Postal Surveys of Doctors’ Careers: Who Writes
Comments and What do they Write About?
, TREVOR W. LAMBERT and
MICHAEL J. GOLDACRE
UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Oxford University
Department of Public Health, Institute of Health Sciences, Old Road, Oxford OX3 7LF, UK
Abstract. This study aimed to characterise the doctors who wrote comments at the end of a
postal questionnaire about their careers, to quantify the frequency of negative comments, and
to study relationships between the questionnaire content and the topics of comment. Grad-
uates of all UK medical schools in 1999 were surveyed at the end of their pre-registration year.
Structured questions about career intentions, current jobs and attitudes were accompanied by
an invitation to write comments about any aspect of training, career choices or work. Com-
ments were transcribed and coded according to theme and whether they were positive, neg-
ative or neutral. Numbers of comments on each theme, and of positive and negative
comments, were counted. Bivariate analyses based on respondents’ answers to structured
questions were used to characterise those who wrote comments on each theme. The survey
response rate was 65%, and 40% of respondents wrote comments. Sixteen themes were
identiﬁed. Ninety-four percent of those who commented said something negative or critical.
Respondents who wrote comments diﬀered in some characteristics from the whole cohort. The
structured content of the questionnaire, particularly certain attitude statements, prompted the
writing of comments on related themes, although not all attitudinal items acted in this way.
Key words: free-text comments, self-completion questionnaires, surveys, methodology, doctors’
Self-completion questionnaires are increasingly used in health care research
to investigate the views of health professionals, patients and care-givers.
Where surveys are primarily composed of questions with closed-format
response options, it is common practice to include an invitation to respon-
dents to add written comments at the end of the questionnaire. In survey
research it is important to be aware of potential diﬀerences between the
characteristics of those subjects who respond and those who do not, and
Author for correspondence: Julie Evans, Oxford University Department of Primary
Health Care, Institute of Health Sciences, Old Road, Oxford OX3 7LF, U.K.
Tel.: 01865 226999; Fax: 01865 227036; E-mail: firstname.lastname@example.org
Quality & Quantity (2005) 39: 217–239 Ó Springer 2005