The face of obstetrics and gynaecology is changing, driven by the reduction in inpatient length of stay, the increase in the total number of general specialists, an explosion of knowledge from advances in science and information technology, increasing patient education and an increased emphasis on life-work balance with a concomitant reduction in working hours. Specifically, the last 20 years have seen the rise of subspecialization to the point where almost one in three specialists pursue further subspecialist training according to the Workforce Intentions Survey (RANZCOG, 2013). Unfortunately, there is limited published information on the factors that determine why specialists choose to subspecialise.
The purpose of this study was to assess why trainees choose to enter an advanced training program in endoscopic surgery.
Methodology
This study employed a mixed methods design. Between 2014 and 2017, all candidates for, and trainees in the AGES Accredited Training Program were invited to participate. Candidates attending interviews from 2014 completed questionnaires at the interviews. The answers to these questions informed the exploratory interviews of 2016 and 2017. Study subjects were selected by exhaustive criterion sampling.
Data analysis
Interview data were organised into categories and analysed by NVivo 10 and analytic induction in a staged, independent analysis. Units, themes and sub-themes were finalised and the data processed in a framework approach to data analysis. The validity of the qualitative data analysis and interpretation was established using traditional approaches in qualitative research including data triangulation.
Quantitative continuous and categorical data were subject to parametric, nonparametric and regression analysis where appropriate using SPSS Professional.
Ethics approval for this study was granted from Queensland University of Technology Human Research Ethics Committee (1500000108 ).
Results
In 2014 and 2015, there were 36 candidates for the AGES accredited training program and 32 completed the questionnaire. In 2015, there were 22 candidates and 6 participated in interviews. In 2016, 18 trainees were invited, 6 participated in the interviews. In 2017, all graduates of the AGES Training Program (13) were invited to participate in interviews, of which 6 agreed and 4 attended the interviews.
The main themes identified in the study were learning, recognition and the training program, each with a fluid set of subthemes.
Conclusion
Not surprisingly, the main reasons for entering the training program were increased opportunity to learn and gain skills. However, professional recognition, peer networks and to access to a formalised training program were equally important themes.