Abstract
BackgroundSpecialty selection by medical students determines the future composition of the physician workforce. Selection of career specialties begins in earnest during the clinical rotations with exposure to the clinical and intellectual environments of various specialties. Career specialty selection is followed by choosing a residency program. This is the period where insight into the decision process might help healthcare leaders ascertain whether, when, and how to intervene and attempt to influence students' decisions. The criteria students consider important in selecting a specialty and a residency program during the early phases of their clinical rotations were examined.MethodsQuestionnaires distributed to fifth-year medical students at two Israeli medical schools.Results229 of 275 (83%) questionnaires were returned. 80% of the students had considered specialties; 62% considered one specialty, 25% two, the remainder 3-5 specialties. Students took a long-range view; 55% considered working conditions after residency more important than those during residency, another 42% considered both equally important. More than two-thirds wanted an interesting and challenging bedside specialty affording control over lifestyle and providing a reasonable relationship between salary and lifestyle. Men were more interested in well-remunerated procedure-oriented specialties that allowed for private practice. Most students rated as important selecting a challenging and interesting residency program characterized by good relationships between staff members, with positive treatment by the institution, and that provided much teaching. More women wanted short residencies with few on-calls and limited hours. More men rated as important residencies affording much responsibility for making clinical decisions and providing research opportunities. More than 50% of the students considered it important that their residency be in a leading department, and in a large university medical center. Only 5% considered it important to do their residency in the country's peripheral areas, while 30% reported interest in a residency in the country's center.ConclusionsThe fifth year of a six-year medical school is an opportune time to provide students with information and guidance on the various specialties and selecting a residency program as they begin to solidify their perceptions and ideas about the various specialties. This study serves as an impetus to medical educators and healthcare leaders to become interested in students' career selection.
Highlights
Many students enter medical school with some idea of which medical specialty they wish to pursue [1,2,3]
Much of the research performed on the medical specialty selection process has generally focused on students before or immediately upon beginning medical school, on students in their final year of medical school, or interns
Even though interests in specific specialties have been found in other studies to continually change during medical school and internship, this study shows that distinctive patterns, e.g., those of male vs. female students, of opinions, biases, and criteria, are already evident during the fifth year of medical school [4]
Summary
Many students enter medical school with some idea of which medical specialty they wish to pursue [1,2,3]. Gaining insight into students’ criteria for selecting medical specialties and residency programs during this period might provide an understanding of the nature of the early decision process. This information should be important for healthcare system leaders since specialty selection determines the future composition of the physician workforce. Career specialty selection is followed by choosing a residency program This is the period where insight into the decision process might help healthcare leaders ascertain whether, when, and how to intervene and attempt to influence students’ decisions. The criteria students consider important in selecting a specialty and a residency program during the early phases of their clinical rotations were examined
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