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      Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977

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          Abstract

          Objective

          To report attitudes to retirement of late-career doctors.

          Design

          Questionnaires sent in 2014 to all UK medical graduates of 1974 and 1977.

          Setting

          United Kingdom.

          Participants

          3695 medical graduates.

          Main outcome measures

          Factors which influenced doctors’ decisions to retire and factors which encouraged doctors to remain in work.

          Results

          The response rate was 85% (3695/4369). 55% of respondents overall were still working in medicine (whether they had not retired or had retired and returned; 61% of men, 43% of women). Of the retirees, 67% retired when they had originally planned to, and 28% had changed their retirement plans. Fifty per cent of retired doctors cited ‘increased time for leisure/other interests’ as a reason; 43% cited ‘pressure of work’. Women (21%) were more likely than men (11%) to retire for family reasons. Women (27%) were more likely than men (9%) to retire because of the retirement of their spouse. General practitioners (GPs) were more likely than doctors in other specialties to cite ‘pressure of work’. Anaesthetists and GPs were more likely than doctors in other specialties to cite the ‘possibility of deteriorating skill/competence’. Radiologists, surgeons, obstetricians and gynaecologists, and anaesthetists were most likely to cite ‘not wanting to do out-of-hours work’.

          Doctors who were still working were asked what would encourage them to stay in medicine for longer. Factors cited most frequently were ‘reduced impact of work-related bureaucracy’ (cited by 45%) and ‘workload reduction/shorter hours’ (42%). Men (30%) were more motivated than women (20%) by ‘financial incentivisation’. Surgeons were most motivated by ‘reduction of on-call or emergency commitments’.

          Conclusions

          Retention policy should address ways of optimising the clinical contribution of senior doctors while offering reduced workloads in the areas of bureaucracy and working hours, particularly in respect of emergency commitments.

          Related collections

          Most cited references8

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          Factors influencing junior doctors' choices of future specialty: trends over time and demographics based on results from UK national surveys.

          To study trends in factors influencing junior doctors' choice of future specialty.
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            A systematic review of physician retirement planning

            Background Physician retirement planning and timing have important implications for patients, hospitals, and healthcare systems. Unplanned early or late physician retirement can have dire consequences in terms of both patient safety and human resource allocations. This systematic review examined existing evidence on the timing and process of retirement of physicians. Four questions were addressed: (1) When do physicians retire? (2) Why do some physicians retire early? (3) Why do some physicians delay their retirement? (4) What strategies facilitate physician retention and/or retirement planning? Methods English-language studies were searched in electronic databases MEDLINE, Web of Science, Scopus, CINAHL, AgeLine, Embase, HealthSTAR, ASSA, and PsycINFO, from inception up to and including March 2016. Included studies were peer-reviewed primary journal articles with quantitative and/or qualitative analyses of physicians’ plans for, and opinions about, retirement. Three reviewers independently assessed each study for methodological quality using the Newcastle-Ottawa Scale for quantitative studies and Critical Appraisal Tool for qualitative studies, and a fourth reviewer resolved inconsistencies. Results In all, 65 studies were included and analyzed, of which the majority were cross-sectional in design. Qualitative studies were found to be methodologically strong, with credible results deemed relevant to practice. The majority of quantitative studies had adequate sample representativeness, had justified and satisfactory sample size, used appropriate statistical tests, and collected primary data by self-reported survey methods. Physicians commonly reported retiring between 60 and 69 years of age. Excessive workload and burnout were frequently cited reasons for early retirement. Ongoing financial obligations delayed retirement, while strategies to mitigate career dissatisfaction, workplace frustration, and workload pressure supported continuing practice. Conclusions Knowledge of when physicians plan to retire and how they can transition out of practice has been shown to aid succession planning. Healthcare organizations might consider promoting retirement mentorship programs, resource toolkits, education sessions, and guidance around financial planning for physicians throughout their careers, as well as creating post-retirement opportunities that maintain institutional ties through teaching, mentoring, and peer support.
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              Participation in medicine by graduates of medical schools in the United Kingdom up to 25 years post graduation: national cohort surveys.

              To determine--as a guide to assess outcomes of medical education, and for medical workforce planning--whether the great majority of graduates from UK medical schools eventually practice medicine.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2017
                31 October 2017
                : 7
                : 9
                : e017650
                Affiliations
                [1] departmentUK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health , University of Oxford , Oxford, UK
                Author notes
                [Correspondence to ] Dr Trevor W Lambert; trevor.lambert@ 123456dph.ox.ac.uk
                Author information
                http://orcid.org/0000-0001-9688-3036
                Article
                bmjopen-2017-017650
                10.1136/bmjopen-2017-017650
                5695300
                29089347
                2e5b4ff8-614f-49a8-ae92-60e6809572ef
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 05 May 2017
                : 07 June 2017
                : 21 June 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000276, Department of Health;
                Categories
                Health Policy
                Research
                1506
                1703
                Custom metadata
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                Medicine
                attitude of health personnel,physicians,workforce,medical,retirement
                Medicine
                attitude of health personnel, physicians, workforce, medical, retirement

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