Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study
Objective To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations.Design A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data).Setting All UK medical schools, foundations and specialty training...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-02-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/3/e077635.full |
| _version_ | 1797289777822695424 |
|---|---|
| author | Jonathan M Read Colin Melville Luigi Sedda Daniel Thomas Smith Lucy Hitchings Ben Fleet |
| author_facet | Jonathan M Read Colin Melville Luigi Sedda Daniel Thomas Smith Lucy Hitchings Ben Fleet |
| author_sort | Jonathan M Read |
| collection | DOAJ |
| description | Objective To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations.Design A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data).Setting All UK medical schools, foundations and specialty training organisation.Participants All UK medical students from 2002 to 2015, for a total of 97 932 participants.Outcome measures 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.Methods Leslie matrix, principal components analysis, Gini coefficient, χ2 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).Results 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.Conclusion 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. |
| first_indexed | 2024-03-07T19:10:54Z |
| format | Article |
| id | doaj.art-01f3ff050e7b4dacb9fa2c1b4939134f |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-07T19:10:54Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-01f3ff050e7b4dacb9fa2c1b4939134f2024-03-01T00:50:09ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114310.1136/bmjopen-2023-077635Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort studyJonathan M Read0Colin Melville1Luigi Sedda2Daniel Thomas Smith3Lucy Hitchings4Ben Fleet5Joint Universities Pandemic and Epidemiological Research (JUNIPER consortium)5 School of Medical Sciences, The University of Manchester, Manchester, UK1 Lancaster Ecology and Epidemiology Group, Lancaster Medical School, Lancaster University, Lancaster, UKGeneral Medical Council, London, UK1 Mathematics and Statistics, Lancaster University, Lancaster, UK2 Lancaster Medical School, Lancaster University, Lancaster, UKObjective To determine and identify distance patterns in the movements of medical students and junior doctors between their training locations.Design A retrospective cohort study of UK medical students from 2002 to 2015 (UKMED data).Setting All UK medical schools, foundations and specialty training organisation.Participants All UK medical students from 2002 to 2015, for a total of 97 932 participants.Outcome measures 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.Methods Leslie matrix, principal components analysis, Gini coefficient, χ2 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).Results 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.Conclusion 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.https://bmjopen.bmj.com/content/14/3/e077635.full |
| spellingShingle | Jonathan M Read Colin Melville Luigi Sedda Daniel Thomas Smith Lucy Hitchings Ben Fleet Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study BMJ Open |
| title | Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study |
| title_full | Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study |
| title_fullStr | Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study |
| title_full_unstemmed | Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study |
| title_short | Determining the distance patterns in the movements of future doctors in UK between 2002 and 2015: a retrospective cohort study |
| title_sort | determining the distance patterns in the movements of future doctors in uk between 2002 and 2015 a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/14/3/e077635.full |
| work_keys_str_mv | AT jonathanmread determiningthedistancepatternsinthemovementsoffuturedoctorsinukbetween2002and2015aretrospectivecohortstudy AT colinmelville determiningthedistancepatternsinthemovementsoffuturedoctorsinukbetween2002and2015aretrospectivecohortstudy AT luigisedda determiningthedistancepatternsinthemovementsoffuturedoctorsinukbetween2002and2015aretrospectivecohortstudy AT danielthomassmith determiningthedistancepatternsinthemovementsoffuturedoctorsinukbetween2002and2015aretrospectivecohortstudy AT lucyhitchings determiningthedistancepatternsinthemovementsoffuturedoctorsinukbetween2002and2015aretrospectivecohortstudy AT benfleet determiningthedistancepatternsinthemovementsoffuturedoctorsinukbetween2002and2015aretrospectivecohortstudy |