Using qualitative methods, what factors do child & adolescent higher trainees and new consultants (within 1 year of appointment), report in choosing their higher training subspecialty?

AIMS: This Research aims to identify factors reported by recent and current trainees in choosing Child & Adolescent (C&A) Psychiatry for their higher training/career path. The hypothesis is that via thematic analysis prominent factors will emerge to inform future recruitment and retention. BACKGROUND: The need to attract more doctors into Psychiatry has been identified by NHS, Royal College of Psychiatrists and the Media; Health Education England figures show core psychiatry had lowest fill rates of any specialty in 2016,17 &18. Some subspecialties experience particular difficulties e.g. C&A. Royal College of Psychiatry analysis of workforce in March 2018 showed the numbers of C&A psychiatrists of all grades have fallen by 6.3% in four years and for consultants alone the decrease was 6.9% over the same period. However, very little research has been completed investigating why trainees might choose C&A Psychiatry with a literature search revealing only one report of C&A trainees views in the UK in 2006. METHOD: A qualitative design was chosen to provide insight into the factors affecting participants in choosing their career. The theoretical framework supporting the study relates to capturing experience via a case study approach, aiming to explore reported issues in a real life context and considering similarities in the cases to inform future recruitment. The Research was approved by The Health Research Authority and local Research & Development departments. Purposeful sampling was used with voluntary participation following informed consent and non-identifiable demographic data were collected and analysed quantatively. Semi-structured interviews to saturation were conducted with fourteen (N = 14) participants asked questions exploring their subspecialty choice. Responses were recorded and transcribed verbatim prior to thematic analysis, including triangulation via a co-coding process to check areas were not over-represented and/or subject to researcher thoughts and possible unconscious biases. RESULT: Semi-structured interviews included all North-East C&A trainees and 3 recently qualified Consultants. Demographics results included 5 male and 6 female participants and 6 non-UK graduates. interest in children/specialty; specialty experience; supportive supervisors/team; work-life balance; opportunity to impact/intervene early. Limitations include study of a single geographical area and possible researcher bias. CONCLUSION: This Research provides novel findings re factors influencing career choice of C&A Psychiatry to inform future recruitment and retention. Clear themes have emerged re important recruitment/retention factors and the study highlights need for more research to investigate reasons why C&A is not chosen.