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PubMed1993

Appointment as a staff grade doctor: success or failure?

This paper describes the characteristics of applicants for the first cohort of staff grade posts in an English health Region based on extraction of data from the curricula vitae and application forms of all doctors who applied for such posts over a two year period. 374 doctors applied for 34 staff grade posts in the 16 health Districts of the Northern Region from 1 January 1989 to 31 December 1990. The mean number of applicants for each post was 11, with a mean age of 43 years and a mean time since qualification of 18 years. One-third of the applicants had a higher qualification; about a quarter had passed the first part of an examination for such a qualification or had a Diploma, and nearly one-fifth of applicants did not possess any higher qualification. Between specialties there was wide variation in the time spent by applicants in each grade of their previous posts. Applying the criteria to identify 'stuck doctors' as set out in the national medical manpower plan Hospital Medical Staffing: Achieving a Balance: Plan for Action revealed wide variations within and between specialties. The criteria proposed in Achieving a Balance may not be adequate to identify 'stuck doctors', a finding which has clear implications for national medical manpower policy.

Age Distribution↗
PubMedDate not supplied

Should I take my first offer? A graduate nurse survey.

The newly graduated registered nurses' experiences of applying for graduate nurse positions and securing employment in nursing has received little attention in academic nursing literature. This article reports on a survey questionnaire of a cohort of 1995 graduates from the School of Nursing at Flinders University of South Australia. The survey was the first phase of a research project dealing with the transition from education to employment or from university student to registered nurse. The aim of the survey was to explore the graduates' experiences of searching and applying for employment, and their entry into a graduate nurse program (GNP) or employment as a registered nurse. Results indicate a disjointed and haphazard road that graduates must negotiate to secure a position. Anecdotal evidence suggests significant angst among final year nursing undergraduates at Flinders University of South Australia regarding a GNP place. The application process is costly in time and money for graduates and employer organisations. The duplication is unnecessary in this era of economic rationalism, cost-effectiveness and sustainability. Nursing students in the final semester of their undergraduate program need to focus on developing their role as a registered nurse, but instead are focusing on multiple applications to GNPs or employment for when they are registered. It is argued that a consortium, which centralises the process of application, would be beneficial to the graduates. Also, the limited number of GNP places available in the acute care sector, indicates that graduate registered nurses are working as registered nurses without any formal support. The recommendation is that GNPs be extended into diverse settings where nurses work such as in aged care, nursing agencies, rural and remote services, and the community.

Australia↗
PubMed1995

A reexamination of the NRMP matching algorithm. National Resident Matching Program.

Most graduating medical students in the United States find their first professional appointments through the National Resident Matching Program (NRMP). This service receives rank-order lists of preferences from students and from hospitals, and then generates final assignments of students to hospitals through the use of a specific computerized matching algorithm. The author uses recent findings from the mathematics and economics literatures to demonstrate three difficulties with the NRMP's matching algorithm and the official descriptions thereof. First, the algorithm favors hospitals over students, a feature known to the NRMP since at least 1976, but, in the author's opinion, not made clear in NRMP literature for students. Second, the author argues that the NRMP's justification that its algorithm mimics orderly, noncentralized admission processes is not correct. Institutions operating under non-centralized procedures must typically make more initial offers than there are positions, in the realization that some fraction of their offers will be declined. This arrangement enlarges the choices available to many applicants, and thereby benefits them, whereas the NRMP's algorithm unrealistically assumes that no institution would ever send out any extra offers. Third, the NRMP's algorithm contains incentives for students to misrepresent their true preferences when constructing their rank-order lists. This feature is a substantial disadvantage of the current algorithm and is incorrectly described in literature distributed to students and in published articles from the NRMP.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMedDate not supplied

Educators' responsibilities in implementing the ADA.

The Americans with Disabilities Act (ADA) prohibits educational programs from discriminating against academically qualified applicants with disabilities and requires each academic program to develop a list of essential requirements for the program. This article describes how the ADA affects educational programs. It also presents a sample list of essential requirements for radiologic science education programs that supports ADA requirements. Documenting the essential requirements is in the best interests of the program and its students, providing a defensible basis for student admissions and the measurement of academic progress.

Persons with Disabilities↗
PubMedDate not supplied

["Fitness for public service" - results of standardised acceptance examinations].

From Nov. 1 1990 to Dec. 31 2001 4928 applicants (61 % female, 39 % male) were examined, totalling 6580 pre-employment examinations, to decide whether they fulfilled the health requirement criteria for civil servants. Standardised aptitude criteria were used, career-specific requirements taken into account. To exclude with a high probability were any risks of premature disability for service or frequent disorders. In 394 cases (= 5.99 %) the results were negative. This assessment was final in 298 cases (= 4.53 % of all examinations) or was confirmed negative in repeated examinations even after special conditions had been imposed. Main reasons for disqualification were second- and third-degree adipositas with additional risk factors or a metabolic syndrome, chronic cardio-vascular and metabolic diseases requiring permanent treatment, malignant neoplasms or non-fulfilment of the criteria for special careers. The comparatively high rate of disqualification is mainly due to the high average age of the applicants examined (40 % of all applicants were over 40, 13 % were older than 50). Purpose, sensitivity and specifics of such examinations are discussed. Taking into consideration the high rate of civil servants prematurely unfit for work, such pre-employment examinations are regarded as highly justified. Moreover, it is necessary to have clear guidelines, aptitude criteria and examination procedures for individual careers. It is also important to adhere strictly to local responsibility for pre-employment examinations.

Adult↗
PubMed1982

Characteristics of the residency interview process preferred by medical student applicants.

This study elucidates the characteristics of the interview day preferred by medical students applying to family practice residencies. Interviews and informal meetings with residents were regarded as being the most helpful, followed by interviews with the director or faculty. Perceptions of other components of the interview day are also described. October was the month most students preferred, and two interviews each lasting 20 to 30 minutes were considered ideal. Group interviews were regarded negatively. The results of this survey are generalizable to other residency programs and could be helpful in planning the interview day.

Attitude of Health Personnel↗
PubMed1996

Reasons for rejection: why people fail to qualify as firefighters.

In the decade beginning 1 January 1985, 916 individuals (including five females) were medically examined with a view to joining the full-time service of Strathclyde Fire Brigade (SFB). One hundred and nine (11.9%), including two females, were rejected. The five main causes of failure were: ocular (n = 46, 42.2%); lack of stamina (n = 21, 19.2%); 'others' (n = 12, 11.0%); cardiovascular (n = 9, 8.3%) and orthopaedic (n = 6, 5.5%). Thirty-two had chest X-rays. One abnormality was found -an azygous lobe-but it played no part in the decision to decline the applicant. There was little life- or health-threatening pathology found. The most serious cases were murmurs consistent with mitral stenosis and regurgitation (one each), one case of ocular melanoma, four cases of hypertension and two cases of haematuria/ proteinuria (++). This study shows that potentially serious findings can occasionally be detected in a population of 18-30 year olds who might be expected to be of better than average fitness, and that routine chest X-rays are not helpful in the selection process.

Employment↗
PubMed1989

Characteristics of successful and unsuccessful applicants to orthopedic residency training programs.

In 1985 there were 288 applicants for the ten postgraduate Year 1 orthopedic residency positions in Galveston and San Antonio, of which 119 (41%) applicants successfully obtained a residency position in one of 76 orthopedic programs approved by the Accreditation Council for Graduate Medical Education. Successful applicants were younger and had higher Medical College Admissions Test scores, National Board of Medical Examiners, Part I (NBME-I) scores, and medical school grade point averages than unsuccessful applicants. Variables that increased acceptance rates were medical student status, an NBME-I score above 500, class rank in the top 40%, and membership in Alpha Omega Alpha honor society. Foreign citizenship and prior residency experience in a different specialty strongly decreased acceptance rates. Variables that did not affect acceptance rates were: gender, military experience, marital status, graduate degree, research, publications, or NBME-II scores.

Adult↗
PubMed2000

Criteria used by employers to select new graduate employees.

OBJECTIVE: To find out what criteria and methods are used by Australian employers to select new graduates to work in their practices. DESIGN: Questionnaires were completed by 258 employers and the responses were analysed using the SAS system. RESULTS: During selection, employers placed most reliance on formal interviews or visits to the practice. These occasions were used to assess the applicant's personal qualities including their ability to interact effectively with clients and colleagues. Employers used resumes mainly in selection of applicants to interview and many discounted nominated referees as being insufficiently critical. Academic knowledge was regarded as less important than personal qualities and very few employers reported using gender as a basis for selection. CONCLUSIONS: Senior veterinary students need to be aware of the importance placed by employers on interpersonal skills and personal qualities and should make every effort to engage in practical work, paid work and other activities that will help develop these attributes. They should be conscious that practitioners with whom they work may be contacted by potential employers and they should learn to present themselves realistically in a resume.

Australia↗
PubMed2005

Short-listing for orthopaedic specialist registrar posts--what is important?

INTRODUCTION: Competition for specialist registrar (SpR) posts in orthopaedics is high. The aim of the current study was to provide evidence-based advice for applicants applying for SpR posts in orthopaedics. METHODS: The short-listing forms of 273 applicants for orthopaedic SpR posts in South Thames (West) were reviewed. The experience of short-listed candidates was compared with those that were not. RESULTS: We have shown a high chance of being short-listed between 5 and 6 years after qualification with a sharp fall off either side of this. It is clear that a wide range of appropriate experience is more important than high volume and low quality experience in orthopaedics alone. CONCLUSION: Candidates who plan ahead and gain a broad experience have a better chance of progressing in an orthopaedic career. Good, early career advice is essential to achieve this.

Career Mobility↗
PubMed2005

Organizational justice and Black applicants' reactions to affirmative action.

Using organizational justice as a guiding framework, the authors studied perceptions of affirmative action programs by presumed beneficiaries. Three conceptual issues were addressed: (a) the content of different affirmative action plans; (b) the 3-way interaction among distributive, procedural, and interactional justice; and (c) the distinction between outcome favorability and distributive justice. These ideas were tested with a sample of Black engineering students who responded to 1 of 6 plans. Participants distinguished among the various plans, with some policies being viewed as more fair than others. In addition, a 3-way interaction among the 3 types of organizational justice was observed. Specifically, the 2-way interaction between distributive and interactional fairness was only significant when procedural justice was low. Implications for organizational justice and for the design of affirmative action programs are discussed.

Aptitude↗
PubMed2001

The effect of arbitration program characteristics on applicants' intentions toward potential employers.

The authors examined intentions toward prospective employers with different alternative dispute resolution (ADR) policies and no ADR policy. In Study 1, students (N = 124) were randomly assigned to 1 of 4 conditions in which 2 variables, arbitration policy presence or absence and firm desirability, were manipulated. The presence of a voluntary, nonbinding arbitration policy had no impact on intentions and did not interact with firm desirability. In Study 2, students (N = 273) were randomly assigned to 1 of 8 conditions (mandatory vs. voluntary arbitration, binding vs. nonbinding arbitration, and highly desirable vs. less desirable employer). Both mandatory and binding arbitration policies were related to less favorable intentions toward firms. Predictions regarding the interaction of ADR policy and firm desirability were partially supported. Some support was found for the interaction between ADR policy and ethnicity.

Adult↗
PubMed1994

Preemployment drug screening at the Johns Hopkins Hospital, 1989 and 1991.

During identical 2-month periods in 1989 and 1991, all applicants for employment at a major teaching hospital participated in preemployment drug screening. In 1989, before establishment of a formal preemployment testing program, screening was conducted without identifying information. Of 593 applicants screened, 64 (10.8%) were confirmed positive for one or more drugs. Marijuana metabolites were detected with the greatest frequency (35 samples, 55% of positive screens), followed by cocaine (36%), then opiates (28%). In 1991, after a formal preemployment testing program was in place, 365 applicants were screened, and 21 (5.8%) were confirmed positive. Opiates were most often detected (48% of positive screens), followed by cocaine (38%), then marijuana metabolites (28%). During both periods, positive urine screens were associated with ethnicity (non-White) and occupational category (blue-collar). Whereas in 1989 positive screens were associated with male gender, in 1991, females were more likely to test positive. The decline in prevalence following implementation of a screening program supports the notion that preemployment testing can serve as a deterrent for drug-using persons in applying for employment.

Adult↗
PubMed1992

Comparative analysis of successful and unsuccessful candidates for the pediatric surgical matching program.

Only one third of the applicants for training in pediatric surgery obtain a position through the pediatric surgery matching program. In order to identify factors that contribute to a successful outcome, we conducted a retrospective survey of all participants in the matching process for positions during the years 1983 to 1991. This survey was designed to identify characteristics associated with success in the match through comparison of successful and unsuccessful applicants. Significant factors associated with a successful match included: a greater incidence of residency-supported research (P = .012) with a greater number of publications (P = .003) and national presentations (P = .014), specifically at the annual meetings of the American Pediatric Surgical Association (P = .05) and the American Academy of Pediatrics (P = .05). In addition, successful candidates had more contact with (P = .004) and letters of recommendation from (P = .015) well-known pediatric surgeons involved in the general surgical residency program. This information should be invaluable to those counseling medical students and residents interested in a career in pediatric surgery.

Adult↗
PubMed1995

Audit of pre-employment assessments by occupational health departments in the National Health Service.

Pre-employment health assessment of applicants to the National Health Service (NHS) is one of the functions of occupational health departments in the NHS. This paper describes the results of a process and outcome audit of this activity, concentrating on the current practice of occupational health departments. The audit was carried out by 40 NHS occupational health units who provided information on a standard questionnaire on all pre-employment assessments undertaken over a three-month period. This produced 9139 questionnaire returns. The analysis showed that the most common method of assessment was the use of a self-administered questionnaire alone (49.4%). A self-administered questionnaire followed by a nurse interview as standard practice was the next most common method (34.1%), but referral to a physician was uncommon. The outcome of the assessments for 98% of all applicants was 'fit for work'. A total of 120 individuals (1.3%) were assessed as 'fit to work, but with some restriction' and 65 individuals (0.7%) were considered 'unfit'. The most common reasons for rejection were abnormal body mass index (40%), skin conditions (21.5%) and psychiatric conditions (10.8%). The most common reasons for restriction were musculoskeletal conditions (27.5%), skin conditions (15%) and abnormal body mass index and psychiatric conditions (both 10.8%). The audit identified wide variation between occupational health departments in the NHS in the practice of restriction and rejection. A decision on the value of pre-employment assessment in the NHS mus take into consideration the ability of the process to achieve its aim, the time and manpower involved in the process, and the probability of low restriction and rejection rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Employment↗
PubMed1998

Setting an uncorrected visual acuity standard for police officer applicants.

Government agencies have used uncorrected visual acuity (UVA) standards for many years for police officer applicants. With the passage of the Americans With Disabilities Act of 1990, public employers have concern about the validity of these standards. This report shows how data can be used to set a reasonable standard. The report includes a description of a survey of incumbents, acuity testing of a sample of incumbents, collection of essential task information, and experimentation based on the essential tasks. A series of focus group meetings resulted in agreement that 2 essential tasks officers must be able to perform when visually incapacitated are identifying a weapon in a typical room and finding spectacles that have been dislodged. The experimentation showed that a noticeable performance decrement begins to appear at 20/125 level of acuity. As a result of the research, the City of Columbus, Ohio, changed the UVA standard from 20/40 to 20/125.

Adult↗
PubMed1990

Effects of discrimination by sex and race on the early careers of British medical graduates during 1981-7.

OBJECTIVE: To examine the possible effects of discrimination by sex and race on the career patterns of doctors up to six years after qualifying. DESIGN: Postal questionnaire follow up survey. PARTICIPANTS: 1572 Doctors who graduated from five British medical schools in 1981, 1983, and 1985, including 587 women and 131 doctors from ethnic minorities. MAIN OUTCOME MEASURES: Reported success rates of applications for training posts. RESULTS: Comparison of the career patterns of women and men yielded no evidence of discrimination against women in competition for posts. In contrast, there were striking differences in career patterns between graduates of native European origin and those of ethnic minority origin. Graduates from ethnic minorities reported lower success rates and more difficulty in obtaining house officer posts, registrar posts, and places in vocational training schemes in general practice. Most of this discrimination seemed to occur at the stage of shortlisting for interview. Graduates from ethnic minorities were more likely than graduates of native European origin to have experienced spells of unemployment while seeking work. They were also more likely to have changed their original choice of career because of difficulty in obtaining suitable training posts or unfavourable career prospects. CONCLUSIONS: Discrimination against ethnic minorities occurs in the competition for training posts among graduates from British medical schools. There was no evidence of discrimination against women graduates. Shortlisting procedures based on objective scoring systems may help to ensure equality of opportunity in future.

Career Mobility↗
PubMed2003

The National Resident Matching Program and antitrust law.

In May 2002, a group of physicians filed a class action lawsuit alleging that the National Resident Matching Program (NRMP) violates antitrust laws. The plaintiffs contend that NRMP practices have stabilized lower-than-competitive wages and imposed exhausting working conditions on residents. They also maintain that NRMP procedures virtually force applicants for house officer positions to forfeit their right to negotiate for better wages and conditions. The plaintiffs also allege that the defendants have collectively fostered anticompetitive accreditation standards through the Accreditation Council for Graduate Medical Education. Jung v Association of American Medical Colleges could present antitrust law with some difficult challenges. Although the matching program on its face appears to limit competition in a manner that previous cases have found illegal, it operates in the context of important professional activities (medical education and quality improvement) that may generate some judicial deference. At this early stage, no confident prediction can be made about the outcome of the case if it goes to trial; however, the plaintiffs appear to have a plausible case under existing antitrust doctrine, and lengthy litigation is possible. Given the important questions that the litigation will not address, such as the potential costs of a finding of illegality to the government and other payers, and the impact of such a finding on the health care system as a whole, a legislative solution seems highly desirable.

Antitrust Laws↗