From scut work to strategy: Why and how resident doctors can use cognitive crafting to stay in training

BACKGROUND: Across the globe, resident doctors, physicians in postgraduate training to become specialists, report high dissatisfaction, with many considering leaving training. A key driver is the growing burden of scut work- "mundane tasks" including repetitive administrative and routine clinical work, driven by legislation, staffing shortages, and workplace inefficiencies. PURPOSE: This study examines why and how cognitive crafting, thinking about mundane tasks as valuable for one's development as a doctor, may support retention in medical training. METHODOLOGY: Using survey data from 270 resident doctors in the United Kingdom, we tested hypotheses proposing that perceived job-role alignment and career progression self-efficacy mediate the negative relationship between understanding the value of mundane tasks and intentions to leave training. A supplemental analysis of 35 qualitative interviews further illuminated the mechanisms underlying these results. RESULTS: The significant negative association between understanding the value of mundane tasks and intentions to leave training was fully mediated by perceived job-role alignment, as well as by a sequential pathway operating through perceived job-role alignment and then career progression self-efficacy. Qualitative findings suggest that doctors can view mundane tasks as valuable opportunities for relationship-building, socialization, and learning. CONCLUSION: Our findings indicate that cognitive crafting may support resident doctors' retention by enhancing perceived job-role alignment and career progression self-efficacy. PRACTICE IMPLICATIONS: Training programs could explicitly frame routine tasks as integral to professional development and support resident doctors in cognitively reframing them as meaningful work.