Post Foundation Training Careers Choices of Junior Doctors in NHS Wales: Investigating Motivational Drivers and Correlational Patterns

In Wales, the retention of junior doctors after foundational training has shown a disproportionate decline compared to the rest of the UK. Recent industrial actions driven by pay erosion and working conditions accentuate systemic flaws within NHS Wales and expose critical gaps in its workforce retention strategy. The organisation's limited responsiveness to junior doctors' professional needs and their essential motivational drivers negatively impacts service quality, workforce productivity, and patient safety. This study investigates the motivational factors influencing junior doctors' career choices after foundation training in NHS Wales, examining links between experiences, motivations, and retention to provide evidence-based insights for future improvements and remedial actions. Adopting a mixed-methods approach within a pragmatic philosophy, the research combines a quantitative survey of 155 FY1–FY2 doctors with qualitative interviews involving 8 NHS Wales trainers and 2 BMA representatives. Quantitative data were analysed using descriptive statistics, Spearman's Rank-Order Correlation, and Chi-Square Tests of Independence, while qualitative data were explored through thematic analysis guided by Herzberg's Two-Factor Theory and Social Cognitive Career Theory. Findings from the literature and empirical data indicated that FY1–FY2 doctors' career choices are mainly based on experience, influenced by training quality, interactions with trainers, and organisational culture. Along with their personal motives – which cannot be fully captured or measured with the analytical tools used due to the complexity of human behaviour – these experiences affect their decision to stay in or leave NHS Wales after their foundational training. The study concludes that retention issues stem from structural inefficiencies, inconsistent training experiences, and limited organisational responsiveness to junior doctors' motivational drivers. Although theoretical frameworks such as Herzberg's Two-Factor Theory and SCCT are conceptually relevant, their effectiveness depends on active organisational implementation and alignment with workforce realities. This dissertation recommends targeted interventions to address dissatisfaction areas like rota fairness, workload, and psychological safety, while also enhancing motivational drivers through mentorship, career development options, and structured professional support. Strategies that improve self-efficacy, clarify outcome expectations, reduce contextual barriers, and facilitate goal-oriented career planning are essential for boosting workforce retention and enhancing long-term NHS Wales performance.

Name dc:type.qualificationname

mba

Level dc:type.qualificationlevel

masters

Grantor dc:publisher.institution

University of Wales Trinity Saint David

Year dc:date.issued

2025

Author dc:creator

• Gladkyi, Pavlo

• HD28 Rheoli. Rheoli Diwydiannol
• R Meddygaeth (Cyffredinol)

Dc Identifier Grantnumber

UWTSD

OAI identifier oai:identifier

oai:repository.uwtsd.ac.uk:4027