How does 'banter' influence trainee doctors' choice of career? A qualitative study

Background:- Negative comments from senior colleagues about specialties, such as general practice and psychiatry, are known to influence trainees' career choice, but little is known about the extent of this influence or the mechanism by which it works. There have been calls to ban these disparaging comments, also known as 'banter'. This study explored how recently qualified doctors make sense of banter in the context of other experiences and information. Methods:- Semi-structured telephone interviews were conducted with 24 trainee doctors in their second postgraduate year in South West England. Thematic Analysis was used to code the data and organise them into themes. Results:- Trainees are commonly exposed to banter about the merits of different specialties and those who work in them, but these messages are not received uncritically and are not perceived to be decisive in determining career choice. The views of senior doctors are assimilated with other experiences and information, as trainees strive to assess their 'fit' with a specialty. While banter is seen as positioning specialties in a status hierarchy, other factors such as work-life balance and feeling 'at home' in a specialty are often believed to be more significant factors in career choice. We posited two theories of banter; the 'propaganda model' and the 'person-specialty fit model,' and found the latter to provide a better understanding of how banter informs career choice. Conclusions:- Banter often comprises stereotypes and caricatures, but despite its biases and distortions, it may still aid career choice. The challenge is not to ban banter, but to provide more accurate and reliable knowledge and experiences of what working life is like in different specialties.