Sci59 Online is a psychometric instrument that has been designed by a rigorous and validated process (Gale, R and Grant, J. (2002). Sci45: the development of a specialty choice inventory. Medical Education. 2002 Jul; 36 (7) 659-66). It is based on a questionnaire with 130 items, expressed both positively and negatively, to avoid bias. These questions are the ones that discriminate powerfully between specialties and represent the survivors from a list of nearly 400 questions that were tested as part of the development process. All questions that were answered in a similar fashion by people in all specialties were removed from the list.

The answers to the 130 questions provide a profile of the skills and aspirations of the individual at that time in their career development. The results are clustered into 12 dimensions of attributes that tend to co-vary. This personal profile is matched against the profiles of the average consultant or principal in that specialty to assess the quality of fit. The programme is matching the skills and attributes needed for the normal end point in career development and not the next training position. The output of Sci59 Online acts as a guide to the individual. It lists the career choices that provide a reasonable match to their personal profile and, importantly, those that have a very poor degree of match. This is only a guide and a stimulus to further investigation into potentially suitable career choices. Both individuals and specialties are subject to change and development.

There are no right answers and no benefits from manipulating the outcome; it is much better to be honest with yourself so that the output is more useful to your career choices.

Sci59 Online is aimed at those in the formative years of medical training. Some have suggested that this means anyone from the middle of medical school to the end of training. Towards the end of training, the programme can only really confirm a career choice, for most, or help those having to consider changing specialty. Foundation 1 or 2 doctors and other newer trainees in specialties are the main target group. Medical students may well benefit, too, from observing which specialties best fit their attitudes and attributes as they develop over their course and in being stimulated to consider career goals they have not thought suited them. Consultants, we have noticed, find it interesting to check their own career choice but we did not design Sci59 Online to help the consultant population, unless particular doubts or difficulties are being experienced.

We trust that Sci59 Online will serve your needs. It can only guide your career choices; it cannot make them for you. You will need to do some research and to listen to other viewpoints before you can make a firm decision. We are confident that the product has been well designed and tested. We are always keen, however, to learn about any difficulties you encounter in using the system or in interpreting the output. There is a facility for you to email your comments or concerns. Resource constraints prevent us offering to interpret your results, unfortunately.

Uses of Sci59 Online

Early choice of specialty
Sci59 Online is an offshoot of Sci45 which came into being because of the need, in an increasingly structured training system, to provide sound advice to trainees to help them find a specialty to which they are suited. The increasing trend to structured training has meant that both specialties and junior doctors are being forced to make crucial and virtually exclusive career decisions at earlier and earlier points in training.

We envisage that a doctor in training will fill in the online questionnaire at several points along their career development path; to help formulate a choice or to confirm a choice already made. Sci59 Online is intended to be used alongside a host of other sources of information and opinions from, among others, colleagues, family, friends, mentors, supervisors and providers of education. The output of Sci59 Online is free of partiality and provides a rational view of the specialties that match your needs.

The junior doctor is sometimes not fully informed about the details of life as a consultant or principal in every specialty because they will not have had exposure to all aspects of the job during training. Yet, they have to select a specialty and commit to it very early and without the previous opportunities to switch specialty relatively easily. It is often surprising to trainees how early they have to make decisions about their careers and how relatively inflexible the system is in relation to change of training pathway. This means it is difficult to overcome an inappropriate choice of career path, although not impossible.

In our research to design and develop Sci59 Online, it became very clear that many doctors in training seem to think only one stage at a time and although they are very informed about the next step they are less informed about later stages. Very few trainees had very much idea what it was like to function as a consultant in their chosen specialty. Even fewer had a broad knowledge of more than a few specialties.

Selecting trainees
In terms of the specialty choosing trainees, the current system requires decisions to be made without the benefit of having seen the trainee in a clinical setting over a number of years. The specialty committing its training slots and training resources to a junior needs to feel reassured that the doctors they choose have the attributes and attitude that will enable them to stay the course and become functioning consultants. High attrition rates or trainees not reaching the required standards can have detrimental effects on the specialty locally and nationally.

How Sci59 Online was developed
The idea behind Sci59 Online is that it provides an objective match between the skills, attitudes and aspirations of individuals and those needed for success in each specialty. It measures the individual across 12 dimensions and offers the user a range of specialties that match their personal profile. The output can be configured in a number of different ways, showing the best and worst matches to a full listing of all specialties in order of matching. In addition, the output shows on which dimensions there were the strongest matches between person and specialty.

The validity of the programme lies in the methodology used to develop it. We started with semi-structured interviews with 60 consultants in about 25 specialties to elicit the characteristics of the job and the attributes of the successful and unsuccessful trainee. A list of 80 attributes of jobs and 80 attributes of successful trainees was derived and sent to 350 consultants who were asked to rate each attribute for its importance in their specialty and to add any new items they considered important.

The list was subjected to factor analysis and discriminant function analysis to reveal those aspects that co-varied and those that actually differed significantly between specialties and could therefore reveal preferences. The list of aspects was turned into questions and the list of questions was refined by further testing on a consultant sample, to remove redundant or difficult to understand questions, and then on a sample of 500 second year SHOs. All this development resulted in a questionnaire with 130 items. You are using the web-based version of that questionnaire and the accompanying analysis suite.

The internal design of the analysis suite of programmes is such that it is easy to update the requirements of a specialty as it evolves and adapts to an ever changing technological landscape and changing patient expectations. We have updated specialty profiles regularly and will continue to do so.