Career plans of final-year medical students in South Africa

Abstract

Those of rural or small-town origin (N=350) were less likely than those of city origin (N=376) to want to work abroad (p<0.001), were more likely to want to work in rural areas (p<0.0001), and were less likely to want to spend most of their career in the private sector (p<0.05). Among respondents planning to work abroad, those of non-urban origin were more likely to work there short-term than those of urban origin (p<0.001). Although only 47% of respondents had made a definite career choice, 93% nevertheless indicated their first choice of specialty. Internal medicine (including sub-specialties) was the leading choice overall (22%) and among women (21%). Surgery (including sub-specialties) was second overall (20%), the top choice of men, and the second-ranked choice of women (26% v. 16%; p<0.001). Paediatrics was the third-placed choice overall (12%). It was significantly more popular among women than men (16% v. 6%; p<0.001), as was obstetrics and gynaecology (11% v. 6%; p<0.05). The top three influences on specialty choices were ‘Plans to have a family’ (62%), ‘Acceptable hours of practice’ (55%), and ‘Intellectual challenge’ (45%). Other important influences were ‘Opportunities for health promotion and prevention’ (37%), ‘Working with new technology’ (36%), and ‘Continuity of patient contact’ (35%). Women rated all of the above more highly than men, with the exception of ‘Working with