Abstract
BackgroundOne of the purposes of undergraduate medical education is to assist students to consider their future career paths in medicine, alongside the needs of the societies in which they will serve. Amongst the most medically underserved groups of society are people in prison and those with a history of incarceration. In this study we examined the experiences of medical students undertaking General Practice placements in a prison health service. We used the theoretical framework of the Social Cognitive Career Theory (SCCT) to explore the potential of these placements to influence the career choices of medical students.MethodsQuestionnaire and interview data were collected from final year students, comprising pre and post placement questionnaire free text responses and post placement semi-structured interviews. Data were analysed using inductive thematic analysis, with reference to concepts from the SCCT Interest Model to further develop the findings.ResultsClinical education delivered in a prison setting can provide learning that includes exposure to a wide variety of physical and mental health conditions and also has the potential to stimulate career interest in an under-served area. While students identified many challenges in the work of a prison doctor, increased confidence (SCCT- Self-Efficacy) occurred through performance success within challenging consultations and growth in a professional approach to prisoners and people with a history of incarceration. Positive expectations (SCCT- Outcome Expectations) of fulfilling personal values and social justice aims and of achieving public health outcomes, and a greater awareness of work as a prison doctor, including stereotype rejection, promoted student interest in working with people in contact with the criminal justice system.ConclusionPlacements in prison health services can stimulate student interest in working with prisoners and ex-prisoners by either consolidating pre-existing interest or expanding interest into a field they had not previously considered. An important aspect of such learning is the opportunity to overcome negative preconceptions of consultations with prisoners.
Highlights
One of the purposes of undergraduate medical education is to assist students to consider their future career paths in medicine, alongside the needs of the societies in which they will serve
In this study we examined the learning experiences of medical students undertaking General Practice placements in prisons and the reported influence of this training on confidence in and understanding of working with people in custody and with a history of incarceration
We further examined the potential for medical student placements in prisons to influence the career choices of medical students using the Social Cognitive Career Theory (SCCT) Interest model as an explanatory framework
Summary
One of the purposes of undergraduate medical education is to assist students to consider their future career paths in medicine, alongside the needs of the societies in which they will serve. In this study we examined the experiences of medical students undertaking General Practice placements in a prison health service. Being in custody may be an opportunity to address their high health needs and to create societal benefits by improving health behaviours prior to re-entry into the community, such as through stabilisation of substance misuse [15]. Despite these demonstrable needs, there is underrecruitment of health professionals into custodial health services. It is likely that career preferences are influenced by educational experiences as students [23]
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