Frontlines and Crossroads: The Impact of COVID-19 on the Motivations of Medical Students from Selected Philippine Medical Schools in Pursuing Their Medical Studies

Abstract

BACKGROUND: The onset of the COVID-19 pandemic made changes to the Philippine medical education system to transfer to an online setting, which meant the loss of practical skills needed for future clinical encounters. Most students consider the desire to serve others as their motivation to pursue medicine, but stated that online learning was more favorable for theoretical lessons and not for practical skills. These students had to cope with lifestyle changes which challenged their resolve, as well as deal with the technology and infrastructure required for online learning. The study aimed to compare the strength and nature of motivations of medical students to pursue their studies before and after the onset of the pandemic, and to propose recommendations to support them through the pandemic and beyond. METHODS: Semi-structured interviews were conducted using a study questionnaire that dealt with determining respondents’ motivations for pursuing a medical degree, the impact of the pandemic and how it may have changed their motivations, and what recommendations they can propose to motivate other medical students. Interview transcripts were then analyzed through a qualitative inductive thematic analysis. Pre-clinical and clinical students (clerks and postgraduate interns) enrolled during SY 2020-2021 from Metro Manila and from among the 3 major Philippine island groups were selected to approximate the distribution of medical schools across the country. A total of 17 eligible participants were selected through purposive sampling of different personal backgrounds. Recruitment and call for participants were coursed through the Association of Philippine Medical Colleges - Student Network as well as through social media. Data from interview transcripts were familiarized and ideas from important recurring patterns shared among respondents’ answers were made into codes, which were subsequently organized into themes both unique and generalizable across student groups. RESULTS: Six major themes arose: 1) Contextualizing the pre-clinical and clinical experiences, 2) Challenges of online learning; 3) Desire for lived experience; 4) Tensions between personal contexts and online learning; 5) Grit driven by a desire to serve; 6) Resilience over adversity and sunk cost. Most pre-clinical students were motivated to pursue medicine by a desire to serve, while clinical students were straightforward about financial reward as motivation. Despite the limitations of online education, lack of social interaction and skills training, medical students had strengthened motivations to continue their studies as the pandemic highlighted the need for physicians, reinforcing their intrinsic desire to serve others. Mental health and financial issues were a concern for some, but these students did not wish to quit so as not to lose momentum with their studies. CONCLUSION: While most medical students interviewed felt more motivated in pursuing their studies during the pandemic, there was a desire and a call for more support in their studies and training. Their personal stories suggested there is room for improvement in certain aspects of local medical education. Addressing their concerns through financial and educational support, and bridging clinical skills with online learning would thus help them create quality healthcare in the pandemic context and beyond.