To examine the changes in anticipated practice patterns over the course of advanced physician training.


METHODS
Longitudinal study of doctors in Australia who passed the Part I clinical examination of the Royal Australasian College of Physicians in 1991, 1992 and 1993, followed annually up until 1995. Changes in future practice plans regarding full- or part-time work, rural or urban practice and pure clinical work or a mixture with research were examined among generalist and specialist trainees and among men and women. Statistical analysis included the calculation of chi square for trend statistics and intraclass correlation coefficients.


RESULTS
At least one follow-up questionnaire was received form 80% of the 334 original respondents. The majority had been able to obtain their training job of choice. By the time of last follow-up, around 80% planned to practise in a capital city, indicating a shift during training from those who initially stated no preference. There was also a shift towards combining research with clinical practice and among women wishing to practise part-time only. Generalists were more likely to wish to practise outside a capital city than specialists.


CONCLUSIONS
The training programme should be revised so that careers in rural and provincial centres are encouraged and so that it is sensitive to the needs for physicians to develop research capacity. Training and career opportunities should allow all candidates (particularly women) wishing part-time employment to achieve their full career potential.
Kanagarajah
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Illawarra Area Health Service, Department of Rehabilitation and Geriatrics, Port Kembla Hospital, NSW.
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Heller
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D000328:Adult; D001315:Australia; D002321:Career Choice; D016009:Chi-Square Distribution; D004503:Education, Medical, Graduate; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008511:Medicine; D010820:Physicians / Q000523:psychology*; D013038:Specialization; D011795:Surveys and Questionnaires