‘Dogfight’ for jobs: do trainees now need a PhD to get a hospital position?

An oversupply of trainees means that early career oncologists feel forced to do PhDs in the “dogfight” for the few jobs available, a new survey shows.

The hyper-competitive job market in medical oncology means that trainees feel increasingly anxious and pessimistic about their uncertain career prospects and resentful at having to do a higher degree that takes them away from clinical work.

Responses from a survey of 170 advanced trainees and early career medical oncologists in Australia reveal widespread concerns about highly precarious job prospects and perception that they need to be more highly qualified and involved in research to have any chance of a medical oncology position in a major city.

A common theme in the responses from doctors in training was that there had been  disproportionate growth in the number of trainee positions, which was not matched by employment opportunities. Many believed senior consultants were increasingly working beyond retirement age, further limiting the number of positions available for younger doctors.

“It’s a dogfight basically for jobs,” commented one female early-career consultant, while a male counterpart said: “Obviously, there’s far more trainees coming through now and there’s more patients but there has not been a reciprocal increase in public hospital positions and funding. That’s a source of angst for many people.”

Advanced trainees said they were told that getting a higher degree and being involved in a research project was the only way they would “get a foot in the door at any teaching hospital”, particularly in the city. As one participant put it: “PhD in the city, no PhD in the country”.

However, while many trainees believed that research was a valuable skill, it created tensions and problems because it took them away from face to face clinical work,

“Most of us are now going into research as a holding pattern for several years and you produce good stuff whilst you wait for something to come up,” said one female early career medical oncologist.

Others said the need to be involved in research to secure a full-time position further increased work demands as they struggled with expectations to see increasing numbers of patients.

“The bits that are challenging for me at the moment I think are sort of the work-life balance, the job security, the competition, the having to do research on top of 50, 60, 70 hour weeks, the stress, seeing everyone else stressed and not happy,” said one female advanced trainee.

Researchers from the University of NSW who conducted the survey said the findings showed a need for better workforce planning in medical oncology, particularly funding of early career positions. It was particularly important to have a sustainable and efficient medical oncology workforce given the number of cancer patients was expected to increase by 40% by 2020, they said,  and the expectation with increasingly complex care and sub-specialisation was increasing.

The survey findings are published in the Asia Pacific Journal of Clinical Oncology.

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