Trends in junior doctors' certainty about their career choice of eventual clinical specialty: UK surveys.

INTRODUCTION: The paper explores whether UK qualified junior doctors' certainty about their choice of eventual clinical specialty has changed in recent years following structural changes to postgraduate training. MATERIALS AND METHODS: We analysed data from questionnaire surveys of all doctors who qualified in the UK in 11 'year of qualification' cohorts between 1974 and 2009. We report on responses to questions at years 1, 3 and 5 after qualifying. RESULTS: Overall, 1 year after qualification, 28.6% (6576/23018) of doctors specified that they were certain about their choice of future specialty, 47.7% specified that their choice was probable and 23.7% were uncertain about it. By year 3 after qualification, 88% of doctors specified that their current specialty choice was definitely or probably their final choice, as did 95% in year 5. Levels of certainty in year 1 showed little change across the cohorts who qualified between 1974 and 2002 (average 28% 'definite'), dropped in the 2005 cohort and then increased to 38% in the qualifiers of 2008 and 2009. Similar changes occurred in years 3 and 5 among doctors surveyed after 2005. There was large variation in certainty of choice by specialty chosen but no important difference between men and women. CONCLUSIONS: Levels of confidence about early choice of specialty are now higher than they were prior to the 2005 changes to postgraduate training.