The specialty choice of medical students in China: a stated preference experiment.

Dong Liang,Cheng-Xiang Tang

doi:10.1186/s12909-016-0619-z

Abstract

BackgroundPrimary Care Providers (PCPs), such as internists and general practitioners, have been deemed a way of delivering cost-effective care in an equitable way because PCPs are responsible for providing accessible basic medical care for the general population. This study aims to examine medical students’ preferences for PCP-based specialty choices in the context of an ageing population in China.MethodsWe implemented a Best-Worst Scaling (BWS) experiment, a recently developed preference elicitation method based on random utility theory. Three hundred and fifty graduating medical students from three medical colleges were randomly recruited to evaluate 11 common medical specialties in China. A counting approach, a conditional logit model, and K-means clustering have been used to analyse the relative importance of items and preference heterogeneity among medical students.ResultsOne hundred and ninety of 350 students completed valid questionnaires. General surgery was identified as the most preferred specialty among the overall sample, yet internal medicine shares the same importance as surgery. Both geriatric medicine and psychiatric medicine were found to be the least selected specialties. Finally, the K-means clustering further suggested there was preference heterogeneity across our sample.ConclusionsTwo aims were fulfilled in this study. First, through our experimental approach the results provide a better understanding of the career desires of medical students in China. Second, the results of this study indicate that despite the fact a non-PCP-based specialty is the most popular among the sampled students; a PCP-based specialty is still an important alternative choice.

Highlights

Primary Care Providers (PCPs), such as internists and general practitioners, have been deemed a way of delivering cost-effective care in an equitable way because primary care providers (PCP) are responsible for providing accessible basic medical care for the general population
Our study employs a Best-Worst Scaling (BWS) experiment, a recently developed preference elicitation method based on random utility theory, to explore how students make decisions about choosing their medical specialty
This study aims to address two gaps in the current literature: (i) To explore perceptions and preferences regarding the choice of a medical specialty through the application of a rigorous methodology; (ii) To investigate how graduating medical students in China value the PCP-based medical specialties

Summary

Introduction

Primary Care Providers (PCPs), such as internists and general practitioners, have been deemed a way of delivering cost-effective care in an equitable way because PCPs are responsible for providing accessible basic medical care for the general population. This study aims to examine medical students’ preferences for PCP-based specialty choices in the context of an ageing population in China. Very few studies have investigated the provision of health care professionals in China, even though the Chinese health care system faces big challenges, such as an ageing population and rapidly changing socio-economic influences [1]. Rapid income growth has adversely affected daily activities causing a rising obesity and road traffic fatalities [3]. These changes call for a significant response from China’s health care professionals. We have found no present study in China that has ever tried to investigate these complexities using rigorous methods

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