National report on doctors three years after graduating from New Zealand medical schools in 2012-2016

Abstract

EXECUTIVE SUMMARY This report provides the findings from MedicalSchoolsOutcomes Database (MSOD) questionnaires administered between 2015and 2019to five cohorts of doctors who had graduated from a New Zealand medical school threeyears previously(PGY3), between 2012and 2016. A total of 1,131from the 2,211eligible doctors(51%) completed questionnaires.Over this time there has been stability in the proportion of women (≈57%)and men (≈43%)responding: this represents only a slight over-representation of women, who constitute 54% of the 2012to 2016graduates. The median age of the respondents has been consistently27.4 years: the median age of the 2012to 2016graduate group at PGY3 is27.5 years.The self-identified ethnicity of respondents indicates a trend toward an increasing prevalence ofdoctors identifying as Māori and/or Pacific people, howeverthe proportionsstillunderrepresent the proportion of Māori and Pacific people in the New Zealand population.Three yearsafter graduating, 91% of respondentsagree or strongly agree their internship is preparing them for work as a doctor, 51% of respondents are working as a registrarand/or are in training under supervision, 39% are House Officers, and 43% areenrolledin a College training programme. The majority ofthosenot currently in a vocational training programme, intend to enter onein their fourth year post-graduation (PGY4)year(47%) or fifth year post-graduation (PGY5)(45%). Only 3% of respondents intendto work in a clinical role outsideNew Zealandwithinthe next twoyears. In the longer term, 97% of respondents intend to work in New Zealand: 62% in a major city, 29% in a regional centre or large town, and the remainder in smaller towns.The percentage of respondents in PGY3 decided on a future medical specialty approaches85%.Consistently,the top preferenceisGeneral Practice(26%), followed byInternal MedicineandSurgery. Over half therespondentsselectedone of these threespecialties as their first-choice preference. These numbers are not reflected in some current college training enrolments in PGY3, for exampletheentryrequirements for those intending to practice surgery are typically not met until afterPGY3. Those decided on an Internal Medicine specialty favour the Cardiology, Gastroenterology and Hepatology, and General Medicine sub-specialties; those decided on Surgery favour Orthopaedic Surgery and General Surgery. Close to three-quarters (74%) of respondents indicated an interest in medical teaching, and nearly a half (47%)an interest in research. Threeyearsafter graduation, respondents indicate both external and internal factors influencetheir specialtypreference,with the highest ranked factors being atmosphere/workculture typical ofthe discipline, influence of consultants/mentors, work experience since graduation, and self-appraisal of own skills/aptitudesin addition tointerest in helping people. By comparison, the least influential factors influencingspecialtypreferencecontinue to include financial costs of vocational training, financial costs of medical school education and/or debt, risk of litigation and associated insurance costs,andinfluence of parents/relatives.