L’enseignement et l’enseignant influencent le choix de la spécialité médicale. Enquête auprès de 207 étudiants

Abstract

Determinants of career choice are numerous. The impact of teaching has not yet been reported.The objectives were to assess determinants of career choice among DCEM 4 (sixth year) medical students at Paris Descartes University and Pierre-et-Marie-Curie University; and to determine the impact of teaching on career choice.Prospective study based on an online survey, after the 2011 National Grading Examination, among 865 DCEM 4 students. Collection of socio-demographic data, commonly reported determinants of medical specialty choice, and the impact of the teaching on this choice.Two hundred and seven (24%) students (67% female) answered the survey. During their medical studies, students changed their mind on their career choice an average of 3 times (range 0-10). Nearly 60% of them made their final choice during the fifth year. Choices varied significantly between the beginning and end of the studies (P<0.0001), with interest in surgical and pediatric careers falling significantly (P<0.0001 and p=0.0003 respectively). At the time of expressing the final choice, surgical careers were mainly chosen by male students (19.8% of males vs. 9.9% of females, P=0.04), whereas medical careers were chosen equally by males and females (37.7% vs. 35.5%, P=0.75). The main determinant was interest in the specialty (96% of students), followed by perceived quality of life (56% of students). Teaching was a determinant for 74% of students, of whom 88% were influenced by the teaching they received during their clinical training. In 42% of cases, the teacher did not belong to the university corpus. In 10% of cases, students were discouraged from their choice by a teacher (a university professor in 50%).Our results highlight the impact of both teaching and the teacher on medical students' career choice. If career choice is now compelled in France by the "careers law", teaching is more than ever an effective way of interesting students in specialties which might appear less attractive. At a time when the selection of candidates for hospital-university careers is mainly based on publications, this study calls for reflection on the evaluation of these candidates' teaching qualities.