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Background Falling retention in UK general practice is a well-described problem but there has been little previous research into its underlying causes. Poor psychosocial work conditions may help explain falling workforce morale and early retirement from the profession. Aims To explore the impact upon morale and retirement decisions of changes in psychosocial aspects of UK general practice over the course of a career. Methods Biographical narrative interviewing method (BNIM) was used to obtain and analyse career narratives of 12 London general practitioners (GPs), aged 55–65, half of whom had retired. Findings were theorized using the Job Demands-Control-Support (JDCS) model. Results A spontaneous, consistent theme was evident across all 12 interviews: changes in the psychosocial work environment had contributed to a steady decline in morale. Sequential, multilayered reductions in autonomy were the most commonly cited causes for reduced enthusiasm. Increasing demands in the form of both a rising workload as well as a complaints culture drained energy and morale. The GPs described increasingly fragmented teams and therefore reduced social support for the role. Nonetheless, retirement decisions were not straightforward, provoking complex emotions. Conclusions The combination of increasing demands with reduced autonomy puts practitioners under intense strain, diminishing the satisfaction they derive from their work and affecting retirement decisions. The Job Demands-Control-Support (JDCS) model is an empirically tested model that could be used to inform improved work design in general practice. [ABSTRACT FROM AUTHOR]

This paper investigates linkages between education and work domains for a birth cohort of British men and women, In particular, the analyses examine Sørensen's conceptualization of open and closed position systems. We investigate one application of these concepts by examining whether open versus closed education systems (i.e., ability group and school type) generate jobs with first employer of differing duration and jobs in open versus closed work position systems. The methodology features a continuous-time discrete-state stochastic model of the transition from the first employer. The data include multiple event histories through age 23 for a 1958 birth cohort of over 11,000 British men and women. In general, we find important differences in the determinants of transitions from open versus closed employment systems. The major differences include gender and earlier life course location in open versus closed education systems and ability tracks. The empirical results only partially support hypotheses in the literature about the timing of transitions (duration dependence) in open and closed employment systems. [ABSTRACT FROM AUTHOR]