Abstract
BackgroundDuring their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues.MethodsQuestionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria. Analysis focused on seven specialties where >20% of students reported they had positive inclinations. For each such specialty, the specialty and selection criteria query were compared using unpaired two-tailed Student’s t-tests to determine differences between students with positive inclinations toward the specialty with those not so inclined. These data were placed in tables, with the significant differences highlighted to facilitate visual recognition of cluster patterns.ResultsCompleted questionnaires were obtained from 317 of 455 students. Students often had positive inclinations toward more than one specialty (specialty clusters) associated with a group of selection criteria (selection criteria clusters). For example, interest in internal medicine was clustered with interest in internal medicine subspecialties, cardiology and research. Furthermore, there was a “reciprocal” aspect to some specialty cluster patterns. For example, those interested in internal medicine had little interest in surgical specialties. Selection criteria clusters revealed occupational interests and socio-environmental factors associated with the specialty clusters. For example, family medicine, which clustered with pediatrics and psychiatry, had a sub-cluster of: Bedside specialty with family orientation affording long-term patient care. Another sub-cluster was time for childrearing and family, only daytime work and outpatient care. Clusters also revealed students’ perceptions that differed from expected: Cardiology is changing from a cognitive to a procedure-oriented subspecialty, clustering not only with internal medicine and its subspecialties but also with emergency medicine, surgical subspecialties and anesthesiology.ConclusionsThe concept that career choice involves selecting from a cluster of related specialties provides information about the specialties students might be considering. Moreover, students are not only looking for individual aspects of a specialty, but for a package including clusters of socio-economic and occupational features. Practically, examining clusters can help in career counseling of medical students and assist residency program directors in marketing their specialties.
Highlights
During their final year of medical school, Israeli students must consider which specialty to choose for residency
To formulate physician workforce policy, healthcare leaders and policymakers, along with residency program directors and department chairs, require objective information about students’ selections and the selection process. During their final year of medical school, Israeli medical students must begin to seriously consider which specialty to choose for residency training and a career
Once the factor and cluster analyses of the entire dataset provided a better understanding of how the various queries on the questionnaire were associated, we focused on data from specialties where greater than 20% of the students replied that they had a positive/very positive inclination (Likert data used as categorical data)
Summary
During their final year of medical school, Israeli students must consider which specialty to choose for residency. To formulate physician workforce policy, healthcare leaders and policymakers, along with residency program directors and department chairs, require objective information about students’ selections and the selection process During their final year of medical school, Israeli medical students must begin to seriously consider which specialty to choose for residency training and a career. The final decision is usually made during the subsequent rotating internship year, the sixth year affords elective time to explore a variety of specialties and subspecialties not included among the required clinical rotations This specialty selection process involves students formulating a plan for their future by examining both their professional interests and personal situations [1, 2]. This process of elimination or circumscription involves contextual influences, such as gender, socioeconomic valuation (e.g. prestige, income) and work-life balance [5]
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