Medical Career Choice Research Articles

Why Do Medical Students Choose Orthopaedics as a Career?

The primary influence on medical students' career choice is their third-year clerkship. However, orthopaedics is not a required rotation in the curriculum of most medical schools. Our goals were to identify factors that motivate students to choose an orthopaedic career and to compare these with the factors that influence students to choose nonorthopaedic disciplines. Fourth-year medical students and orthopaedic residents at the postgraduate year (PGY)-1 level at eight orthopaedic training programs in the United States were surveyed to determine the reasons that they chose orthopaedics instead of other medical or surgical fields. Of the 622 individuals who responded to our survey, 125 were entering orthopaedics and 497 were not. Although career choice in both groups was most heavily influenced by third and fourth-year clinical rotations and faculty contacts, orthopaedics-bound respondents were more likely than non-orthopaedics-bound respondents to be strongly influenced by experiences and people prior to medical school. Orthopaedics-bound respondents were less likely to report a faculty member as the most important person influencing career choice. Fifty-one percent (sixty-three) of 124 students who selected orthopaedics had already decided to pursue this field prior to their third-year rotation. Patient care was chosen by 71% (347) of 490 non-orthopaedics-bound respondents and 75% (ninety-four) of 125 orthopaedics-bound respondents as the most important factor for pursuing a particular field. Income was not selected as the deciding factor by respondents in either group. Although faculty contacts and third-year clinical rotations played an important role in student selection of specialty training, they were less influential for those choosing an orthopaedic career than for those choosing other disciplines. Many students choosing orthopaedics made this decision prior to medical school. We believe that increased exposure to positive clinical role models and experiences during medical school would enhance medical students' options for choosing orthopaedic surgery as a career. Anticipated income did not play a deciding role in career selection.

A questionnaire study of final year medical students investigating the factors influencing them to consider or reject a career in paediatrics

<h3>Aims</h3> To report on the factors that influence final year medical students9 career choices, their attitudes to and experiences of paediatrics, and how these have impacted upon their decision to consider or reject paediatrics as a career choice. <h3>Background</h3> Competition ratios for paediatric training are amongst the lowest of all hospital specialties. In order to delicer a high class child health service in the future, paediatrics needs to attract trainees. Junior doctors in the UK are selecting their specialty at an earlier stage than previously, so experiences of paediatrics during medical school are even more important than in the past in influencing career choice. <h3>Methods</h3> Questionnaire study of 135 final-year medical students. <h3>Results</h3> Significantly more of the students who were considering paediatrics were female (76%, with 60% of the respondents overall being female, p&lt;0.0001). 73% of female students and 12% of male students agreed that the opportunity to work less-than-full-time was important to them when considering their career choice. The majority of students felt that paediatrics offered good opportunities for variety of work (89%) and career progression (78%), but only 55% agreed that there were good opportunities for being involved in research. Under half of students (48%) agreed that paediatricians have well balanced lives, yet only 43% felt that paediatricians do lots of out-of-hours work and 35% that paediatricians are busier than other doctors; between 63% and 78% of students reported that these factors did not impact on their career decision. Most students (75%) agreed that paediatricians are positive role models, though only 65% agreed that paediatricians are well respected by other doctors. A considerable number of students (40%) did not feel involved in the team during paediatric attachments, despite agreeing that people were friendly and they felt welcome. <h3>Conclusions</h3> Students should be offered greater patient exposure and team involvement during paediatric attachments, along with targeted and specific careers advice. Opportunities for flexible working within paediatrics should be explored and developed, and it would be valuable to investigate further the professional image of the specialty.

Are medical students influenced by preceptors in making career choices, and if so how? A systematic review

Increasingly medical students undertake clinical training in distributed learning environments. The driving factor for this is predominantly to address medical workforce shortages. In these environments students are often taught by private practitioners, residents, house staff and registrars, as well as faculty. Through a mix of short- and long-term preceptorships, clerkships and rotations, medical students are exposed to a wider range of preceptors, mentors and role models than has traditionally been the case. The aim of this systematic review was to understand if and how medical students' career choices are influenced by their interactions with preceptors. A search of Ovid Medline, Scopus, ISI Web of Science, PubMed, Eric and CIHNAL was undertaken. The search was structured around the key terms: Medical Student, Career Choice and Preceptor, and variants of these terms. Search limits were set to English-language publications between 1995 and 2010. A total of 36 articles met the selection criteria from the 533 citations sourced from the search. Required preceptorships as short as 3 weeks' duration influence the career choice of students when they rate the preceptor as a high quality teacher. Preceptors who are judged (by students) as high quality teachers have the greatest influence on student career choice by up to four-fold. When students judged a preceptor as being a negative role model, a poor teacher or lacking discipline specific knowledge they will turn away from that field. The positive influence of relationships between preceptors and students on career choice is strongest where there is continuity of preceptors, continuity of care, and continuity of patient interactions. The longer the duration of the preceptorship the greater the influence on student career choice, particularly in primary cares environments. This review adds to the literature by identifying how differing components and combinations of components of a preceptorship influence medical student career choices. Multiple components of the preceptorship combined have a greater influence. In free choice, longitudinal integrated clerkships' duration of placement and continuity relationships with preceptors have the greatest influence on medical students in pursuing a primary care career. This information informs medical schools, curriculum designers and policy-makers in reforming medical education to address workforce shortages.

Outreach in Surgery at the Undergraduate Level: An Opportunity to Improve Surgical Interest among Women?

Medical career choice is often formed at the premedical level, thus surgeons must reach out to undergraduates to enhance interest in surgery. Because there is a predominance of women among undergraduates (57%), this outreach also serves as an opportunity to introduce women to a surgical career. We developed an undergraduate course ("Surgery 99") offering course credit for participation in clinical research projects in surgery, shadowing surgeons in the operating room, and receiving mentorship for a surgical career. Six surgeons (50% women) served as course instructors. The final exam was a thesis with oral presentation. For enrollment, 132 students applied and 13 were accepted each quarter. Eleven students (85%) were women. None of the students had prior exposure to surgery. All but one student (93%) found the experience met or exceeded their expectations. Upon exit, knowledge attained was ranked highest, followed by observation in the operating room, and clinical research experience. All found that the course affirmed their decision to attend medical school and promoted their interest in surgery residency. We demonstrate a successful model for outreach in surgery at the undergraduate level that can positively influence interest in a surgical career, especially among women.

The medical career choice motivations — Results from a Hungarian study

Abstract Some decades ago being a medical doctor was characterized unambiguously as a profession that offers help and serves the patients’ needs during medical treatment. In today’s society, this image of the medical profession has been substantially changed. The present paper aims to examine medical career choice motivations and preferences of choosing speciality, in the light of current social and economic changes in Hungary. The study was carried out by using a voluntary, self-administrated, questionnaire among first-year medical students and resident doctors in four medical faculties in Hungary. The career choice motivations of the first-year medical students and resident doctors are similar and match to the traditional health profession career choice motivations. Nevertheless the first-year students consider high income as one of the most important factors. They appear more conscious and more ambitious regarding their future speciality choice. The Hungarian health care system and medical education must be prepared for the presence of students that are aware of the high market value of a medical diploma, have excellent language skills, and consider migration as one main factor in their motivation when choosing a medical profession.

Almost Internists: Analysis of Students Who Considered Internal Medicine but Chose Other Fields

Medical students' career choices affect health care. To understand how to increase the number of students who choose careers in internal medicine (IM), students who seriously considered IM but chose another field ("Switchers") and those who rejected IM ("Never Considered") were compared with those who chose IM ("Choosers"). Fourth-year medical students from 11 U.S. institutions were surveyed about demographics, medical school educational experiences, and aspects of the specialty of IM. Univariate analysis and multivariate logistic regression models examined associations between student characteristics and classification as Switchers, Choosers, and Never Considered. A total of 1,177 students completed the survey (82% response rate). There were 274 (23%) Choosers, 398 (34%) Switchers, and 499 (43%) Never Considered. The authors' models explained over 80% of variance in these three career choice classification groups. For most responses, an increasingly favorable gradient from Never Considered to Choosers was observed. Multivariate analysis revealed six items that were associated with higher probability of choosing IM: types of patients internists see, timing of career decision, interest groups, intellectual challenge, satisfaction among internists, and the core IM clerkship. Several potentially modifiable educational experiences and aspects of IM distinguished Switchers from the other two groups. The percentage of variance explained by group suggests that these findings identify important underpinnings of career decisions. These items also suggest ways that educational experiences and aspects of the specialty could be redesigned by academicians and policy makers to improve the attractiveness of IM careers.

Influence of Names on Career Choices in Medicine

AbstractThree studies showed that medical doctors and lawyers were disproportionately more likely to have surnames that resembled their professions. A fourth study showed that, for doctors, this influence extended to the type of medicine they practiced. Study 1 found that people with the surname "Doctor" were more likely to be doctors than lawyers, whereas those with the surname "Lawyer" were more likely to be lawyers. Studies 2 and 3 broadened this finding by comparing doctors and lawyers whose first or last names began with three-letter combinations representative of their professions, for example, "doc," "law," and likewise found a significant relationship between name and profession. Study 4 found that the initial letters of physicians' last names were significantly related to their subspecialty, for example, Raymonds were more likely to be radiologists than dermatologists. These results provide further evidence names influence medical career choices.

Factors Dominating Choice of Surgical Specialty

There has been much focus on factors influencing medical students' career choice, prompted by such concerns as a sufficient future surgical workforce, declining applicant pool, changing gender composition, and a cultural shift in values and priorities. Once in a surgical residency, there are little data on factors influencing general surgery (GS) residents' final specialty choice. A survey instrument was developed and content validated in conjunction with the Association of American Medical Colleges Center for Workforce Studies. The final instrument was distributed electronically between March 24 and May 2, 2008, through 251 GS program directors to all ACGME-accredited GS residents (n = 7,508). Response rate was 29% (2,153 residents; 89% programs). Half of GS residents remained undecided about specialty choice through the 2(nd) year, declining to 2% by year 5. Of the two-thirds who decided on a specialty, 16.5% chose to remain in GS, 14.6% chose plastics, 9.3% cardiothoracic, and 8.5% vascular. The specialty choice factors most likely to be very important were type of procedures and techniques, exposure to positive role model, and ability to balance work and personal life. Relative importance of factors in specialty choice varied by gender and chosen specialty. Mentors play a key role in specialty choice (66% decided had mentors versus 47% undecided). Work schedule was the most frequently selected shortcoming in every specialty except plastics. Cardiothoracic surgery followed by GS had the highest shortcomings. The majority of GS residents plan to subspecialize. Three factors dominate specialty choice. Faculty need to understand their impact potential to modify or change perceptions of their specialty.

Does GPs' self-perception of their professional role correspond to their social self-image? - A qualitative study from Germany

BackgroundThere is a decline in the relative numbers of general practitioners in Germany. Earlier research showed that the professional relationship between general practitioners and specialists is overshadowed by conflicts which could influence medical students not to choose a career in general practice. The aim of the study is to analyse potential discrepancies between general practitioners' self-perception of their professional role and their social self-image in relation to medical specialists and to identify potential barriers that might prevent medical students from becoming a general practitioner.MethodsA qualitative study design consisting of 16 interviews with general practitioners was chosen. Data analysis was carried out using the qualitative content analysis by Philipp Mayring.ResultsThere is a discrepancy between general practitioners' professional self-perception and how they perceive they are viewed by specialists. General practitioners communicate a positive self-perception of their professional role. While general practitioners think that specialists in outpatient care have a positive view on general practice, it is assessed to be negative by specialists working in hospitals and as medical teachers.ConclusionThe negatively influenced social self-image may originate particularly from "badmouthing" general practitioners at universities and in hospitals. "Badmouthing" demonstrates the importance of the consideration of psychological aspects in medical teachers and hospital specialists acting as role models. Negative comments should be considered as an important factor in influencing medical students and trainees' career choices. These aspects should be more integrated in future medical education curricula.

Themes and Characteristics of Medical Studentsʼ Self-Identified Clerkship Learning Goals: A Quasi-Statistical Qualitative Study

Investigators sought to clarify the characteristics of students' self-identified learning goals. Goals collected from two schools were categorized into content themes and as "specific" or "general" qualitatively. Associations between learner characteristics and the distributions of goals were analyzed quantitatively. Investigators obtained 879 goals from 290 students. Clinical skills were most frequently identified (89%), followed by medical knowledge (44%), career choice (17%), and attitudinal goals (15%). Within clinical skills, 12 subcategories emerged. Improving oral presentations and critical-thinking ability were more common during the first six months (15% versus 7%, P = .05; 16% versus 8%, P = .04), whereas management skills dominated during the second half of the academic year (18% versus 31%, P = .01). Half of students (n = 146; 50%) listed only "general" goals, and the specificity did not increase over time. Students' main goal was acquiring clinical skills. Their focus within clinical skills shifted to more advanced skills but remained nonspecific.

The Development and Initial Validation of Social Cognitive Career Theory Instruments to Measure Choice of Medical Specialty and Practice Location

Social cognitive career theory served as the basis for the instrument development for scales assessing self-efficacy, outcome expectations, and goals to predict medical career choice. Lent and Brown's conceptualization of social cognitive constructs guided the development of items to measure choice of medical specialty and practice location. Study 1 involved four stages: identification of attitudes and beliefs, generation of scale items, evaluation of scale items by experts, and a pilot study. The pilot study tested the item pool with 293 medical students and allowed item and exploratory factor analyses. Study 2 administered the scales to a second sample of 499 medical students. Confirmatory factor analysis assessed consistency and validity, and identified six psychometrically sound instruments. Initial validity for the scales was found encouraging, with further testing of these measures expected to support their use. Implications for use in research are discussed.

Factors Associated With Medical Students' Career Choices Regarding Internal Medicine

Factors Associated With Medical Students' Career Choices Regarding Internal Medicine

Career choice motivations of medical students and some characteristics of the decision process in Hungary

Abstract The changed circumstances of medical work, raises the question of how socio-economic changes over the last few decades has affected the professional socialisation of medical students. This paper explores the career choice motivations of medical students, as well as some characteristics of the process of making that choice and their effects on professional socialisation. The study was carried out with a self-administered questionnaire with 503 students in general medicine, randomly selected from two Hungarian Medical Schools. More than half of the students contemplated becoming a doctor as early as in their childhood. Their final decision was typically made in high school. Significant differences can be demonstrated in professional socialisation between those individuals identifying with the profession in early childhood and others turning to the profession later. Altruistic motivations were the most significant career choice reasons. In conclusions, the medical career choice must have deeper roots, yielding to an evolutionary psychological analysis as well, one aspect of which is altruism.

Factors Associated With Medical Students' Career Choices Regarding Internal Medicine

Shortfalls in the US physician workforce are anticipated as the population ages and medical students' interest in careers in internal medicine (IM) has declined (particularly general IM, the primary specialty serving older adults). The factors influencing current students' career choices regarding IM are unclear. To describe medical students' career decision making regarding IM and to identify modifiable factors related to this decision making. Web-based cross-sectional survey of 1177 fourth-year medical students (82% response rate) at 11 US medical schools in spring 2007. Demographics, debt, educational experiences, and number who chose or considered IM careers were measured. Factor analysis was performed to assess influences on career chosen. Logistic regression analysis was conducted to assess independent association of variables with IM career choice. Of 1177 respondents, 274 (23.2%) planned careers in IM, including 24 (2.0%) in general IM. Only 228 (19.4%) responded that their core IM clerkship made a career in general IM seem more attractive, whereas 574 (48.8%) responded that it made a career in subspecialty IM more attractive. Three factors influenced career choice regarding IM: educational experiences in IM, the nature of patient care in IM, and lifestyle. Students were more likely to pursue careers in IM if they were male (odds ratio [OR] 1.75; 95% confidence interval [CI], 1.20-2.56), were attending a private school (OR, 1.88; 95% CI, 1.26-2.83), were favorably impressed with their educational experience in IM (OR, 4.57; 95% CI, 3.01-6.93), reported favorable feelings about caring for IM patients (OR, 8.72; 95% CI, 6.03-12.62), or reported a favorable impression of internists' lifestyle (OR, 2.00; 95% CI, 1.39-2.87). Medical students valued the teaching during IM clerkships but expressed serious reservations about IM as a career. Students who reported more favorable impressions of the patients cared for by internists, the IM practice environment, and internists' lifestyle were more likely to pursue a career in IM.

Career preference of medical students and career choice of recent graduates. Factors influencing the preference for a choice of a medical specialty in general and in public health in particular.

Career preference of medical students and career choice of recent graduates. Factors influencing the preference for a choice of a medical specialty in general and in public health in particular.

16. Postgraduate training and its effect on practice location, career choice and practice profile: Tracking 10 years of output from the University of Toronto

The purpose of this study is to investigate the relationship between location and specialty of training and practice characteristics such as type of practice (i.e. community versus academic), socio-demographic profile of patients and their complexity, hospital/health facility affiliations and workload/productivity.&#x0D; The analysis required an extraction of registrant data from the University of Toronto Postgraduate Web Evaluation and Registration (POWER) system for a cohort of exiting residents and fellows from 1993 to 2003. The data extract was linked to several administrative databases held by ICES, including physician practice and billing information from the Ontario Health Insurance Plan (OHIP) and anonymized patient demographic data from the Registered Persons Database (RPDB). &#x0D; Results of this study will inform workforce policy issues such as the overall contribution made by Toronto graduates to Ontario, other Canadian provinces and international practice pool of physicians, trends regarding medical career choice, similarities and differences between career choices of International Medical Graduates versus Canadian Medical Graduates, impact of location/program of training, impact of length of training and profile/geography of patients served by graduates of Toronto. The study will aim to create a methodology/template for analysis that can be applied to other medical schools and catchment areas in human health resource planning. &#x0D; Chan B, Willett J. Factors Influencing Participation in Obstetrics by Obstetrician-Gynecologists. 2004; 103(3):493-498.&#x0D; Noble J, Baerlocher MO. Future Practice Profiles of Canadian Medical Trainees. Clinical and Investigative Medicine 2006; 29(4):288-289.&#x0D; Watson DE, Katz A, Reid RJ, Bogdanovic B, Roos N. Family Physician Workloads and Access to Care in Winnipeg: 1991 to 2001. Canadian Family Physician 2004; 171(4):339-342.

When, what and how South Australian pre-registration junior medical officers' career choices are made

This study aimed to provide better understanding of how pre-registration junior medical officers (PJMOs) make their career choices by investigating when decisions are made, what factors impact on choices, and the role of experience in this process. A third (n = 54) of PJMOs from the 2003 cohort at South Australian teaching hospitals participated in the current research. Inductive content analysis was used to discover themes in data gathered from semistructured interviews. Interviews revealed that although 26% (14/54) of participants had made their career decisions in their pre-registration year, 50% (27/54) had still to decide on a career choice. The factors identified as impacting on career choice were grouped into 5 main categories: job satisfaction; lifestyle; career path; training programme, and the wider environment. Depending on the demographic profile of the PJMO, different relative importance was assigned to these factors. The most important elements used to confirm or disconfirm PJMOs' potential career choices were the experiences they had of different specialty areas. This study allowed an in-depth exploration of the factors that affect the decision-making process of PJMOs. It also found that defined groups of PJMOs place different degrees of importance on these factors, which may have implications for medical workforce planning. It is clear that experience and role models are a crucial component of the career decision-making process. This has importance for specialties that are not incorporated into junior medical training.

Using questionnaires to determine whether medical graduates' career choice is determined by undergraduate or postgraduate experiences

Background: There has been increased interest in the factors influencing the career choice of doctors. Feminization of the medical workforce, changing health care needs, reform of training has ensured that this is an important issue for workforce planners and educationists.Aims and Methods: Questionnaires were distributed to graduates from the University of Liverpool 5 years post graduation requesting the most important influences on career choice.Results and Conclusions: The majority of graduates felt their career choice was primarily dictated by their postgraduate experience. Graduates chose their career pathway for a number of reasons including specialties that would secure home-work balance, disenchantment with training programmes, and work experiences post graduation rather than their undergraduate clinical attachments.

Improving Recruitment into Geriatric Medicine in Canada: Findings and Recommendations from the Geriatric Recruitment Issues Study

As the number of Canadians aged 65 and older continues to increase, declining recruitment into geriatric medicine (GM) raises concerns about the future viability of this medical subspecialty. To develop effective strategies to attract more GM trainees into the field, it is necessary to understand how medical students, residents, GM trainees, and specialists make career choices. The Geriatric Recruitment Issues Study (GRIST) was designed to assess specific methods that could be used to improve recruitment into geriatrics in Canada. Between November 2002 and January 2003, 530 participants were invited to complete the GRIST survey (117 Canadian geriatricians, 12 GM trainees, 96 internal medicine residents, and 305 senior medical students). Two hundred fifty-three surveys (47.7%) were completed and returned (from 54 participating geriatricians, 9 GM trainees, 50 internal medicine residents, and 140 senior medical students). The survey asked respondents to rate factors influencing their choice of medical career, the attractiveness of GM, and the anticipated effectiveness of potential recruitment strategies. Although feedback varied across the four groups on these issues, consistencies were observed between medical students and residents and between GM trainees and geriatricians. All groups agreed that role modeling was effective and that summer student research programs were an ineffective recruitment strategy. Based on the GRIST findings, this article proposes six recommendations for improving recruitment into Canadian geriatric medicine training programs.

Do teaching faculty resources affect the choice of medical career?

The faculty to student (F/S) ratio is a key criterion in ranking medical universities. In France, the registration of students at the medical university in their home region is mandatory. At the end of undergraduate studies, students have to take the National Ranking Exam (NRE), and choice of specialty is based on their rank. The purpose of this study was to investigate the relation between teaching faculty resources in medical universities and the ranking of students on the NRE. All 32 public medical universities with a complete curriculum were included. Correlation of the 2003–2004 F/S ratio with the mean rank of students at the 2004 NRE was assessed using Spearman's rank correlation coefficient [rs]. The overall university F/S ratios ranged from 1.16 to 2.62 overall, and from 0.68 to 1.63 and 0.47 to 1.08 for tenured and non-tenured positions, respectively. All were significantly correlated with mean rank at the NRE (rs = −0.53, rs = −0.50, rs = −0.52, respectively, all p < 0.01). As this link between teaching means and students’ performance has consequences in the competition for career choice, large disparities among medical universities are not legitimate in a regulated model. Deregulation of regional applications should be considered to come close to equality of opportunity.