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Lay Abstract: Lots of autistic people are unemployed. Even when they are employed, autistic people might be given fewer opportunities than non-autistic people to progress in their careers. For example, assumptions about autistic people's differences in social communication might mean they are not given as many promotions. Indeed, we know that many autistic people are in jobs lower than their abilities (known as 'underemployment'). We reviewed 33 studies that tell us something about career progression for autistic people. Our review found that lots of autistic people want to progress in their careers, but there are many barriers in their way. For example, when they told their employer about being autistic, some people were given fewer opportunities. Research has also shown that autistic people do not get enough support to progress and that gaps in their employment history can make it difficult to progress. Our review suggested that good employment support (e.g. mentors) might help autistic people to progress in their careers. However, not much research has evaluated employment support for autistic people, which means we do not know how useful it is. Future research should find the best support that allows autistic people to live and work in ways that are meaningful to them.

Background: Certification in infection control (CIC) is a standardized indicator of the knowledge and competencies essential for effective infection prevention practice. Evidence measuring success of training programs for certfication in infection control is limited., Methods: From 2017 through 2023, 51 novice infection preventionists (IPs) were enrolled in a training program that combined didactic learning, application of knowledge in practice, and mentorship from advanced-practice and near-peer IPs. Participants were tracked through completion of certification examination and pass rates were compared with rates for 2023 CIC candidates., Results: All participants engaged in the training program attempted the CIC examination. The training group had a pass rate of 98%. This is 27% higher than the most recent rate published by Certification Board of Infection Control and Epidemiology (CBIC) of 71%., Discussion: Participants were significantly more likely to pass the CIC exam on the first try, showing that a supported, competency-based training program can be successful in supporting novice IPs in certification success., Conclusions: Building foundational knowledge on key concepts in infection prevention and control and enhancing learning through supervised, direct application of skills improves CIC certification exam pass rates and supports progression of early career IPs to more independent practice., (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Mentoring plays a pivotal role in mentees' professional advancement. However, the factors that affect career progression in informal mentoring relationships, especially with respect to faculty members, have not been extensively explored. This study aimed to explore the factors that affect career progression in informal faculty mentorings within mentor and mentee relationships., Methodology: A Qualitative Exploratory Study was designed and conducted from May to October 2023. Faculty members with informal mentoring relationships were recruited through purposive sampling. Seven faculty mentors and eight faculty mentees from various institutions participated in the study. Semi-structured interviews were used to collect data, which were audio-recorded and verbatim transcribed. The transcripts were then analysed using NVivo Software and coded. Braun and Clark's framework was used for the thematic analysis. The study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist to ensure comprehensive and transparent reporting of the qualitative research process., Results: A total of 76 codes emerged which were classified into six themes: (1) an ideal mentee, (2) an ideal mentor, (3) factors promoting the relationship, (4) the role of gender, (5) factors deteriorating the relationship, (6) overcoming barriers / trust-building strategies. Within each theme, mentor-mentee needs and behaviours were identified, which could lead to positive or deteriorating outcomes., Conclusion: Factors affecting career progression in informal faculty mentoring sessions include mentees' positive mindset, internal motivation and clarity of vision, mentors' skills, reputation, and role modelling. Effective communication, trust, respect, and clear goals are also essential. Challenges, such as busy schedules, cross-gender mentoring, and societal biases, affect these relationships. Overcoming these barriers involves sharing experiences, psychosocial support, empathy, active listening, and feedback., (© 2024. The Author(s).)

Background: Emergency nurses are the first clinicians to see patients in the ED; their practice is fundamental to patient safety. To reduce clinical variation and increase the safety and quality of emergency nursing care, we developed a standardised consensus-based emergency nurse career pathway for use across Australian rural, regional, and metropolitan New South Wales (NSW) emergency departments., Methods: An analysis of career pathways from six health services, the College for Emergency Nursing Australasia, and NSW Ministry of Health was conducted. Using a consensus process, a 15-member expert panel developed the pathway and determined the education needs for pathway progression over six face-to-face meetings from May to August 2023., Results: An eight-step pathway outlining nurse progression through models of care related to different ED clinical areas with a minimum 172 h protected face-to-face and 8 h online education is required to progress from novice to expert. Progression corresponds with increasing levels of complexity, decision making and clinical skills, aligned with Benner's novice to expert theory., Conclusion: A standardised career pathway with minimum 180 h would enable a consistent approach to emergency nursing training and enable nurses to work to their full scope of practice. This will facilitate transferability of emergency nursing skills across jurisdictions., Competing Interests: Declaration of Competing Interest Authors KC, MM, MF, RZS, JC, SK are creators HIRAID® education materials which are the subject of an intellectual property agreement with the University of Sydney. RZS is Editor-in-Chief and JC and MF are Senior Editors of Australasian Emergency Care but none of them had any role to play in the peer review and editorial decision-making of this paper whatsoever. An independent Backspace Acting Editor-in-Chief managed this paper. Other authors have no competing interests to declare., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: Existing evidence suggests that organisation-level policies are important in enabling gender equality and equity in the workplace. However, there is little research exploring the knowledge of health sector employees on whether policies and practices to advance women's career progression exist in their organisations. In this qualitative study, we explored the knowledge and perspectives of health managers on which of their organisations' workplace policies and practices contribute to the career advancement of women and their knowledge of how such policies and practices are implemented and monitored., Methods: We employed a purposive sampling method to select the study participants. The study adopted qualitative approaches to gain nuanced insights from the 21 in-depth interviews and key informant interviews that we conducted with health managers working in public and private health sector organisations. We conducted a thematic analysis to extract emerging themes relevant to advancing women's career progression in Kenya's health sector., Results: During the interviews, only a few managers cited the policies and practices that contribute to women's career advancement. Policies and practices relating to promotion and flexible work schedules were mentioned most often by these managers as key to advancing women's career progression. For instance, flexible work schedules were thought to enable women to pursue further education which led to promotion. Some female managers felt that women were promoted to leadership positions only when running women-focused programs. There was little mention of capacity-building policies like training and mentorship. The health managers reported how policies and practices are implemented and monitored in general, however, they did not state how this is done for specific policies and practices. For the private sector, the health managers stated that implementation and monitoring of these policies and practices is conducted at the institutional level while for the public sector, this is done at the national or county level., Conclusions: We call upon health-sector organisations in Kenya to offer continuous policy sensitisation sessions to their staff and be deliberate in having supportive policies and other pragmatic interventions beyond policies such as training and mentorship that can enable women's career progression., (© 2024. The Author(s).)

How do parenthood and publishing contribute to gender gaps in academic career advancement? While extensive research examines the causes of gender disparities in science, technology, engineering, and mathematics (STEM) careers, we know much less about the factors that constrain women's advancement in the social sciences. Combining detailed career- and administrative register data on 976 Danish social scientists in Business and Management, Economics, Political Science, Psychology, and Sociology (5703 person-years) that obtained a PhD degree between 2000 and 2015, we estimate gender differences in attainment of senior research positions and parse out how publication outputs, parenthood and parental leave contribute to these differences. Our approach is advantageous over previous longitudinal studies in that we track the careers and publication outputs of graduates from the outset of their PhD education and match this data with time-sensitive information on each individual's publication activities and family situation. In discrete time-event history models, we observe a ∼24 per cent female disadvantage in advancement likelihoods within the first 7 years after PhD graduation, with gender differences increasing over the observation period. A decomposition indicates that variations in publishing, parenthood and parental leave account for ∼ 40 per cent of the gender gap in career advancement, suggesting that other factors, including recruitment disparities, asymmetries in social capital and experiences of unequal treatment at work, may also constrain women's careers., (© 2024 The Authors. The British Journal of Sociology published by John Wiley & Sons Ltd on behalf of London School of Economics and Political Science.)

Objective: Researchers from underrepresented groups leave research positions at a disproportionate rate. We aim to identify factors associated with self-efficacy in career advancement and career commitment among underrepresented post-doctoral fellows and early-career faculty., Methods: Building Up is a cluster-randomized trial with 25 academic health institutions. In September-October 2020, 219 Building Up participants completed the pre-intervention assessment, which included questions on demographics, science identity, mentoring, self-efficacy in career advancement (i.e., advancement is open to me, confidence in career progression, confidence in overcoming professional barriers), and career commitment (i.e., intent to continue research training or studying in a field related to biomedical sciences). Using logistic and multinomial logistic regression, we identified characteristics independently associated with self-efficacy in career advancement and career commitment., Results: The cohort is 80% female, 33% non-Hispanic/Latinx Black, and 34% Hispanic/Latinx. Having mentors that address diversity was significantly associated with the belief that advancement is open to them (OR = 1.7). Higher science identity (OR = 4.0) and having mentors that foster independence (OR = 1.8) were significantly associated with confidence in career progression. Higher science identity was also significantly associated with confidence in overcoming professional barriers (OR = 2.3) and intent to continue studying in a field related to biomedical sciences (OR = 3.3). Higher age (OR = 2.3) and higher science identity (OR = 4.2) were significantly associated with intent to continue research training., Discussion: Science identity and mentoring play key roles in self-efficacy in career advancement and career commitment. These factors may contribute to retention of underrepresented early-career biomedical researchers., Competing Interests: None., (© The Author(s) 2024.)

Objective: Clinician-scientists are critical to medical innovation and research. However, the number of clinician scientists in the UK has been declining steadily over the last decade. One of the cited reasons is poor student recruitment to academic training pathways. The SMART study aims to assess current student perceptions on research and identify key factors influencing whether a student is interested in research., Design: We conducted a cross-sectional survey study between January and May 2022., Setting: This was a multi-centre national study with data collected across 40 universities offering medical courses in the UK., Participants: Participants were UK medical students enrolled in medicine for 21/22 academic year., Main Outcome and Measure: The main outcomes were related to participant perceptions on research and whether they were interested in engaging with research in their future career. These measures were correlated with demographic and non-demographic details using regression analyses., Results: One thousand seven hundred seventy-four individuals participated in the SMART survey from 40 medical schools. Nearly half the participants felt there were barriers preventing them from doing research (46.67%) and almost three-quarters felt it was at least somewhat difficult to combine research with medical school (73.49%). Of the options available, most commonly students did not want to pursue an academic career (43.11%) or training pathway (42.49%). However, most participants felt it was useful to do research at medical school (59.54%) and were also interested in doing more research in the future (69.16%). Regression analysis identified many factors influencing student's perceptions of research including year of study, gender, socioeconomic status, family background, research exposure at medical school, ethnicity, and country of pre-university education., Conclusions: The SMART study is the first of its kind in the UK, shedding light on medical student perceptions. While some express strong interest in academic careers, a larger proportion show a broader interest in research. Demographic factors like gender, parental occupation, and socioeconomic status play a role. Further exploration is needed for specific groups to address barriers, promote research, and boost academic pathway recruitment., (© 2023. The Author(s).)

Background: UK medical graduates can apply for specialty training after completing a 2-year internship (foundation training). Postfoundation training application requirements vary depending on specialty but fundamentally require key skills such as teaching, research, and leadership., Objective: This study investigated whether medical student demographics impact their self-reported familiarity with the Post-Foundation Training Pathways (PFTPs) and Post-Foundation Application Process (PFAP)., Methods: This was a cross-sectional study using a Bristol Online Survey. We invited all UK medical students to answer a range of questions about their demographics. Students were then asked to rank their familiarity with PFTPs and PFAP on a scale of 1 to 5 (1=least familiar and 5=most familiar). The responses were collected between March 2022 and April 2022 and exported for further analysis. Statistical analysis was conducted in Stata (version 17.1; StataCorp) using chi-square tests., Results: A total of 850 students from 31 UK medical schools took part. There was a significant difference between gender and self-reported familiarity with PFTPs (P<.001) and PFAP (P<.001), with male students expressing higher familiarity. Similarly, there was a difference between ethnicity and self-reported familiarity with PFTPs (P=.02) and PFAP (P<.001), with White students more likely to express higher familiarity than their Black, Asian, or Mixed Ethnic counterparts. Lastly, there was an overall difference between medical background and age and self-reported familiarity with PFTPs and PFAP (all P<.001), with students from medical backgrounds and older students being more likely to express higher familiarity., Conclusions: The impact of gender, ethnicity, age, and medical background on students' self-reported familiarity with PFTPs and PFAP is significant. Further studies are required to evaluate the impact of these factors on tested knowledge of PFTPs and PFAP and whether this impacts the success rate of postfoundation applications., (©Kaveh Davoudi, Tushar Rakhecha, Anna Chiara Corriero, Kar Chang Natalie Ko, Roseanne Ismail, Esther R B King, Linda Hollén. Originally published in JMIR Medical Education (https://mededu.jmir.org), 24.11.2023.)

Background: There is an under-representation of Black, Asian and minority ethnic nurses in senior positions within the UK's national healthcare system., Objectives: To understand student nurses' perspectives on the role of race and ethnicity on career expectations, course learning and delivery, and areas for additional training and skill development for all nurses in understanding structural inequalities in healthcare., Design: Qualitative study involving semi-structured interviews., Settings: University in south-east England, UK., Participants: 15 nursing students (14 women, one man) from a range of ethnic backgrounds, age-groups and nationalities., Methods: Interviews lasting 30-60 min were conducted with nursing students and thematic analyses undertaken., Results: Four inter-related themes were constructed: altered career expectations, lack of understanding, absent discussion of racism and missing representation. Experiences of racism were not uncommon for students from Black, Asian and minority ethnic backgrounds and these experiences affected these students' career expectations. Students described a lack of understanding about racism and that it was a taboo topic on their course and in placements., Conclusions: Findings highlight an urgent need for universities to challenge existing nursing curricula to ensure inclusive, anti-racist educational provision that works equitably for all future nurses. The importance of representation was highlighted among those who deliver courses, in the content of nursing curriculum through inclusive education, decolonised curricula and with student voices embedded to enable the development of culturally-competent nursing graduates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Introduction: Diversity, equality and belonging are important aspects within Allied Health Professional (AHP) groups. Mentoring is considered as a solution to improve career progression. To date, there is no consensus on what good mentoring looks like and whether current models are fit for purpose for Black and Minoritised Ethnicity AHPs., Methods: Scoping review to understand mentoring among Black and Minoritised Ethnicity (BME) AHPs through searches in four electronic databases using pre-defined criteria., Results: From 1440 studies screened, 2 studies were included in this review that researched mentoring for BME AHPs in a health and/or social care setting. Themes that emerged from the literature were related to access and amount of mentoring for BME AHPs, psychosocial mentoring may influence cross-race mentorship outcomes and organisational issues related to workforce pressures and management support. There is uncertainty around the importance of same race relationships in mentoring but there is some evidence that within cross-race mentoring this could influence outcomes., Conclusion: It is unknown if mentoring enables career success in BME AHPs. There is emerging evidence on the importance of psychosocial mentoring within cross-race relationships. Careful reflection and further research is needed on how current mentoring models work and ensure fair access to mentorship and support for BME AHPs., Competing Interests: Dr Vimal Sriram is a paid employee of NIHR Applied Research Collaboration. The author declares that this article presents independent research supported by the National Institute for Health Research (NIHR) under the Applied Health Research (ARC) programme for Northwest London. The views expressed in this publication are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health. The authors report no other conflicts of interest in this work., (© 2023 Atwal et al.)

Background: The quality of the academic workforce is influenced by multi-level interactionist factors yet there is limited research into these influencing factors., Aim: To investigate relationships between individual characteristics of Australian occupational therapy academics and work-related variables., Method: An exploratory cross-sectional online survey collected demographic data and used standardized scales including the Turnover Intention Scale, 9-item Utrecht Work Engagement Scale, Work-Life Balance Scale, Role Overload Scale and Self-Defined Burnout Scale. Data were analysed using descriptive and inferential statistics., Results: Academics who were more than five years in their current academic level were: significantly more likely to consider leaving their job; more often frustrated when not given opportunity to achieve their work-related goals; and less engaged. Those who had worked in higher education for longer than ten years were more likely to report role overload while participants working in higher education for less than five years were less likely to report burnout., Conclusions and Significance: To meet current and future demand for Australian occupational therapists, an engaged and supported academic workforce is needed. These findings suggest the need for attention to mentoring and career development particularly for those in academic levels longer than five years to increase work engagement and retention.

Introduction: With the rise in global migration, hospitals and health systems in developed countries are looking to supplement their workforces with migrant nurses who have been reported to feel devalued, underutilized with experience of deskilling and unmet expectations as they transitioned. Despite the plethora of literature reporting on the experiences of internationally trained nurses, only limited work has been done regarding understanding the experiences of Migrant African nurses. Thus, this study sought to synthesize existing qualitative studies to develop in-depth understanding of the transitioning experiences of migrant African nurses, their career progression and to highlight existing gaps to guide future studies as well as inform policies., Method: A meta-synthesis was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Enhancing transparency in reporting the synthesis of qualitative research statement. A pre-planned search strategy was developed guided by the SPIDER tool for qualitative synthesis searching EMBASE via OVID, CINAHL via EBSCO, PubMed, Web of Science, and PsychINFO databases. We included published studies that 1) focused on migrant African nurses, 2) employed a qualitative design and 3) reported in English., Results: The search yielded 139 studies of which nine studies met the inclusion criteria and included in final synthesis. Three themes with corresponding subthemes emerged from data synthesis: 1) Navigating reality shock (a. Navigating a new culture, b. Survival strategies and support amidst the shock); 2) Discrimination and limited opportunities for promotion (a. Prejudices and preference for White over Black, b. Lack of recognition and limited opportunities for a workplace promotion); and 3) Finding one's feet (a. Standing up for oneself and looking beyond discrimination, b. Experiencing growth)., Conclusion: Transitioning to a new setting can be a challenging experience for migrant African nurses warranting the availability of a tailor-made adaptation or orientation programme. Though African nurses may experience discrimination and prejudices as part of their transition, they consider their situation to be better off compared to back home. Therefore, clear transitioning policies which focus on career pathways are required by hiring institutions, and migrant nurses should be proactive in taking active roles in pushing their career ahead, instead of maintaining a culture of silence., (© 2023. The Author(s).)

Introduction: In order to meet the rising demands for imaging and radiotherapy services, the chronic workforce deficits experienced in many countries must be addressed. Improving workforce retention is essential; factors influencing radiographer attrition from the NHS have been previously reported as challenging working patterns, lack of flexibility in working patterns and lack of timely career progression and CPD. This article explores how these influencing factors for radiographers to leave the NHS change at different stages of the career trajectory., Methods: A qualitative research design using framework analysis explored via semi-structured telephone interviews (n = 44) the perspectives of radiography managers, radiographers who have left the NHS, and those considering leaving. Purposive sampling ensured representation across radiography disciplines, geographical and organisational diversity, and stages of career., Results: The application of Generation Theory revealed how the emphasis on the influencing factors to leave or remain within the NHS changes across the working life of radiographers. Early career radiographers were found to be a more transient workforce leaving for increased career opportunities, mid-career radiographers were more likely to leave due to the lack of progression and CPD and late career radiographers due to the inflexibility of working patterns and conditions. It is imperative managers consider the needs and requirements of each generation of radiographers to improve radiographer retention., Conclusions: The different needs between the generations of radiographers should be viewed in terms of the strengths that they may bring to the workplace, rather than the challenges that they may pose. This generational timeline does not stand still and the learning is a continuous process., Impact on Practice: Recommendations are presented which will be a catalyst for sharing of best practice between radiology and radiotherapy centres., Competing Interests: Conflict of interest statement None., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background and Aim: The COVID-19 pandemic, the new Intercollegiate Surgical Curriculum Programme curriculum and the European Work Time Directive significantly reduced surgical exposure for trainees. This study analyzed the operative experience of Phase 1 trainees (CT1/ST1 vs. CT2/ST2) against the Annual Review of Competence Progression (ARCP) criterion of 120 procedures yearly., Methods: National survey research in October 2021. Study end-point was the completion of >4 weekly procedures, equivalent to 120 cases per year. Chi-square test and multivariate regression analysis were performed., Results: 205 participants from 5 Deaneries were included, 48.3% were CT1/ST1 and 51.7% were CT2/ST2. About 54.5% of year-1 and 50% of year-2 trainees were 28 30 years old, 55.6% and 50.9% were male, and 39.4% and 38.7% were White British. About 39.4% of CT1/ST1 and 22.6% of CT2/ST2 performed <4 weekly procedures (P = 0.01), with no difference in the "Observed" (P = 0.6) or "Assisted" (P = 0.3) number of cases. CT2/ST2 recorded more "ST-S" (p 0.04), "S-TU" (P = 0.03), and "Performed" (P = 0.02) operations. For CT1/ST1, older age (HR 2.4, 95% CI [1.1; 5.3], P = 0.02) and southern deaneries (HR 1.7, 95% CI [1.2; 2.4], P = 0.004) were independent factor for <4 weekly procedures. For CT2/ST2, northern regions were associated with more favorable training (HR 1.4, 95% CI [1.1; 1.7], P = 0.01)., Conclusion: Over one third of Phase 1 trainees do not meet the ARCP requirement of >120 procedures annually. Age and region of training are independent factors in the number of logbook cases., Relevance for Patients: This research focuses on training opportunities for junior surgical residents across the United Kingdom. The degree and type of exposure to the operating theatre have a significant impact on the development of surgical competencies. These are undoubtedly related to patient outcomes, as the quality of care delivered to patients and relatives greatly relies on the training background of future consultant surgeons., Competing Interests: Nothing to declare., (Copyright: © 2022 Author(s).)

The UK regulatory body for registered veterinary nurses (RVNs), the Royal College of Veterinary Surgeons (RCVS), maintains the professional register of RVNs. Every year, a proportion fail to re-join the register. This research aimed to identify the factors that predict retention and to make recommendations to inform the Royal College of Veterinary Surgeons as the regulator as well as both the veterinary nursing and veterinary professions. An analysis of the raw quantitative data generated by the 2014 and 2019 RCVS surveys of the veterinary nurse profession was undertaken using multivariable logistic regression analysis. First, bivariable associations were estimated using unadjusted odds ratios to explore whether there are any (unconditional) associations between each predictor and the outcome. Predictors that were significant unconditional predictors of intention to leave were then entered into a multivariable logistic regression, yielding adjusted odds ratios. Quantitative analysis found significant relationships between intention to leave and the following factors in both the 2014 and 2019 survey data: job satisfaction; believing that veterinary nursing offers good opportunities for career progression; satisfaction with employer support; and having a second job. The following factors were significant in 2014, but not in 2019: undertaking nurse clinics, feeling valued, and being respected by veterinary surgeons. The factors that influence the retention of registered veterinary nurses (RVNs) within the profession are multifactorial and individual. Nurses are responsible for ensuring that those they work with are aware of their skill set and that they themselves are accountable for utilisation of those skills. When veterinary nurses are supported by their employers, they are more likely to stay in the profession. Having a clearly defined career structure and mapped routes for progression will be helpful with retention. A sense of job satisfaction was another important factor in retention. A pay structure linked to a career pathway framework, such as in human-centred nursing, is an area for further work., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Jeffery and Taylor.)

Aim: To explore the experiences of female registered nurses (RNs), who encounter workplace gender discrimination in nursing., Design: This study used a qualitative exploratory design informed by feminist perspectives and was underpinned by social constructionism., Methods: Women who were RNs (N = 10) and employed in New South Wales (NSW) were purposively selected to convey their experiences of workplace gender discrimination. Data were collected through semi-structured interviews, between April and July 2020. Analysis was guided by the work of Anderson and Jack (Women's words; 1991) who recommend three ways of listening. Interviews were transcribed verbatim and Braun and Clarke's (Qualitative Research in Psychology, 3, 77-101; 2006) six-step guide was used to develop themes., Results: Thematic analysis revealed five overarching themes: It's a man's world; Gender stereotypes; Being a woman and nurse; Reluctance to call out gender discrimination and The status quo. Findings from this study highlighted that participants believed men's career progression in nursing were favoured over women., Conclusion: Findings from this research highlight that socially constructed gendered norms continue to form the basis of inequality for women in the workplace. Fostering and sustaining workplace cultures that support family and work life balance, and that do not discriminate against women, is fundamental to ensuring equality for women., Impact: There is limited qualitative research into women's experiences of workplace gender discrimination in nursing. This research highlights the need for workplace strategies to be implemented to ensure women are better supported and equally represented in leadership positions and advanced practice roles in nursing. All nurses should be given equal consideration based on experience and qualifications. Career development and progression opportunities should be fair, equitable and transparent with clearly documented criteria., (© 2021 John Wiley & Sons Ltd.)

Objective: To evaluate undergraduate biomedical education student opinions and expectations on mentorship., Methods: A survey was administered to students enrolled in the undergraduate biology, neuroscience and nursing programs at a large public research-intensive university. The survey queried demographics, previous mentorship experiences, ideal qualities of mentors, benefits/value of mentorship and future plans for seeking mentorship. Survey responses were evaluated using either t-test comparisons or one-way ANOVA., Results: The majority of the respondents were female and were interested in pursuing professional schools (nursing and medicine). Survey results indicate high student interest in receiving mentoring, but few were active participants in a mentoring relationship. Respondents indicated either lack of knowledge or discomfort in identifying a mentor. While faculty mentors versus peer mentors were preferred, respondents indicated that mentoring by either faculty or peers would be of value. Survey results indicate that desired benefits of mentoring included guidance in future education and career decisions, networking and career advice., Conclusion: The major conclusions are that despite high student interest in being mentored, their participation in mentoring is very low. These finding are supportive of the development of structured mentoring programs to facilitate and enhance mentoring of undergraduate STEM students and aid in their academic career progression., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

An intercalated degree offers medical students an avenue to explore their interests and become competent in scientific literacy. Although intercalating can pose a financial burden and time commitment, they do provide competitive academic and speciality training applications. The aim of this review was to explore academic development and subsequent outcomes of career progression. Medline and EMBASE were systematically searched using keywords. After the removal of duplicates, the studies were screened against the inclusion criteria. For the five studies included in this review, a narrative synthesis was performed. The two main themes were academic development and career progression. All studies showed a plethora of academic achievements during and after intercalation. Two studies showed that students are more likely to enter a career in academic medicine. A further two studies have shown that the transferable skills of academia have allowed alumni to make more competitive applications for foundation year and speciality training. The results have shown a correlation between academic achievements and an increase in competitiveness in foundation programmes and speciality applications. There are clear discrepancies in the success of academic careers depending on the institution and type of intercalated degree. Current literature suggests a master's degree results in more academic success compared to a bachelor's degree. Due to the sheer diversity of intercalated degrees offered to medical students in the UK, there is limited literature on post-graduate career progression. More research should be undertaken to look at the implications of intercalation on post-graduate career progression., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, El-hassan et al.)

Background: The measures put in place by health authorities to ensure the professionalism of doctors are important. Hospitals in China have included academic outputs in the promotion criteria to incentive medical clinicians to engage in scientific research so that to improve job performance (JP). However, such practice disproportionally focuses on academic outputs but ignores the force of needs fulfilled brought by intrinsic incentive. This study aims to discuss the realistic problem regarding the promotion mechanism and the potential drivers to clinical JP., Methods: This study was based on multi-source data collection on clinical performance from electric medical record (EMR), person-environment (P-E) fit from the survey, and academic output from personnel files of ward clinicians ( n = 244) of general public hospitals who sought for career progression in Shanghai in 2020. Independent-Sample t -test and chi-square test were used for comparison of two sample means or constituent ratio between promoted and not promoted clinicians. Linear multilevel regression was conducted to examine the relationship between clinical performance and academic outputs and P-E fit., Results: Clinicians who were promoted were more productive in producing academic outputs than those who were not ( t = -5.075, p < 0.001). However, there was no difference in clinical performance between the two groups ( t = -1.728 to 0.167, p > 0.05). The regression showed that academic outputs were not related to clinical performance, while higher P-E fit was associated with the improvement of various clinical performances., Conclusion: This study shows that P-E fit plays a more important role in facilitating clinical performance than academic performance and highlights the importance of intrinsic motivation of clinicians in achieving clinical performance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dong, Xiao, Shi, Zeng, Wu and Li.)

Based on a collection of auto-ethnographic narratives that reflect our experiences as academic mothers at an Australian university, this paper seeks to illustrate the impact of COVID-19 on our career cycles in order to explore alternative feminist models of progression and practice in Higher Education. Collectively, we span multiple disciplines, parenting profiles, and racial/ethnic backgrounds. Our narratives (initiated in 2019) explicate four focal points in our careers as a foundation for analyzing self-definitions of professional identity: pre- and post-maternity career break; and pre- and post-COVID-19 career. We have modeled this research on a collective feminist research practice that is generative and empowering in terms of self-reflective models of collaborative research. Considering this practice and these narratives, we argue for a de-centering of masculinized career cycle patterns and progression pathways both now and beyond COVID-19. This represents both a challenge to neo-liberal norms of academic productivity, as well as a call to radically enhance institutional gender equality policies and practice., (© 2021 John Wiley & Sons Ltd.)

Recruitment and retention are of major concern to all in medicine. Improvement in recruitment to UK speciality training programmes does not directly translate into senior workforce capacity, which remains dependent on trainee progression. In 2021, Silkens et al undertook a mixed-methods study to investigate this and described a trainee-driven shift away from conventional training pathways and expectations. These findings suggest a need for a broad change in approach to careers, underpinned by commitment to reducing differential attainment, acknowledgment that trainees may have a range of unique needs, and development of a culture of equality, diversity and inclusion.

This article examines the link between terms of employment (full time, part time and casual) at an Australian regional university and women's career progression. The literature identifies lack of transparency in recruitment, promotion and retention; mobility and location; and management perceptions of women's choice to work flexibly as factors impacting on career progression. However, the voices of women working in regional universities and particularly those of professional staff are often not present in current research. This study moves towards addressing this research deficit. Feminist institutionalism is used to analyse the relationship between national legislation, university policies and informal institutional practices in relation to women's career progression In early 2020, twenty-one women provided written responses to questions on the link between terms of employment and career progression. The main findings tend to support other research about women working in universities; that is, carers need flexible work arrangements. But there are particular differences for women in regional universities who have to travel between dispersed campuses, which brings an added dimension of complexity to career progression. Their choices about terms of employment and fulfilling carer responsibilities resulted in insecure employment for some participants which had an impact on wellbeing and confidence. In addition, care/household responsibilities and the choice to work flexibly had a negative effect on career progression, and managers did not necessarily support flexible work options (despite national legislation that enables employees with child care responsibilities to negotiate flexible work arrangements with managers, and institutional gender equality policies)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 White and Goriss-Hunter.)

Background: The challenge of research funding constraints has brought to bear enormous pressure on researchers. Research productivity is relevant to prestige and career progression of academic staff. However, this study aimed to explore significant challenges associated with researchers' productivity and the impact of non-funding of research in Nigerian research and tertiary institutions. Methods: This study adopted a qualitative exploratory design involving academics at various research and tertiary institutions across the six geographical regions in Nigeria. A semi-structured questionnaire was distributed electronically to all participants who consented to take part in this study. Exactly 4,159 questionnaires were administered and 2,350 were completely filled and returned. Pearson correlation matrices with logistic regression were used for data analysis and are presented in frequencies and percentages. Results: On challenges faced by respondents, 42.98% reported a lack of research funding, 17.11% mentioned brain drain challenge while 8.85% indicated a lack of motivation. Of the 23,927 publications reported, the number of those in sciences, engineering, and medical sciences averaged 9.6, 11.5, and 9.5 respectively. The average number of publications by women (10.8) was more than by men (9.7). Lecturers had the highest average research publication number (11.8) followed by researchers (10.2) and others (3.9). Men had the highest (11.9) average number of conferences compared to women (9.2). Participants in engineering had an average number of 13.8 conferences per respondents followed by those in education (11.2), sciences (11.1), and 10.9 for those in agricultural sciences. The result revealed a negative significant correlation between research publication and academic qualification at p < 0.01. Positive significant correlation was observed between research productivity and discipline at p < 0.05. Findings show that the combined influence of the independent variables on research productivity was significant using linear regression analysis. Conclusions: The failure to prioritize research has resulted in underdevelopment in Nigeria. It is therefore imperative that the federal government prioritize research and establish a functional Special Research Trust Fund to oversee research funding in Nigeria., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Igiri, Okoduwa, Akabuogu, Okoduwa, Enang, Idowu, Abdullahi, Onukak, Onuruka, Christopher, Salawu, Chris and Onyemachi.)

Background: International medical graduates (IMGs) have a primary medical qualification obtained from outside their country of practice. In the United Kingdom (UK), postgraduate medical training after foundation years involves obtaining a national training number (NTN) in their specialty of choice by national selection. In this paper, we aim to quantify how IMGs feel to obtain an NTN and what unique obstacles they may face in doing so., Materials and Methods: A survey with a combination of closed and open-ended questions was circulated to IMGs via social media and text message. The survey was aimed at those IMGs practising at a middle grade (non-consultant) level, whether they had obtained a training number or not. Data collected included demographics, years of postgraduate experience before UK arrival, number of attempts at obtaining a training number, and the most significant perceived difficulty to obtaining a training number. We also asked whether difficulties in obtaining a training number would cause IMGs to contemplate changing specialty. Data from the survey responses were analysed using SPSS 22., Results: Out of a total of 203 doctors approached, 197 responded, of which the majority were male. All responders had at least five years of postgraduate experience before relocating to the UK. Only 56 (28.8%) had a training number at the time of the survey. Almost all the responders had made at least one unsuccessful attempt to obtain a training number. In addition, 152 (76.6%) of responders felt that timely career progression in the UK was unlikely without having a training number. 57 (29.6%) of responders considered changing specialty due to inability to obtain a training number., Conclusion: Obtaining an NTN remains a crucial goal among IMGs in the UK, despite the obstacles and repeated failures in doing so., Competing Interests: There are no conflicts of interest on the part of the authors preparing this manuscript., (© 2021 The Authors.)

In the United Kingdom, undergraduate students from Black, Asian and other minority ethnic backgrounds receive lower classes of degrees than white students, and similar gaps have been reported in other countries. Such award gaps limit ethnic diversity in academic research, and in the broader job market. Whilst there has been some success in reducing the award gap in the UK, a significant gap still persists. Here, based on an analysis of students studying cell biology at University College London, I show that differences in performance at exams contribute significantly more to the award gap than differences in performance in coursework. From these data, plus scrutiny of the literature, alternative policies are identified to speed up the closure of the award gap and to remove the barriers that prevent students from Black, Asian and other minority ethnic backgrounds from progressing to PhD and postdoctoral positions., Competing Interests: LC No competing interests declared, (© 2021, Cramer.)

Introduction: In many countries a widening imbalance exists between radiographer workforce supply and demand. Improving retention is a rapid method of workforce expansion which is gaining importance with policy makers and providers. To better understand the current leaver profile, this study aimed to identify why radiographers leave the NHS early, and what incentives are important in their decision to stay., Methods: A qualitative framework methodology used semi-structured telephone interviews to explore the perspectives of radiography managers, radiographers who have left the NHS, and those considering leaving. Purposive sampling ensured representation across radiography professional groups, geographical and organisational diversity, and stages of career., Results: Three over-arching themes were identified across all radiographer professional groups (n = 44): 1) Challenging working patterns and the impact on employee health and wellbeing; 2) Lack of flexibility in working terms and conditions; 3) Lack of timely career progression and access to CPD, and the need to feel valued. Radiographers were keen to express how they 'loved being a radiographer'; small concessions and changes to workplace culture might be the incentive to remain in radiography that some were clearly searching for. Manager participants recognised the need to offer greater flexibility in working patterns but this was challenging within financial and service delivery constraints., Conclusions: While some influencing factors varied between radiographer professional groups, the three themes were consistent across participants. Failure to address these concerns will exacerbate the loss of experienced and highly trained staff from the NHS at a time when demand for services continues to rise., Impact on Practice: Recommendations are presented related to three primary themes which will be a catalyst for sharing of best practice between radiology and radiotherapy centres., (Copyright © 2021 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.)

Introduction: The general medical council (GMC) conducts the National Training Survey (NTS) annually. Part of the survey illustrates the statistics of United Kingdom medical school graduates in core and speciality application. We aimed to review the speciality training application and performance of graduates of Queen's University Belfast (QUB), and compared with graduates of medical schools in England, Scotland, and Wales., Method: The progression reports from the GMC NTS 2016-2019 were accessed on the GMC website. All data available were extracted in April 2020. The mean results for all graduates of 33 UK medical schools in Northern Ireland, England, Scotland, and Wales were collated from the NTS. Applications to the seven specialities with the greatest number of posts available across the UK were analysed., Results: No differences were noted in the majority of the application stages when comparing graduates from QUB with other UK medical school graduates. However, QUB graduates were less likely to be invited for an interview when applying for core surgical training AND receive an offer for Core Anaesthetic and ACCS Training. QUB graduates were less likely to apply for General Practice training., Conclusion: Our study evaluates the performance of QUB graduates compared to other UK medical graduates in core/speciality application. Based on our findings, QUB and postgraduate deaneries may consider focussing on strengthening applications for aspiring surgeons, improving interview performance for anaesthetics and ACCS applicants, and attracting trainees to pursue a career in General Practice., (Copyright © 2021 Ulster Medical Society.)

This study examined individual, task, and environmental constraints that influence the career progression of youth Brazilian elite basketball players and the probability of reaching Novo Basquete Brasil (NBB) and to determine if the association of the relative age effect (RAE) is a key factor in the career progression. The sample consisted of 4,692 male players who were registered to participate in at least one U15, U17, or U22 youth Brazilian basketball championship between 2004 and 2018. Athletes who reached a high-performance level were coded like NBB players (9.6%). The birthdates, height, body mass, playing position, geographic region, club, competition category, and team performance were retrieved from the official data archive of the Brazilian Basketball Confederation and the National Basketball League. The maturity status was estimated using the predicted age at peak height velocity. A binary logistic regression examined the influence of each characteristic on the probability of a youth Brazilian basketball player to reach the NBB. The receiver operating characteristic (ROC) curves and the associated area under the curve (AUC) were used to assess the discriminant ability of the model. The taller and younger players not selected early into national teams, without specialization by playing position, who participated in U22 national championship, migrated to the southeast region, and remained in the formation process over time have a greater chance to reach the NBB. The ROC curve demonstrated an AUC of 93%. A combination of individual, task, and environmental characteristics influences the sport career of a young Brazilian basketball player in reaching the NBB. Further, early-maturing athletes have a greater chance to reach higher performances. RAE influences lower-level categories, but not a "NBB player's" career progression. The coaches, stakeholders, and practitioners should perform a holistic evaluation of sport talent in terms of a constraint-based theoretical model with the aim of avoiding bias produced by the maturational status and RAE in the youth Brazilian elite basketball., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Ribeiro Junior, Werneck, Oliveira, Panza, Ibáñez and Vianna.)

Objective: To identify strategies and barriers to career progression in early-career colorectal surgeons., Design: Qualitative research study performed via semi-structured interviews with early-career, board-certified colon, and rectal surgeons. Responses were analyzed, coded, and categorized to understand strategies towards career progression, perceived barriers to career progression, beliefs about case mix, and referral patterns., Setting: Interviews conducted in person and via telephone across the United States and Canada., Participants: Early-career board-certified colorectal surgeons RESULTS: Twenty-two board-certified colorectal surgeons currently employed in 14 states and 1 foreign country were interviewed. Fourty-five percent were female. Their current practice environment was described as academic (77%), private practice (18%), or military (5%). Seventy-seven percent of surgeons were satisfied with their career progression. Seventy-two percent were satisfied with the case volume. Seventy-two percent were satisfied with their case mix. When asked about strategies for career progression, surgeons made 77 comments focused on three main themes: optimization of their job search, optimization of relationships while on the job, and efforts to augment individual achievement. When asked about barriers to career advancement, surgeons most frequently commented on a lack of time and a lack of mentors. When asked about case mix, 63% of surgeons felt that they had no control over it. They were evenly divided between believing that a broad case mix or a niche specialized case mix was more instrumental for career progression., Conclusions: Early-career colorectal surgeons were mostly satisfied with their career progression, volume, and case mix. In discussing their careers, many have developed a number of strategies focused on growth as an individual as well as relationship building. They also identified a number of barriers including lack of time and lack of mentorship. Early-career surgeons may be able to utilize these strategies and anticipate barriers prior to starting their first job, leading to greater likelihood of career satisfaction., (Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

The academic disciplines of Science, Technology, Engineering and Mathematics (STEM) have long suffered from a lack of diversity. While in recent years there has been some progress in addressing the underrepresentation of women in STEM subjects, other characteristics that have the potential to impact on equality of opportunity have received less attention. In this study, we surveyed 188 early career scientists (ECRs), defined as within 10 years of completing their PhD, in the fields of ecology, evolutionary biology, behaviour, and related disciplines. We examined associations between ethnicity, age, sexual orientation, sex, socioeconomic background, and disability, with measures of career progression, namely publication record, number of applications made before obtaining a postdoc, type of contract, and number of grant applications made. We also queried respondents on perceived barriers to progression and potential ways of overcoming them. Our key finding was that socioeconomic background and ethnicity were associated with measures of career progression. While there was no difference in the number of reported first-authored papers on PhD completion, ethnic minority respondents reported fewer other-authored papers. In addition, ECRs from a lower socioeconomic background were more likely to report being in teaching and research positions, rather than research-only positions, the latter being perceived as more prestigious by some institutions. We discuss our findings in the context of possible inequality of opportunity. We hope that this study will stimulate wider discussion and help to inform strategies to address the underrepresentation of minority groups in the fields of ecology and evolution, and STEM subjects more widely., Competing Interests: None declared., (© 2020 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Objectives: Because culture reflects leadership, the making of diverse and inclusive medical schools begins with diversity among leaders. The inclusion of women leaders remains elusive, warranting a systematic exploration of scholarship in this area. We ask: (1) What is the extent of women's leadership in academic medicine? (2) What factors influence women's leadership? (3) What is the impact of leadership development programmes?, Design: Systematic review., Data Sources: A systematic search of six online databases (OvidMEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library and ERIC) from the earliest date available to April 2018 was conducted. Bridging searches were conducted from April 2018 until October 2019. ELIGIBILITY CRITERIA: (1) Peer-reviewed; (2) English; (3) Quantitative studies (prospective and retrospective cohort, cross-sectional and preintervention/postintervention); evaluating (4) The extent of women's leadership at departmental, college and graduate programme levels; (5) Factors influencing women's leadership; (6) Leadership development programmes. Quantitative studies that explored women's leadership in journal editorial boards and professional societies and qualitative study designs were excluded., Data Extraction and Synthesis: Two reviewers screened retrieved data of abstracts and full-texts for eligibility, assessment and extracted study-level data independently. The included studies were objectively appraised using the Medical Education Research Quality Study Instrument with an inter-rater reliability of (κ=0.93)., Results: Of 4024 records retrieved, 40 studies met the inclusion criteria. The extent of women's leadership was determined through gender distribution of leadership positions. Women's leadership emergence was hindered by institutional requirements such as research productivity and educational credentials, while women's enactment of leadership was hindered by lack of policy implementation. Leadership development programmes had a positive influence on women's individual enactment of leadership and on medical schools' cultures., Conclusions: Scholarship on women's leadership inadvertently produced institute-centric rather than women-centric research. More robust contextualised scholarship is needed to provide practical-recommendations; drawing on existing conceptual frameworks and using more rigorous research methods., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Intersectionality theory is concerned with integrating social characteristics to better understanding complex human relations and inequalities in organizations and societies (McCall 2005). Recently, intersectionality research has taken a categorical and quantitative turn as scholars critically adopt but retain existing social categories to explain differences in labour market outcomes. A key contention is that social categories carry penalties or privileges and their intersection promotes or hinders the life chances of particular groups and individuals. An emergent debate is whether the intersection of disadvantaged characteristics (such as female gender or minority ethnic status) produce penalties that are additive, multiplicative or ameliorative. Research is inconclusive and as yet pays little attention to moderating factors such as employer type, size, geographic location or work profile. Drawing on administrative records for individuals qualified as solicitors in England and Wales, collected by the Solicitors Regulation Authority (SRA), combined with aggregated workforce data and firm characteristics of their law firms, we undertake a statistical analysis of the intersection of gender and ethnicity in the profession with a degree of precision and nuance not previously possible. In response to calls to broaden studies of inequalities and intersectionality beyond their effect on pay or income (Castilla 2008) we focus on career progression to partnership as our key measure of success. The original contribution of our study is twofold. First, we establish statistically different profiles of law firms, showing how the solicitors' profession is stratified by gender, ethnicity and socio-economic background, as well as the type of legal work undertaken by developing a model of socio-economic stratification in the profession. Second, we demonstrate that while penalties tend to be additive (i.e. the sum of the individual ethnic and gender penalties) this varies significantly by law firm profile and in some situations the effect is ameliorative., (© London School of Economics and Political Science 2018.)

Background: The aim of this study is to highlight career paths of senior women leaders in academic emergency medicine (EM) to encourage younger women to pursue leadership., Methods: This was a qualitative study using semi-structured interviews with female EM leaders. We interviewed 22 recognized female leaders selected using criterion-based sampling and a standardized script of open-ended questions derived from the Intelligent Career Model. Questions were related to job purpose, skills, and networking. Interviews were transcribed verbatim and three trained reviewers analyzed transcripts following grounded theory principles and using Dedoose®. Researchers used an iterative process over several meetings to produce the final set of codes and themes., Results: Our iterative process identified four themes: women leaders made an intentional decision to pursue opportunities to influence emergency medicine, women sought out natural mentors and sponsors to facilitate career development, women leaders intentionally planned their out of work life to support their leadership role, and an important focus for their work was to help others achieve excellence., Conclusions: Our study provides insights from senior female leaders in EM; supporting the value of women pursuing leadership. There is a widely acknowledged need to diversify leadership and support gender-specific needs to develop women leaders in medicine. Becoming a woman leader in EM means making intentional decisions and taking risks. Leaders found benefits in natural mentors and sponsors. Those relationships have power to change the trajectory of emerging women leaders by identifying and reinforcing potential. Work/life balance remains an area which requires intentional planning. Woman leaders encourage succession planning and corroborate the need for increasing the percentage of women leaders to benefit the organizational culture. Leadership in academic medicine is changing with reorientation of a largely autocratic, vertically oriented hierarchy into a more democratic, consensus-driven, and horizontally organized management structure which should complement the strengths women bring to the leadership table.

This study examined the association between individual and team characteristics and the probability of being offered a second contract in professional Australian Football. Contract status was obtained from the AFL for players who were drafted in the AFL National Draft between 1999 and 2013 (n = 999). Individual player characteristics were retrieved from the AFL while variables relating to performance were accessed online via Champion Data®. A binary logistic regression examined the influence of each characteristic on the probability of a professional Australian Football player receiving a second contract. Receiver operating characteristic (ROC) curves and the associated AUC were used to assess the discriminant ability of both a training (n = 938) and test data set (n = 61). The characteristics that influenced the probability of receiving a second contract included first year debut (pr 0.606), draft order (pr - 0.126), draft year (pr 0.059), games played (pr 1.848), team state (pr 0.458), rising star nomination (pr 1.553) and team ladder position (pr -0.043) (χ 2 (8) = 198.28, p < 0.001). The ROC curve demonstrated an AUC of 82.4% (training) and 76.0% (test). A combination of individual and team based characteristics are associated with early career progression in professional Australian Football.

Objective To identify organizational barriers to and facilitators for female surgeons' career progression. Design Systematic review of qualitative and quantitative studies relating to organizational barriers to and facilitators for female Surgeons' career progression. After the quality assessment of the peer-reviewed journal articles, twelve articles were selected for full review. Thematic analysis was used to identify key themes in these selected articles. Setting The studies solely focused on organizational factors linked to female physicians' career progression in surgical specialties. Partcipants Female surgeons. Main outcome measures Organizational barriers and facilitators Results Twelve peer-reviewed journal articles were included in the study which focused on barriers to female surgeons' career progression, ways of facilitating female surgeons' career progression, and female surgeons' job satisfaction. Conclusion The major organisational factors contributing to the lack of career progression for female surgeons are (1) organizational culture which promotes rigid career structure that is inclined to support male surgeons than female surgeons and also male domination in which male surgeons feel superior to female surgeons (2) work family conflict whereby women feel that they have to make a family sacrifice by being women; they experience the difficulty in securing a work-life balance in the masculine career structure in surgical specialties. This implies that policy makers and healthcare organizations need to pay significant attention to organizational facilitators for female surgeons' career progression such as flexible career pathways and work patterns, a variety of different viable career progressions, more family-friendly working conditions, and the promotion of female mentors and role models in surgical specialties to support female surgeons in dealing with the organizational barriers in the male-dominated organizational culture and the lifestyle issues as well.

Reflective practice is a paper requirement of your career progression in health care. However, if done properly, it can greatly improve your skills as a health care provider. This article provides some structure to reflective practice to allow a health care provider to engage more with reflective practice and get more out of the experience.

Progressing up the medical career ladder is a tough business. Most medical and surgical applications center the requirement for a holistic, balanced individual. As a result, there are usually specific marking criteria in predefined sections. This article provides a guide into what employers are looking for and how best to build your portfolio in these areas.

Background: The World Health Organization's Global Code on the International Recruitment of Health Personnel urges Member States to observe fair recruitment practices and ensure equality of treatment of migrant and domestically-trained health personnel. However, international medical graduates (IMGs) have experienced difficulties in accessing postgraduate training and in progressing their careers in several destination countries. Ireland is highly dependent on IMGs, but also employs non-European Union (EU) doctors who qualified as doctors in Ireland. However, little is known regarding the career progression of these doctors. In this context, the present study assesses the determinants of career progression of non-EU doctors with particular focus on whether barriers to progression exist for those graduating outside Ireland compared to those who have graduated within., Methods: The study utilises quantitative data from an online survey of non-EU doctors registered with the Medical Council of Ireland undertaken as part of the Doctor Migration Project (2011-2013). Non-EU doctors registered with the Medical Council of Ireland were asked to complete an online survey about their recruitment, training and career experiences in Ireland. Analysis was conducted on the responses of 231 non-EU hospital doctors whose first post in Ireland was not permanent. Career progression was analysed by means of binary logistic regression analysis., Results: While some of the IMGs had succeeded in accessing specialist training, many experienced slow or stagnant career progression when compared with Irish-trained non-EU doctors. Key predictors of career progression for non-EU doctors working in Ireland showed that doctors who qualified outside of Ireland were less likely than Irish-trained non-EU doctors to experience career progression. Length of stay as a qualified doctor in Ireland was strongly associated with career progression. Those working in anaesthesia were significantly more likely to experience career progression than those in other specialities., Conclusions: The present study highlights differences in terms of achieving career progression and training for Irish-trained non-EU doctors, compared to those trained elsewhere. However, the findings herein warrant further attention from a workforce planning and policy development perspective regarding Ireland's obligations under the Global Code of hiring, promoting and remunerating migrant health personnel on the basis of equality of treatment with the domestically-trained health workforce.

Background: International recruitment is a common strategy used by high-income countries to meet their medical workforce needs. Ireland, despite training sufficient doctors to meet its internal demand, continues to be heavily dependent on foreign-trained doctors, many of whom may migrate onwards to new destination countries. A cross-sectional study was conducted to measure and analyse the factors associated with the migratory intentions of foreign doctors in Ireland., Methods: A total of 366 non-European nationals registered as medical doctors in Ireland completed an online survey assessing their reasons for migrating to Ireland, their experiences whilst working and living in Ireland, and their future plans. Factors associated with future plans - whether to remain in Ireland, return home or migrate to a new destination country - were tested by bivariate and multivariate analyses, including discriminant analysis., Results: Of the 345 foreign doctors who responded to the question regarding their future plans, 16 % of whom were Irish-trained, 30 % planned to remain in Ireland, 23 % planned to return home and 47 % to migrate onwards. Country of origin, personal and professional reasons for migrating, experiences of training and supervision, opportunities for career progression, type of employment contract, citizenship status, and satisfaction with life in Ireland were all factors statistically significantly associated with the three migratory outcomes., Conclusion: Reported plans may not result in enacted emigration. However, the findings support a growing body of evidence highlighting dissatisfaction with current career opportunities, contributing to the emigration of Irish doctors and onward migration of foreign doctors. Implementation of the WHO Global Code, which requires member states to train and retain their own health workforce, could also help reduce onward migration of foreign doctors to new destination countries. Ireland has initiated the provision of tailored postgraduate training to doctors from Pakistan, enabling these doctors to return home with improved skills of benefit to the source country.

We conducted a national survey of Staff, Associate Specialists and Specialty (SAS) doctors working in sexual health clinics in the UK in 2013 in order to explore their career progression. The aim of the survey was to assess SAS doctors' experience in passing through the thresholds and to gather information about the adherence by SAS doctors and employers to the terms and conditions of service laid out by the new 2008 contract. Out of 185 responders, whom the authors estimate comprise 34% of the total workforce, 159 were on the new contract. Of those, most SAS doctors were women (84%), the majority (67%) worked less than nine programmed activities per week; only a few had intentions to join the consultant grade (15%), and a considerable minority (26%) were older than 54 years of age and likely to retire in the next ten years. The survey showed that most participating SAS doctors had undergone appraisal in the previous 15 months (90%), most had a job planning discussion (83%) with their employer and most had some allocated time for supporting professional activities (86%). However, a significant minority had no appraisal (10%), no job planning discussion (17%) and had no allocated supporting professional activities (14%), which allows time for career development in the specialty. Most SAS doctors, who had the opportunity, had progressed through the thresholds automatically (88%); some experienced difficulties in passing (8%) and only a few did not pass (4%). SAS doctors must ensure that they work together with their employer in order to improve adherence to the terms and conditions of service of the contract, which allow for career progression and benefit both the individual doctors and ultimately service provision., (© The Author(s) 2015.)

Objectives: To report the career progression of a cohort of UK medical graduates in mid-career, comparing men and women., Design: Postal and questionnaire survey conducted in 2010/2011, with comparisons with earlier surveys., Setting: UK., Participants: In total, 2507 responding UK medical graduates of 1993., Main Outcome Measures: Doctors' career specialties, grade, work location and working pattern in 2010/2011 and equivalent data in earlier years., Results: The respondents represented 72% of the contactable cohort; 90% were working in UK medicine and 7% in medicine outside the UK; 87% were in the UK NHS (87% of men and 86% of women). Of doctors in the NHS, 70.6% of men and 52.0% of women were in the hospital specialties and the great majority of the others were in general practice. Within hospital specialties, a higher percentage of men than women were in surgery, and a higher percentage of women than men were in paediatrics, obstetrics and gynaecology, clinical oncology, pathology and psychiatry. In the NHS, 63% of women and 8% of men were working less-than-full-time (in general practice, 19% of men and 83% of women; and in hospital specialties, 3% of men and 46% of women). Among doctors who had always worked full-time, 94% of men and 87% of women GPs were GP principals; in hospital practice, 96% of men and 93% of women had reached consultant level., Conclusions: The 1993 graduates show a continuing high level of commitment to the NHS. Gender differences in seniority lessened considerably when comparing doctors who had always worked full-time.

IntroductionThis article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). MethodsThe study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. ResultsFindings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. ConclusionsThe authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.