Specialty training competition stabilises as applications and posts rise

Authors: Helen Jaques 

Publication date:  15 May 2012

Competition ratios for specialty training have largely dropped or levelled off after round one of recruitment across the United Kingdom this year, although the number of applications per trainee and the number of posts available have risen since 2011.

In 2012 a total of 16 635 applications were submitted for 7499 specialty training year 1 posts across the UK, producing an overall competition ratio of 2.2 applications per post. In 2011 15 203 applications were received for 6871 posts, again resulting in an overall competition ratio of 2.2:1.

The reduction in the ratio in most specialties, largely because they have moved towards nationally coordinated recruitment, has resulted in major cost and time savings for the NHS, the Department of Health has said.

Most specialties had competition ratios of roughly 3:1 or lower at the end of the first round in 2012, although the competition ratio was 3.8 for core surgical training and for radiology (down from 4.1 in 2011 for surgery and up from 3.3 for radiology).

Specialty training competition ratios at end of first round in 2012 in UK

Applications* Posts Ratio
Acute care common stem (ACCS)—emergency medicine 419 182 2.3
Anaesthesia and ACCS—anaesthesia 1050 525 2
Core medical training and ACCS—acute medicine 2672 1360 2
Core surgical training 2666 703 3.8
General practice (England only) 5114 2774 1.8
Histopathology 118 80 1.5
Neurosurgery 254 16 15.9
Obstetrics and gynaecology 607 211 2.9
Ophthalmology 287 93 3.1
Paediatrics 736 385 1.9
Psychiatry 609 439 1.4
Public health 616 59 10.4
Radiology 693 181 3.8
Total 16 635 7499 2.2

*The total number of applications rather than of unique applicants.

The competition ratio for specialty training year 1 in neurosurgery remained high at 15.9:1, although only 16 posts were available for training in this specialty in the UK. The competition ratio for public health was also high, at 10.4:1.

Although still low, the competition ratio for core psychiatry training has risen from 0.7:1 in 2011 to 1.4:1 in 2012.

In England the fill rate for most specialties was in the range of 90-100%, with psychiatry lower at 68% (but up from 61% in 2011).

The fill rate for public health medicine fell from 98% in 2011 to 84% 2012, and a very low number of candidates were appointable, an issue that is being investigated by the health department. The fill rate for histopathology was also lower than in 2011 (61% in 2012 versus 93% in 2011), owing to smaller application numbers and a larger number of posts available this year.

As in previous years, the overall number of successful foundation year 2 applicants was lower than the overall number of people who completed the foundation programme. The proportions of candidates being offered and accepting a post were considerably higher among applicants who qualified in the UK than among those who qualified in the European Economic Area or further afield.

In theory almost all foundation year 2 doctors should be able to get a place in specialty training, because the foundation programme prepares junior doctors specifically for specialty training, said Ben Molyneux, deputy chairman of the BMA’s Junior Doctors Committee. “Yet in some specialties 100% of foundation year 2 doctors were found to be appointable, and in other specialties the number was tiny,” he said.

Low appointability rates could be due to different specialties taking different approaches to appointability at interview and shortlisting, he suggested. “Some specialties do set a bar, and you have to hit the minimum standard with your score in interview,” he said. “If you don’t hit the bar then even if you’re a foundation year 2 doctor and you’ve met all the competencies, if you didn’t score high enough you’re not appointable.”

Another example is if doctors make it clear at interview that the specialty they are being interviewed for was not their first choice. “It’s as if a specialty is not your first choice you’re not appointable rather than not appointed,” he said.

Helen Jaques news reporter BMJ Careers


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