Failure to secure a training post in an applicant's first choice deanery as a risk factor for difficulties during training


Dr Richard Crane
Dr Peter Haig
Dr Samantha Scallan


Postgraduate Education


Health Education Wessex
Southampton GP Education Unit


Whilst existing evidence suggests that GP trainees who scored badly in the national recruitment process are more likely to experience problems during training, we wished to identify factors that may contribute to these trainees’ poor progression.

Summary of Work

We undertook a simple retrospective analysis of recruits to Wessex GP training in 2009, focussing upon those trainees who scored greater than one standard deviation below the mean in either stages two or three of the national recruitment process.  The subsequent progress of these trainees (n.39) was tracked using ARCP and exam data.

It quickly became apparent that a large proportion of the lowest scoring trainees were recruited to Wessex via the national clearing process. We therefore decided to compare the outcomes of these trainees to those low scoring recruits who had applied directly to Wessex.

Summary of Results

Of the 39 trainees, 22 (56%) went on to experience problems during training with 19 having been placed on remedial extensions and 3 released from training at the time of the study.

However there was a marked difference between the outcomes of those trainees who had been recruited via clearing and those who had applied directly to Wessex, despite no statistically significant difference between recruitment scores.



Trainees coming to Wessex via clearing were more than twice as likely to require an extension to training than those with comparable recruitment scores who applied directly to Wessex.

Low scoring trainees applying directly to Wessex were more than four times as likely to complete training after three years than those recruited via clearing.

A relatively large proportion of trainees recruited via clearing (14%) resigned or transferred out of the deanery.

Failure to apply directly to Wessex was a significant risk factor for having difficulties during training and for failing to complete training, independent of recruitment scores. 


The London Effect  

Candidates not securing a training post in London often look to other deaneries close to the capital 

If appointed, they often continue to live in London and commute. 

The effects of excessive travelling and dislocation from support networks appears to have a negative effect both on well-being  and  progression through training.


Take-home Messages

Trainees recruited via the national clearing process appear to be at particular risk of difficulties during training. 


Those deaneries which recruit trainees via the clearing process and those requiring a second recruitment round may be well-advised to assess these trainees early for the need for proactive intervention and support.


Crane, R., Haig, P., Scallan, S. (2013). Failure to secure a training post in an applicant's first choice deanery: a significant risk factor for difficulties during training. Education for Primary Care vol 23 (5), p. 272-3

Summary of Work
Summary of Results


Recruitment score comparison


Recruitment cohort  N  Stage 2 mean score Stage 3 mean score
Applied directly to Wessex 11 455 70.9
Recruited via clearing 28 444 69.9
    p=0.55 p=0.68



Comparison of outcomes




Take-home Messages
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