Results from the Scottish Psychiatric Trainees Recruitment Survey 2007-2008

Background

There has been considerable debate about inadequacies in the Modernising Medical Careers (MMC) process across all Specialties. Following Modernising Medical Careers there have been surveys of trainee opinion, showing adverse effects on health and quality of work. In Scotland the process differed significantly from the rest of the United Kingdom, with a single stage recruitment process and all applicants being interviewed.

In view of concerns regarding recruitment and dissatisfaction voiced by trainees in Psychiatry, trainee representatives of the Specialty Board for Psychiatry in Scotland, and the Psychiatric Trainees Committee (PTC) of the Royal College of Psychiatrists undertook an online survey of all current  Psychiatric trainees in Scotland, to provide informed opinion towards the recruitment process for 2008.

The online survey was distributed to all trainees across Scotland via a web-link through regional deanery leads for the four regions in Scotland. The questions focused on the recruitment process in 2007 as well as exploring trainees’ views about the process for 2008. The survey gathered information on shortlisting, interview, communication and feedback along with suggestions for the future selection process. The online survey was available for two weeks from the 16^th to the 29^th of October 2007.

Results

Total number of respondents:        123

Completed:                          113 (92%)

Region:

Years worked in Scotland:

Grade:

Choice of Future speciality:

The past

Just under half (42%) of all trainees who competed for a training post in August did not get a post of their choice. Of these just over 40% ended in a fixed term post and/or about 35% did not procure a post in the region of their choice while 21% did not obtain a training post at all. 4% did not obtain a post in the speciality of their choice.

77% of the trainees felt that they had no confidence in the short-listing process with only 18% expressing confidence in it. 5% did not have an opinion. Most of the criticism was directed towards the subjective sections of the form with 74% feeling that the application form was too subjective in nature.  We received over 80 comments from trainees on this aspect. Most trainees felt that the subjective sections were too vague, poorly discriminative, non-indicative of trainee’s clinical skills and was open to abuse through plagiarism. Some pointed out that these sections could have been filled out with help from others and need not necessarily describe actual incidents and experiences.

Views about the interview process were more evenly split. However even in this case about 48% of all trainees felt that it was not a valid process. It was also interesting to note that only 45% of all trainees received some training (either formal or informal) for the interview process.

In summary it is striking that although the majority of respondents are trainees who have been successful in procuring a run-through training post in the recruitment process, views about the validity of the short-listing and interview process were significantly negative. This reflects the general view that the recruitment process was not perceived as being fair and valid by a substantial number of trainees including those who have been successful .

Communication

The majority of trainees (66%) felt that communication about the overall process had been either poor or extremely poor. A significant number favoured email as a route of communication for general information (87%) and for application-specific information (68%).

However views over the use of email for interview offers and appointment offers were almost evenly split. A lot of trainees felt that a hard copy by post or a telephone call would have been better.  It was also felt that at least 2 separate routes of communication must be used for important information like offers.

It was also striking that 68% of trainees did not receive any feedback about their ranking. Of those who received some feedback only 56% felt that the feedback was helpful.

The Future

Preference to Scottish trainees: A large number of trainees (60%) felt that preference should be given to those who have trained in Scotland in the past. 13% had no opinion while 27% did not agree with this.

A substantial number (78%) preferred a combination of structured CV’s and applications forms used for the short listing process. We also received a large number (75) of suggestions from trainees about changes to the application process. These can be broadly encompassed under the following themes:

• Elimination of ‘describe a time…’ style narrative questions with greater emphasis on objective evidence
• Longer word limits for the descriptive sections if used
• Many felt that the questions were too vague and convoluted
• Previous experience to be taken into consideration, including non-medical experience
• ‘Why career & speciality’ questions
• More time for the application process
• Elimination of the application altogether  or using it only to check eligibility criteria
• Focussed on demonstrating explicit competencies around day to day clinical activities

An overwhelming number of trainees also felt that both the CV and Portfolio should be available at the time of the interview both for ST1-3 level (86%) and for ST4 level (92%). However views about short listing scores being carried forward to the interviews were more evenly split with 49% in favour, 36% against and 15% with no opinion about the matter.

References: A majority of trainees (63%) felt that structured references should be available to the interview panel and contribute to the overall score while 30% felt that they should be available to the panel but not contribute directly to the score. Only 6% felt that references should not be available while 2% had no opinion about the issue.  In all 93% of trainees felt that references should be available to the interview panel.

Transition from ST3-ST4:

We also put forward 4 possible scenarios for the transition process between ST3 to ST4. These scenarios were as follows:

1. Allocate current ST3 candidates to their preferred ST4 sub-specialty posts by “best-fit” model, then appoint trainees applying from outwith Run Through Training (Non-RTT) to “left over” posts
2. Allocate current ST3 candidates to their preferred ST4 sub-specialty posts by interviewing them all, then appoint Non-RTT candidates to “left over” posts
3. Allocate current ST3 candidates to a proportion of available ST4 sub-specialty posts (by best fit or by interviewing them all), then appoint Non-RTT candidates to the remaining proportion of ST4 posts
4. Interview all current ST3s and shortlisted non-RTT candidates together and allocate to all available ST4 posts based on ranking and choice

Trainees were asked to rate these options in order of preference. The results were inconclusive with preferences broadly split between the four options. There was a slight trend towards trainees in current ST3 posts preferring Option 1. These results highlighted the difficulty in formulating an equitable and acceptable solution to this issue.

We also considered the issue of geographical choice in the context of the ST3-ST4 transition. Once again we put forward 3 possible scenarios to be ranked in order of preference. The options were as follows:

1. Priority in Deanery choice given to those already in ST3 posts within that Deanery
2. Priority in Deanery choice given to those already in ST3 posts, FTSTA3/4 posts or SAS posts within that Deanery area
3. No priority – Deanery choice decided by candidate ranking only

The results for this were clearer with a majority (49%) opting for Option 1 as their most preferred choice. Just over 70% of the respondents chose Option 3 as their least preferred choice.

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