Foundation Year 2 doctors’ reasons for leaving UK medicine : an in-depth analysis of decision-making using semistructured interviews

This work was funded by a Scottish Medical Education Research Consortium grant.Objectives:  To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. Setting : All four regions of Scotland. Participants:  Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. Primary and secondary outcome measures:  Semistructured interviews were coded using template analysis. Six perspectives, described by Feldman and Ng, were used as the initial coding template. The codes were then configured to form a framework that explores the interplay of factors influencing Foundation Year 2 (F2) doctors’ decisions to leave UK medicine. Results:  Seventeen participants were interviewed. Six perspectives were explored. Structural influences (countrywide and worldwide issues) included visas, economic and political considerations, structure of healthcare systems and availability of junior doctor jobs worldwide. Organisational influences (the National Health Service (NHS) and other healthcare providers) included staffing and compensation policies, the working environment and the learning environment. Occupational influences (specific to being a junior doctor) comprised the junior doctor contract, role and workload, pursuit of career interests and the structure of training. Work group influences (relationships with colleagues) included support at work, task interdependence and use of locums. Personal life influences consisted of work-life balance, and support in resolving work-life conflict. The underlying theme of ‘taking a break’ recurred through multiple narratives. Conclusions:  F2s give reasons similar to those given by any professional considering a change in their job. However, working within the NHS as an F2 doctor brought specific challenges, such as a need to make a choice of specialty within the F2 year, exposure to workplace bullying and difficulties in raising concerns. Despite these challenges, most F2s did not view their decision to leave as a permanent job change, but as a temporary break from their current working lives.Publisher PDFPeer reviewe

Portfolio Vol. III N 4

Moll, Willlie. I Was in Kitchener Camp. Prose. 5-6. Barrington, John. The Pledging of Homer McGunk. Prose. 7-9. Stewart, John. In Time of Death. Prose. 10. Lindsey, Arthur Ward. Retrospect. Prose. 11-13. Phillips, Allison. Blue Moon. Poetry. 14. Yoxall, Lindsey E. Pro Patria. Prose. 15-16. Beckham, Adela. Wind--Dreams. Poetry. 18. Fields, Brooks. The Doctor Takes a Trip. Prose. 19-20. Deane, Dorothy. Review of New Books. Prose. 21. Smith, Duke. Review of New Recordings. Prose. 21. Timrud, David. Refugee. Prose. 22-23

Physicians’ Knowledge and Beliefs Regarding Athletic Trainers

Purpose: The relationship between athletic trainers (ATs) and physicians is a legal obligation and collaboration to improve patient outcomes. The objective of this study was to examine the knowledge of physicians regarding the educational preparation, legal obligations, and scope of practice for ATs and how it relates to previous experiences with ATs. Additionally physicians’ perceptions of Interprofessional Collaboration (IPC) were studied. Methods: 169 physicians medical doctors (MD)=133/169, 78.7%, doctor of osteopathy (DO)=36/169, 21%) completed a 36-question web-based survey, which included a validated IPC scale. Results: Respondents with experience working with an AT scored significantly higher (P \u3c 0.01) on the knowledge assessment, where physicians currently working with an AT scored higher (5.4/8) than those who previously worked with an AT (4.2/8) and those who had never worked with an AT (3.3/8). Additionally, physicians with previous exposure to an AT as an athlete had significantly higher knowledge scores than those without exposure (P \u3c 0.01). Two areas of weakness in IPC from the physician’s perspective included sharing of important information (2.48/4) and importance of work as compared to others on the team (2.38/4). Conclusions: Physicians who have a current working relationship with an AT and those that had access to an AT as an athlete demonstrated significantly higher knowledge about an AT’s academic preparation, legal obligations, and scope of practice. Moreover, physicians currently working with an AT report positive interprofessional collaborations

Assessing School and Student Predictors of Weapons Reporting

School violence and weapons at school are a major concern for community members, school administrators, and policy makers. This research examines both student-level and school-level variables that predict middle school students’ willingness to report a weapon at school under several reporting conditions. Results substantiate previous analyses of these data that student-level variables explain students’ willingness to report a weapon but extend these findings to include school climate variables that affect willingness to report (i.e., collective identity and conflict). School climate variables were also shown to influence reporting under conditions in which there would be consequences for the weapons-carrying student or for the reporting student; however, school climate was not found to influence anonymous reporting conditions. Although policies aimed at improving school climate may increase a student’s willingness to report and are important in their own right, improving a school’s climate may be a daunting task. This research, therefore, suggests that the most efficient way to encourage weapons reporting is to provide students with an anonymous way to report

Determinants of adherence to nutrition- related cancer prevention guidelines among African American breast cancer survivors

Background: Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors. Methods: AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were used to examine the relationship between adherence to nutrition-related cancer prevention guidelines and potential predictors of adherence. Results: Majority of the survivors met the guideline for red and processed meat (n=191, 83.4%), but did not meet the guideline for fruits and vegetables (n=189, 80.4%). For survivors with annual household incomes \u3c $25,000, the odds of meeting or partially meeting the guideline for fruits and vegetables was 75.4$50,000 (OR= 0.25, 95% CI: 0.08, 0.80). Poor physical functioning (OR= 38.48, 95% CI: 2.26, 656.58), sleep disturbances (OR= 60.84, 95% CI: 1.61, 2296.02), and income \u3e $50,000 (OR= 51.02, 95% CI: 1.13, 2311.70) were associated with meeting the guideline for red and processed meat. Conclusions: Many AA breast cancer survivors are not meeting the nutrition-related cancer prevention guidelines. For this population, more interventions that enhance access to and consumption of healthy diets are needed

Reimagining Restitution: New Approaches to Support Youth and Communities

Courts began ordering youth restitution in the 1960s as a less restrictive sanction than probation or incarceration for mostly white youth. Since then, restitution has been linked to higher recidivism rates and heightened racial and economic disparities in the juvenile justice system. This report provides an overview of the historical and current landscape of restitution imposed on youth, the impact of restitution on youth, victims and communities, and provides recommendations for how jurisdictions can reimagine restitution

Strength in diversity: enhancing learning in vocationally-orientated, master's level courses

Postgraduate education in geography, especially at the Master’s level, is undergoing significant changes in the developed world. There is an expansion of vocationally-oriented degree programmes, increasing recruitment of international students, integration of work place skills, and the engagement of non-traditional postgraduate students as departments respond to policies for a more ‘inclusive’ higher education. This paper sets the context by outlining some programmatic changes in selected countries (Australia, the UK, and the USA). We briefly reflect on how postgraduate ‘bars’ or ‘levels’ are defined and explore in detail what ‘diversity’ or ‘heterogeneity’ means in these new postgraduate settings. The paper then explores some examples of practice drawn from our own experiences, whilst recognising that relevance will vary in other contexts. Finally we consider how diversity can be harnessed as a strength that has potential to enhance taught elements of contemporary postgraduate education in and beyond the discipline