The reasons for staying when so many depart: an exploratory study of junior hospital doctors’ intentions to stay in Ireland
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Date
2024
Authors
Seathu Raman, Siva Shaangari
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
Voluntary turnover continues to be a significant issue impacting the ability of the Irish healthcare system to provide the necessary level of care to its citizens. Junior hospital doctors are at the bedrock of hospital care, but Ireland has a substantial issue with the numbers departing to other countries. Much research has focused on why hospital doctors are leaving in such large numbers with poor working conditions being amongst the most cited reasons for this.
Using a qualitative methodology involving in-depth, semi-structured interviews with more than 30 junior public hospital doctors, this thesis addresses two interrelated research questions. First, why do some junior hospital doctors intend to stay in their roles despite the prevalent challenges and poor working conditions which cause many to leave? Second, did the COVID-19 pandemic impact the working and personal lives/experiences of doctors and their intention to stay, and if so how? Addressing these questions are important through enabling a move away from the somewhat narrow focus in the literature on turnover (i.e. why doctors leave) by providing a more enriching and holistic perspective through focusing on intentions to stay . This additional perspective has become more commonplace in the broader employee turnover literature but has received little consideration in the healthcare literature and context.
Job embeddedness theory is employed to unpack the organisational (on-the-job) and community (off-the-job) factors that influence doctors’ intentions to stay in their jobs. The study illustrates the crucial role of community embeddedness, which arises from doctors’ fit and links, and their reluctance to sacrifice connections, with family, social networks, culture, lifestyle, and the local community. In other words, non-work factors are especially critical in why these doctors remain working in Ireland. This study also provides empirical data on the lived experience of junior hospital doctors during the COVID-19 pandemic, and it offers rich accounts and narratives of the positive and challenging impacts that these critical workers were faced with regarding work and non-work practices and how these were influencing their intention to stay.
This thesis demonstrates the value of applying job embeddedness theory in the healthcare field and in helping us understand junior hospital doctor retention through illustrating the important, yet different, roles that organisational and community embeddedness play in retaining doctors. While the study adds to the existing calls for greater investment in staffing, improved working conditions, and more consistent implementation of HRM practices, the argument is also made for a more proactive approach to assisting doctors, especially those from other countries, in becoming embedded in their communities to improve their intentions to say, and as result aid organisational retention. While we find strong levels of embeddedness amongst many doctors, this is entirely left to individuals themselves rather than there being any assistance offered.
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Keywords
Hospital doctors , Intention to stay , Job embeddedness
Citation
Seathu Raman, S. S. 2024. The reasons for staying when so many depart: an exploratory study of junior hospital doctors’ intentions to stay in Ireland. PhD Thesis, University College Cork.