Medical Students' Insight into Foundation Training (MEDSIFT): a National Cross-Sectional Online Survey reveals close to 50% are considering a career outside the NHS.
Benjamin Cook, Edelyne Tandanu, Umar Rehman, Elena Whiteman, Temidayo Osunronbi, Ghazel Mukhtar, Garikai Kungwengwe, Mohammad Sohaib Sarwar, Sammy Arab, Karanjot Chhatwal, Ricky Ellis, Karl Romain, Akib Khan, Ahmed Ezzat, Justin Wormald, George Adigbli, Manaf Khatib, Simon Filson, Naveen Cavale, Peter A Brennan
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Abstract
Introduction: The new preference-informed allocation (PIA) system introduced for the 2024 UK cohort Foundation Programme (UKFPO) marks a shift away from the traditional meritocratic 'ranking' used in previous years. Instead of appointment to Foundation Programme places, PIA is a computer-generated allocation and deanery preferencing system. This change has raised numerous concerns among both students and clinicians.
Aims: To investigate the opinions of medical students on the new UKFPO PIA system.
Methodology: An online questionnaire was distributed to medical students graduating in 2024, 2025, or 2026 across the UK.
Results: In total, 2297 responses were collected and 2288 were included in the study. Overall, 51.6% (n = 1183) of respondents felt the PIA system was unfair, 76.3% (n = 1746) felt they had lost control of their application, and 46.3% (n = 1049) had noticed a negative effect on their physical or mental health. Notably, 48.2% (n = 1094) of students who responded are now considering a career outside the National Health Service (NHS).
Conclusions: Overall, the PIA system falls short of students' expectations and has led to record numbers of students considering careers outside the NHS. Further changes to this system are needed and should aim to address fairness and equity while rewarding students for their hard work. According to these data, the PIA system risks further deteriorating workforce morale and attrition rates.
期刊介绍：
Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.
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