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Uncovering trends in training progression for a national cohort of psychiatry trainees: discrete-time survival analysis

Silkens, M. ORCID: 0000-0001-8279-1341, Sarker, S-J. & Medisauskaite, A. (2021). Uncovering trends in training progression for a national cohort of psychiatry trainees: discrete-time survival analysis. BJPsych Open, 7(4), article number e120. doi: 10.1192/bjo.2021.958


BACKGROUND: The global rise in mental health issues calls for a strong psychiatry workforce. Yet, psychiatry training worldwide is facing recruitment challenges, causing unfilled consultant posts and possibly threatening the quality of patient care. An in-depth understanding of trainees' progression through training is warranted to explore what happens to recruited trainees during training.

AIMS: To uncover current trends in psychiatry trainees' progression through training in the UK.

METHOD: This national retrospective cohort study with data from the UK Medical Education Database used discrete-time survival analysis to analyse training progression for those trainees who started their core psychiatry post in 2012-2017 (2820 trainees; 59.6% female, 67.6% UK graduates (UKGs)). The impact of sociodemographic characteristics on training progression were also investigated.

RESULTS: The overall probability of completing training in 6 years (minimum years required to complete psychiatry training in the UK) was 17.2% (ranging from 4.8% for non-UKG females to 29% for UKG males). The probability to not progress was highest (57.1%) from core to specialty training. For UKGs, trainees from ethnicities other than White, trainees with a disability, and trainees who had experienced childhood social deprivation (measured as entitlement to free school meals) had a significantly (P ≤ 0.02) lower probability of completing training in 6 years.

CONCLUSIONS: Less than one in five psychiatry trainees are likely to complete training in 6 years and this probability varies across groups of doctors. Completing psychiatry training in 6 years is, therefore, the exception rather than the norm and this has important implications for trainees, those planning psychiatry workforces or responsible for psychiatry training.

Publication Type: Article
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: Education and training, psychiatry training, training progression, discrete survival analysis, UKMED
Subjects: H Social Sciences > HD Industries. Land use. Labor
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:
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