Abstract
BackgroundWith the establishment of a new medical college in Botswana to train generalist-doctors and specialists, we set out to explore the career preferences of medical students, factors that influence their choices and attitude to local postgraduate training.MethodsA descriptive cross-sectional questionnaire-based study was conducted among medical students in their third to fifth year, at the Faculty of Medicine, University of Botswana. The structured, self-administered questionnaires which were hand-delivered covered demographic characteristics of responders, career choices, preferred location of specialisation and factors that influenced the choices.ResultsOf the 143 medical students approached, 116 (81.0%) returned completed questionnaires. Of the responders, 102 (87.9%) intend to pursue postgraduate specialisation against 2 (1.7%) who declined; 12 (10.3%) were undecided. The four most preferred specialties which constituted 68.1% were surgery (28.4%), paediatrics (19.0%), internal medicine (12.9%), obstetrics and gynaecology (7.2%). There was male preference for surgery (p = 0.04), while women were drawn more towards paediatrics and psychiatry (p = 0.04 and p = 0.01, respectively). Personal interest and aptitude was considered the most important factor among most responders (46.2%), followed by enjoyment of the posting (19.8%). A high proportion of responders 80 (69.0%) preferred to specialise abroad for better exposure/opportunities (48.3%), while for 15.5%, their preferred courses are not currently available locally.ConclusionOur findings indicated that while four major specialties are preferred, significant gender differences exist with female students leaning towards non-surgical disciplines. Students prefer specialising abroad on the pretext that foreign centres offer better training opportunities, and many specialist programmes are unavailable locally.
Highlights
With the establishment of a new medical college in Botswana to train generalist-doctors and specialists, we set out to explore the career preferences of medical students, factors that influence their choices and attitude to local postgraduate training
Preferred location to specialise A high proportion of responders 80/116 (69.0%) preferred to go abroad to specialise; 25 (21.6%) chose University of Botswana (UB) while 11 (9.5%) are indifferent (Table 1)
Altruism and convenience rank high among respondents (22.4%) who opt to specialise in University of Botswana Faculty of Medicine (UBFoM) (Table 2)
Summary
With the establishment of a new medical college in Botswana to train generalist-doctors and specialists, we set out to explore the career preferences of medical students, factors that influence their choices and attitude to local postgraduate training. A country’s health care service is largely affected by the career choice and specialisations of its medical practitioners. This is even more important in many sub-Saharan African countries where acute and chronic shortages of skilled health personnel subsist [1, 2]. Botswana is not affected by such shortages, less than a quarter of the physician-population are citizens. This puts the country at risk if the largely expatriate doctors cannot be replaced on retirement or migrate to other countries [3, 4].
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