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Background There is an increasing global interest in selection processes for candidates to surgical training. The aim of the present study is to compare selection processes to specialist surgeon training in the European Union (EU). A secondary goal is to provide guidance for evidence-based methods by a proposed minimum standard that would align countries within the EU. Methods Publications and grey literature describing selection strategies were sought. Correspondence with Union Européenne des Médecins Specialists (UEMS) Section of Surgery delegates was undertaken to solicit current information on national selection processes. Content analysis of 13 semi-structured interviews with experienced Swedish surgeons on the selection process. Two field trips to Ireland, a country with a centralized selection process were conducted. Based on collated information typical cases of selection in a centralized and decentralized setting, Ireland and Sweden, are described and compared. Results A multitude of methods for selection to surgical training programs were documented in the 27 investigated countries, ranging from locally run processes with unstructured interviews to national systems for selection of trainees with elaborate structured interviews, and non-technical and technical skills assessments. Associated with the difference between centralized and decentralized selection systems is whether surgical training is primarily governed by an employment or educational logic. Ireland had the most centralized and elaborate system, conducting a double selection process using evidence-based methods along an educational logic. On the opposite end of the scale Sweden has a decentralized, local selection process with a paucity of evidence-based methods, no national guidelines and operates along an employment logic, and Spain that rely solely on examination tests to rank candidates. Conclusion The studied European countries all have different processes for selection of surgical trainees and the use of evidence-based methods for selection is variable despite similar educational systems. Selection in decentralized systems is currently often conducted non-transparent and subjectively. A suggested improvement towards an evidence-based framework for selection applicable in centralized and decentralized systems as well as educational and employer logics is suggested.

Introductory comment on background to the issue and the Swedish platform for sustainable work in EU Horizon 2020 and Horizon Europe and short presentation of the content and title of articles and contributors.

Objective The aim was to document empirical observations about antecedents to and practices of unsuitable behaviours amongst surgical trainees and develop an interview guide that could be used for the selection process. Design A mixed methods design was adopted combining a survey distributed to senior surgeons and heads of departments, followed by semi-structured interviews with experienced surgeons. Setting All surgical departments and hospitals in The South Swedish Health Care Region. Participants The survey was completed by 54 of 83 eligible surgeons above 50years of age, and 4 of 7 heads of surgical departments. Semi-structured interviews with 13 surgeons representing local, regional, and university hospitals from the same cohort. Results Forty-six (85%) surgeons and four of seven heads of departments responded that they had come across surgical trainees deemed unsuitable to train and work as a surgeon. All heads of department and 31 of 54 of the surgeons believed tendencies towards unsuitability are evident early during training. From the survey, 107 statements described reasons for finding a trainee unsuitable. Qualitative analysis of the interviews and free-text answers of the survey led to identification of 11 problem domains with associated “warning signs”. An interview guide to help detect unsuitability tendencies in candidates during selection procedures was constructed. Conclusions Experienced surgeons have quite consistent views on what makes a person unsuitable as a surgeon. Their views have been systematized into 11 problem domains, and a set of ‘warning signs’ for unsuitable behaviours and traits has been developed. Early detection of these signs and traits is important for the individual, the work environment, and patient safety. A recommendation for a minimum framework for selection including the constructed interview guide is presented.

The case highlights the bi-directional causal relationship between job quality and innovations in the hospital sector. It focuses on The Regional Cancer Care (RCC) South, a unit that developed and coordinated the cancer care at hospitals in the Southern Healthcare Region in Sweden. This unit aimed to foster the exchange of knowledge and expertise of the cancer care professionals on a national level. Simultaneously, it played a role in disseminating the innovations across the regional hospitals. RCC itself was a result of nation-wide organizational and processual innovation. The establishment of RCC entailed the change in work allocation of some employees at the hospitals. They were assigned to work half of the time at RCC and other time at their hospitals. Such innovations in work process also enabled them to take part in the improvement of cancer diagnoses and treatment on a national level. Other workers at the clinics were also able to make an impact on the cancer care at a larger scale by passing on their ideas to their colleagues working at RCC. This case aims to prompt the students to examine the approach that RCC implemented to create a bridge between the regional hospitals, and to aggregate the expertise to improve the cancer care across the country by connecting regional centres, connecting regional centres and local hospitals, and academics and practitioners. It outlines how the organizational restructuring resulted in the improvement of job quality of the medical professionals. At the same time, the high job quality, enhanced with the multidisciplinary nature of the work, was an essential input for more innovative potentials to be realized. Furthermore, the case offers an insight into the challenges the RCC South faced when encouraging the doctors to implement the knowledge and initiatives developed at RCC into the work at their hospitals for which they had held discretion.

That innovation can both create and destroy jobs has long been accepted (e.g. Schumpeter 1939). Recent debate on this issue has focused on technological innovation and the purported effects of a mix of automation and robotisation – mass job losses (Frey and Osborne 2013).

This chapter explores some of the central cultural tenets of career and filmmaking among the Danish film industry elite or what is inelegantly and somewhat grammatically incorrectly referred to as “the ‘cultural’ of production and career” in this chapter’s title. The theory behind this formulation is that it focuses attention on the ideational dimensions of culture in the Danish film industry, especially as derived from reflections on work and career by those working in that industry. In this sense, the approach, though less inclusive and ambitious, resembles Caldwell’s interest in “‘indigenous’ interpretive frameworks” in Production Culture.’ This chapter also argues that production and career decisions and actions are inextricably linked. Sometimes the two are consciously and obviously linked in terms of the implications that working on a given film with given people in a given manner, etc., will have on one’s further work opportunities. Or, the converse, career considerations can affect how films are made in terms of who works on them and what resources, skills, tastes, and perspectives are brought into and used in a production. Sometimes the interrelation of these considerations remains latent. This chapter explores how certain cultural issues underpinning inter-occupational collaboration, especially deference, occupational respect and integrity, and occupational revitalization in particular, support forms of these mutually intertwined considerations. This chapter also focuses on how the content of several of these cultural considerations supports a particular form of auteur ideology and practice in the Danish film industry and shows how this ideology is made up of discrete cultural components that secure expressive space for A-function holders rather than a hierarchically imposed command-and-control coordinating regime.

Part I: Overviews 1. Careers in Creative Industries: An Analytic Overview. Chris Mathieu 2. Creative Labor: Who Are They? What Do They Do? Where Do They Work? A Discussion Based On a Quantitative Study from Denmark. Trine Bille Part II: Theatre, Television and Film 3. Behind the Scenes of Boundarylessness: Careers in German Theatre. Doris Ruth Eikhof, Axel Haunschild, and Franziska Schossler 4. Tournament Careers: Working in UK Television. Dimitrinka Stoyanova and Irena Grugulis 5. Oscar et Cesar: Deep Consecration in French and American Film Acting Careers. Anne E. Lincoln and Michael P. Allen 6. Central Collaborative Relationships in Career-making. Chris Mathieu and Iben Sandal Stjerne Part III: Architecture 7. Frank Lloyd Wright's Artist Reputation: The Role of Networks and Creativity. Candace Jones 8. Reputation-building in the French Architecture Field. Amelie Boutinot Part IV: Music 9. Transnational Careers in the Virtuoso World. Izabela Wagner 10. Composing a Career: The Situation of Living Composers in the Repertoires of U.S. Orchestras, 2005-06. Timothy J. Dowd and Kevin J. Kelly Part V: Visual Arts and Fashion Design 11. Unpacking Unsuccess: Socio-cognitive Barriers to Objective Career Success for French Outsider Artists. Jean Pralong, Anne Gombault, Francoise Liot, Jean-Yves Agard, and Catherine Morel 12. Education and Becoming an Artist: Experiences from Singapore. Can-Seng Ooi 13. 'It was a huge shock': Fashion Designers' Transition from School to Work in Denmark, 1980s-2000s. Lise Skov Notes on Contributors Notes Index