Geographical movement of doctors from education to training and eventual career post: UK cohort studies.
Goldacre M., Davidson J., Maisonneuve J., Lambert T.
OBJECTIVE: To investigate the geographical mobility of UK-trained doctors. DESIGN: Cohort studies conducted by postal questionnaires. SETTING: UK. PARTICIPANTS: A total 31,353 UK-trained doctors in 11 cohorts defined by year of qualification, from 1974 to 2008. MAIN OUTCOME MEASURES: Location of family home prior to medical school, location of medical school, region of first training post, region of first career post. Analysis for the UK divided into 17 standard geographical regions. RESULTS: The response rate was 81.2% (31,353/45,061; denominators, below, depended on how far the doctors' careers had progressed). Of all respondents, 36% (11,381/31,353) attended a medical school in their home region and 48% (10,370/21,740) undertook specialty training in the same region as their medical school. Of respondents who had reached the grade of consultant or principal in general practice in the UK, 34% (4169/12,119) settled in the same region as their home before entering medical school. Of those in the UK, 70% (7643/10,887) held their first career post in the same region as either their home before medical school, or their medical school or their location of training. For 18% (1938/10,887), all four locations - family home, medical school, place of training, place of first career post - were within the same region. A higher percentage of doctors from the more recent than from the older cohorts settled in the region of their family home. CONCLUSION: Many doctors do not change geographical region in their successive career moves, and recent cohorts appear less inclined to do so.