Recent years have seen record numbers of applications to UK psychiatry training, yet consultant vacancies remain high and substantial workforce gaps persist. This contradiction reflects a growing recruitment–retention paradox: increasing pressure at the point of entry has not translated into sustainable workforce capacity. This feature introduces the pressurised leaky funnel, a systems-based conceptual model that reframes the psychiatry workforce as a pathway shaped by upstream recruitment pressures and downstream attrition across five stages: exposure and intent, application, selection, training environment and career outcomes. Drawing on established workforce models and educational psychology theory, the model explains how application volume can expand while misalignment, motivational erosion and identity strain drive cumulative workforce loss across the pipeline. We argue that recruitment, selection and retention should not be treated as separate policy domains but understood as interacting components of a single system. By linking where doctors enter psychiatry with how commitment is sustained or eroded, the model offers a framework for moving beyond short-term recruitment metrics towards progression, retention and long-term workforce sustainability, while highlighting new opportunities for selection reform, training environment redesign and retention-focused workforce planning.

Recruitment and retention challenges continue to hinder the success of clinical trials. Artificial intelligence (AI) has emerged as a promising means to optimize various clinical trial processes; however, its impact specifically on recruitment and retention has not been comprehensively evaluated. This scoping review utilized the Joanna Briggs Institute framework and adhered to PRISMA-ScR guidelines, systematically searching literature published between January 2018 and June 2024 across multiple databases. Of the 21,573 records screened, 121 studies were included. A meta-analysis was conducted to quantitatively assess the performance of AI-driven tools. AI applications for patient screening demonstrated strong performance, achieving a pooled sensitivity of 0.91 (95% CI: 0.84–0.95) and an area under the curve (AUC) of 0.79 (95% CI: 0.72–0.85). AI tools employed for eligibility identification and classification also exhibited strong outcomes, with pooled sensitivities of 0.80 (95% CI: 0.76–0.84) and 0.92 (95% CI: 0.84–0.96), respectively, and precisions of 0.84 (95% CI: 0.80–0.88) and 0.91 (95% CI: 0.85–0.95). AI tools aimed at identifying patient cohorts showed moderate effectiveness (pooled sensitivity: 0.70 [95% CI: 0.52–0.84]; AUC: 0.74 [95% CI: 0.61–0.84]). Overall, AI presents significant potential for enhancing clinical trial recruitment and retention, with effectiveness varying across specific applications. These findings underscore AI’s valuable role in improving trial efficiency and data quality.

Achieving enrollment goals is essential for the successful completion of a clinical trial. This includes enrolling a sample size that provides adequate power and engaging a study population that supports generalizability of research findings. Yet, trial participation is routinely hindered by its complexity, associated risks, and frequently cited barriers to participation including lack of awareness, low trust/mistrust, and logistical burdens that make participation of low value or unrealistic to potential participants [1,2].

In randomized clinical trials, participant retention is critical to ensure the validity and unbiased interpretation of study results. Within a multisite trial of individuals with high impact chronic pain, we explored whether a letter mailed in advance of follow-up study assessments at 3-, 6-, and 12-months from randomization improved participant retention. 4063 advance letters were mailed to 2037 participants at least once throughout their study participation. Increases in participant retention and follow-up assessment rates were observed across all study groups, sites, and timepoints. Mailing a letter in advance of follow-up study assessments in this randomized clinical trial improved participant retention.

In the last twenty-five years there has been a significant alteration in the student experience in the UK. In the early 1980s it was rare for students either to fail to take exams or produce assignments on time or for them to fail to complete the degree they had begun. Now a significant proportion of students who start a programme of study withdraw before completion and this ‘attrition’ has become a particular problem for some universities and for the higher education funding bodies. This article reports the results of a project that conducted qualitative, depth interviews not focussed so much on finding reasons for having left, but rather on the experience and biography of those facing problems and thus likely to consider leaving or being forced to leave. A particular focus of this approach was to investigate a different dimension of the issue: student motivation for studying.

Massive open online courses (MOOC) have been considered by some observers as a powerful opportunity to improve distant learning. The Université catholique de Louvain was the first Belgian university to deliver a political science MOOC (Louv3x) in French, entitled ‘Discovering political science’ (Découvrir la science politique). This paper seeks to explore the challenges a pedagogical team faces when transforming a ‘traditional’ political science introductory course into a MOOC. The paper also explores how the use of a MOOC might impact the learning outcome within on-campus and worldwide students.

Engagement is a positive psychological state that is linked with a range of beneficial individual and organizational outcomes. However, the factors associated with volunteer engagement have rarely been examined. Data from 1064 volunteers of a wildlife charity in the United Kingdom revealed that both task- and emotion-oriented organizational support were positively related to volunteer engagement, and volunteer engagement was positively related to volunteer happiness and perceived social worth and negatively related to intent to leave the voluntary organization. Consistent with theory, engagement acted as a mediator between these factors. The implications for future research and the relevance of the findings for voluntary organizations are discussed.

Despite the benefits of volunteering to the individual, organization and community, the retention of volunteers within volunteer and not-for-profit organizations remains a significant challenge. Examining the motivations of individuals who have ceased their engagement in a volunteer organization may provide insights to improve retention rates. The perceptions of 64 volunteers formerly involved in an international volunteer organization were examined through community telephone interviews and online surveys. Results show that while volunteers valued their participation in the volunteer organization, their decision to cease engagement in the organization was driven by five major themes: ‘Work overload and burnout,’ ‘Lack of autonomy and voice,’ ‘Alienation and cliques,’ ‘Disconnect between volunteer and organization’ and ‘Lack of faith in leadership.’ Strategies to improve and refine organizational practice and culture may contribute to a strengthened membership and retention.

In this article, we are concerned with the recruitment potential of one-off episodic events for attracting and retaining volunteers. Our specific focus is on the neglected pool of non-returning volunteers. These are one-off event participants who are unwilling to volunteer again in future. Many studies generally document an overwhelming willingness of people to repeat volunteering after participating in a one-off event, either due to reasons of social desirability or because they had a good volunteering experience. The positive participant reaction at most one-off events leads to the assumption that such events are useful arenas in which to generate a pool of potential repeat volunteers. Yet, scant attention is given to those people at the events who have no inclination for further volunteering. This article addresses that gap. It is part of a special issue on episodic volunteering from an international perspective and uses data from nineteen countries across the world. Our statistical analyses, which compares returning and non-returning volunteers, finds that on average, 7.42% of episodic event participants do not want to volunteer again in future. The results reveal that younger, less educated, novices who participate on their own are more likely to report unwillingness to repeat volunteering. Non-repeat volunteers unexpectedly had higher levels of altruistic motivation, and as expected, a less satisfactory one-off volunteer experience. The article concludes with implications and recommendations for organizers of events employing episodic volunteers.

Retaining engaged volunteers is crucial to many non-profit organizations. However, research on volunteer engagement is limited, and the distinction between job and organizational engagement in volunteers remains to be investigated. In this paper, we examine both organizational- and job-level engagement, and specifically, whether perceived organizational support would enhance volunteer engagement and associated attitudes. We surveyed 221 volunteers, and asked them about their perceptions of organizational support; their engagement with their volunteer job and the organization they volunteer for; satisfaction; commitment; and turnover intentions. Both organizational and job engagements had significant relationships with the attitudinal variables. However, we found that organizational rather than job engagement mediated the relationship between organizational support and volunteer satisfaction and commitment. While organizational engagement correlated with turnover intentions, neither job nor organizational engagement mediated the relationship between support and the intent to leave. Our findings advance the research on volunteer engagement, and highlight the importance of organizational engagement for this important, but too often overlooked, workforce.

Tension between professional obligations and extraprofessional caregiving responsibilities is one reason physician scientists leave academic medicine. The COVID-19 pandemic exacerbated this challenge by increasing caregiving demands and decreasing time spent on research as much as 40%. CARES at UAB (Caregiving Affected Research Early-Career Scientists Retention Program at the University of Alabama at Birmingham) provided “extra hands” awards to early-career physician and non-physician research faculty to hire personnel to expedite research projects already awarded but deleteriously affected by caregiving during the pandemic. Evaluation included tracking awardee publications and grants, surveying awardees, and conducting semi-structured individual in-depth interviews. CARES at UAB distributed 28 grants totaling $1,005,266. Twenty-six awardees (93% retention) remain in academia 2.25–3.25 years after award initiation. Awardees attribute over 200 manuscripts to the funding and have secured 15 new NIH K-, R-, and U-series grants. Surveys indicate improved awardee well-being and decreased caregiving burden since receipt of funding. Scientific productivity, feeling valued, sense of community, and lifeline emerged as themes from interviews. Group “listening sessions” yielded university-level recommendations around tenure and promotion, caregiving culture, and mentoring. Resource to hire “extra hands” holds promise to retain early-career physician and non-physician research faculty with extraprofessional caregiving responsibilities.

Intentionally enhancing and supporting the early careers of individuals from populations underrepresented in science and medicine (URSM) is essential to achieving health equity. The Health Equity Leadership and Mentoring (HELM) Program at the University of Minnesota and the University of Utah is designed to foster academic excellence and build leadership capacity of postdoctoral fellows, clinical fellows, and early-career faculty who identify as URSM and/or who are committed to careers in health equity research and clinical care. HELM models a culture of psychosocial safety to create a sense of belonging and uses evidence-based and culturally aware mentoring and career development strategies with the goal of retaining diverse faculty. HELM proved agile and adaptive during the Covid-19 pandemic and has been successful in states with and without legislation limiting diversity programs. Across the 2 institutions, the HELM program has supported over 200 trainees and early-career faculty through mid-2024. Among HELM participants who joined the program as faculty, 85%–95% have remained in their faculty positions.