Affordable Access

Access to the full text

Specialist training aspirations of junior doctors in Sierra Leone: a qualitative follow-up study

Authors
  • Woodward, Aniek1
  • Lake, Euphemia Gooding2
  • Rajaraman, Natarajan3
  • Leather, Andrew1
  • 1 King’s Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK , London (United Kingdom)
  • 2 Ministry of Health, Government of Sierra Leone, West African College of Physicians, Freetown, Sierra Leone , Freetown (Sierra Leone)
  • 3 King’s Sierra Leone Partnership, King’s Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK , London (United Kingdom)
Type
Published Article
Journal
BMC Medical Education
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Aug 15, 2018
Volume
18
Issue
1
Identifiers
DOI: 10.1186/s12909-018-1292-1
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundSierra Leone is pursuing multiple initiatives to establish in-country postgraduate medical education (PGME), as part of national efforts to strengthen the health workforce. This paper explored the career preferences of junior doctors in Sierra Leone; and the potential benefits and challenges with regards to the development of PGME locally.MethodsJunior doctors (n = 15) who had graduated from the only medical school in Sierra Leone were purposively sampled based on maximum variation (e.g. men/women, years of graduation). In-depth interviews were conducted in October 2013, and digital diaries and two follow-up interviews were used to explore their evolving career aspirations until November 2016. Additionally, 16 semi-structured interviews with key informants were held to gather perspectives on the development of PGME locally. Results were thematically analysed.ResultsAll junior doctors interviewed intended to pursue PGME with the majority wanting primarily a clinical career. Half were interested in also gaining a public health qualification. Major factors influencing career preferences included: prior exposure, practical (anticipated job content), personal considerations (individual interests), financial provision, and contextual (aspirations to help address certain health needs). Majority of doctors considered West Africa but East and South Africa were also location options for clinical PGME. Several preferred to leave the African continent to pursue PGME. Factors influencing decision-making on location were: financial (scholarships), practical (availability of preferred specialty), reputation (positive and negative), and social (children). Key informants viewed the potential benefits of expanding PGME in Sierra Leone as: cost-effectiveness (compared to overseas specialist training), maintaining service delivery during training years, decreasing loss of doctors (some decide not to return after gaining their specialist degree abroad), and enhancing quality control and academic culture of the local medical school. Major perceived challenges were capacity constraints, especially the dearth of specialists required to achieve training programme accreditation.ConclusionsThis study has provided an insight into the career preferences of junior doctors in Sierra Leone. It is timely as there is increasing political and professional momentum to expand PGME locally. Findings may guide those involved in this PGME expansion in terms of how possibly to influence junior doctors in their career decision-making.

Report this publication

Statistics

Seen <100 times