Failure to Secure a Training Post in an Applicants First Choice Deanery as a Risk Factor for Difficulties During Training

Dr Richard Crane, Dr Peter Haig, Dr Samantha Scallan

Background
Trainees in difficulty present an increasing challenge. Recent emphasis has shifted from remedial activity to early identification of those at risk, combined with proactive intervention. Low recruitment scores have been associated with increased risk of difficulties.
We examined this group more closely to identify other risk factors.

Summary of Work
We identified 39 trainees who scored poorly in the UK national GP recruitment process. It was immediately obvious that a large proportion of these trainees (28) had not chosen to train in Wessex, having come to the deanery through the clearing process or recruitment round two. We then compared their outcomes with the 11 low-scorers who had applied directly to Wessex.

Findings
Every trainee recruited via clearing fell into the cohort of 39. The mean recruitment scores of the clearing group were not significantly different to those of the low-scorers who applied directly to Wessex. Clearing recruits were four times less likely to finish their training after three years, twice as likely to receive a training extension and more likely to resign or be released from training.

Conclusions
Accepting a training post in a deanery other than those applied to is a risk factor for difficulties during training, independently of a low recruitment score. These trainees are more likely to resign or fail to complete training than a trainee who did apply to Wessex. Clearing recruits are a high risk group who should be considered for intervention early. Clearing recruits may be social isolated or commuting long distances and may benefit from additional pastoral support.