Expectations, Preferences and Physicians' Specialty Choice

The specialty of general practice in many countries faces a problem of insufficient recruitment and excessive exit. This has prompted research into the determinants of retention and recruitment, including investigation of the career characteristics physicians most desire. We conceptualise junior physicians’ choice of medical specialty as the outcome of a process concerning preferences over career attributes and expectations regarding the combinations of attributes each medical specialty offers. We investigate these career preferences and expectations via a Best Worst Scaling study conducted at the time junior physicians in England were making their specialty choices. We identify the career attributes most desired by junior physicians and the relative importance of monetary and non-pecuniary attributes. We find systematic differences in career preferences between those applying to general practice and those applying to other specialties. We find the expectations of a career in general practice, among junior physicians not applying to that speciality, differ from those of physicians applying to the speciality and the experience of a sample of current GPs. Junior physicians not applying to general practice strongly desire job characteristics that they do not associate with general practice, but which current GPs do associate with the specialty. This suggests that realigning such inaccurate expectations of general practice could offer a route to increase recruitment to the specialty.