GPs labour trajectories and patients’ health outcomes in general practices

LEAD SUPERVISOR: Dr Catia Nicodemo, Nuffield Department of Primary Care Health Sciences

Co-supervisor: Professor Simon de Lusignan, Nuffield Department of Primary Care Health Sciences

Co-supervisor: Dr Joan Madia, Nuffield Department of Primary Care Health Sciences

Co-supervisor: Professor Stavros Petrou, Nuffield Department of Primary Care Health Sciences

 Commercial partner: EMIS, Leeds

Background:

Despite massive improvements in the production and accessibility of UK educational and training data (e.g., UKMED, UCAS, HESA, NPD), we still know very little about the educational and professional trajectories of medical students or of those who opt as postgraduates for primary care training. 

 Previous studies have shown that students from more affluent socioeconomic backgrounds and independent schools are more likely to attend medical schools (at both undergraduate and graduate levels). A deeper understanding on what are the consequences of different educational trajectories on transitions to general practices and, more generally, to the health care sector is much needed. A recent report from the General Medical Council indicates that the lack of diversity and growing geographical and socioeconomic segregation in the doctors' workforce might have negative consequences on the health of patients, especially for those living in economically deprived areas of the UK.  Importantly, most of the existing evidence on access to medical schools, learning outcomes and trajectories of medical students, as well as its consequences for public health, is purely correlational and thus not ideal for informing policy. Furthermore, only 7% of male and 13% of female graduates say they want a career in general practice. An assessment of undergraduates’ career intentions regarding general practice and the transition from school to the labour market is important to explore further health policies that could help retain GPs and push more students to become GPs.

 Aim: 

The aim of this studentship is to understand in a more comprehensive way than past studies how sociodemographic characteristics and the educational trajectories of medical students determine employment transitions in the healthcare sector and patients’ health outcomes. 

 Methods: 

For this project, the DPhil student will use advanced econometric techniques such as Difference-in-Differences models, network- and peer- effects analysis, and multilevel regression analysis. The student will create a novel dataset obtained from linking UKMED (UK Medical Education Database), the national GP training dataset (a complete record of postgraduate GP training), a primary care appraisal dataset (a database of appraisal data), and ORCHID (Oxford Royal College of General Practitioners Clinical Informatics Digital Hub) datasets.  ORCHID is a primary care database of pseudonymised primary care data, which will also provide health outcomes.

 Objectives: 

First, the student will create a unique database, linking UKMED (educational trajectories of medical students), the national GP training dataset and the ORCHID dataset (transition to GPs and patients outcomes), evaluate the quality of the linkage through different linkage techniques (i.e., deterministic vs probabilistic data linkages), and harmonise variables for the analysis. Second, the student will conduct econometric analysis on a) determinants of educational trajectories and learning outcomes of medical students, accounting for socio-demographic and medical school characteristics; b) transitions to GP practices, retention, and labour careers of doctors; and c) patients outcomes and their intersection with inequalities.

Apply using course: DPhil in Primary Health Care

January 2023 update:

Applications for this iCASE project (for October 2023 entry) are no longer accepted.