Research Article: A Qualitative Study of the Influences on Clinical Academic Physicians’ Postdoctoral Career Decision Making

Date Published: November 23, 2018

Publisher: Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins

Author(s): Veronica F. Ranieri, Helen Barratt, Geraint Rees, Naomi J. Fulop.


To describe the influences on clinical academic physicians’ postdoctoral career decision making.

Thirty-five doctoral trainee physicians from University College London took part in semistructured interviews in 2015 and 2016. Participants were asked open-ended questions about their career to date, their experiences undertaking a PhD, and their career plans post PhD. The interviews were audio-recorded and transcribed. Thematic analysis was used to generate, review, and define themes from the transcripts. Emerging differences and similarities in participants’ reasons for pursuing a PhD were then grouped to produce typologies to explore how their experiences influenced their career decision making.

Participants described four key reasons for undertaking a PhD, which formed the basis of the four typologies identified. These reasons included the following: to pursue a clinical academic career; to complete an extensive period of research to understand whether a clinical academic career was the desired path forward; to improve clinical career prospects; and to take a break from clinical training.

These findings highlight the need to target efforts at retaining clinical academic physicians according to their reasons for pursuing a PhD and their subsequent experiences with the process. Those responsible for overseeing clinical training must be well informed of the long-term benefits of training academically qualified physicians. In light of current political uncertainty, universities, hospitals, and external agencies alike must increase their efforts to inspire and assuage early-career clinical academic physicians’ fears regarding their academic future.

Partial Text

In contrast to UCL’s overall gender distribution for physicians enrolled in a PhD program, our sample included more men (n = 21; 60%) than women (n = 14; 40%). Participants included both current doctoral trainees (n = 23; 66%) and trainees who had submitted their doctoral thesis during the previous year (n = 12; 34%). The stage of clinical training for participants from both of these groups ranged from the beginning of core medical training to the seventh year of subspecialty training (see Table 1). Data saturation may not have been reached in this latter group because of a low response rate in this population. However, when examining participants’ narratives by the differences and similarities in their experiences, we found no distinctions between these groups.

The authors would like to thank the trainees who took part in this study and the University College London administrative services staff who provided the list of doctoral trainees.




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