Influence Of Medical School Research Articles

Why UK medical students change career preferences: an interview study.

IntroductionMedical career preferences are influenced by a multitude of factors. Currently several specialties are undergoing recruitment problems; we must develop our understanding of medical career decision-making to ensure the production of an appropriate workforce. We aimed to explore the changing career preferences of students during medical school, to better understand this.MethodsThis was an interpretivist, qualitative study. Data were collected through semi-structured interviews with seven final-year students to explore why their career preferences had changed during medical school. Transcripts of these interviews were thematically analysed.ResultsThree overarching themes emerged from the analysis: The ‘influence of medical school’, ‘perceived suitability to specialty’ and ‘belonging and fitting in’. A thematic map captured the participants’ perceptions on why their preferences had changed, with major influences echoing existing research. However, novel findings included participants’ personalities and enthusiasm changing over time, the need for a ‘sense of belonging’ and participants defining the term ‘variety’ uniquely, perceiving their current specialty preference to match their definition.DiscussionThis was an original, in-depth study on changing career preferences, which is an ill-defined subject within the literature. Analysis revealed preferences changed for a variety of medical school, personal and specialty reasons, leading to the construction of an updated model of medical career decision-making. Medical career preference remains a dynamic and ever-evolving phenomenon, influenced by an intricate interplay of internal and external factors. An understanding of this is crucial for future workforce planning.Electronic supplementary materialThe online version of this article (10.1007/s40037-020-00636-7) contains supplementary material, which is available to authorized users.

Withholding Treatment From the Dying Patient: The Influence of Medical School on Students' Attitudes.

To determine motives and attitudes towards life-sustaining treatments (LSTs) by clinical and preclinical medical students. This was a scenario-based questionnaire that presented patients with a limited life expectancy. The survey was distributed among 455 medical students in preclinical and clinical years. Students were asked to rate their willingness to perform LSTs and rank the motives for doing so. The effect of medical education was then investigated after adjustment for age, gender, religion, religiosity, country of origin, and marital status. Preclinical students had a significantly higher willingness to perform LSTs in all cases. This was observed in all treatments offered in cases of a metastatic oncologic patient and an otherwise healthy man after a traumatic brain injury (TBI). In the case of an elderly woman on long-term care, preclinical students had higher willingness to supply vasopressors but not perform an intubation, feed with a nasogastric tube, or treat with a continuous positive air-pressure ventilator. Both preclinical and clinical students had high willingness to perform resuscitation on a twelve-year-old boy with a TBI. Differences in motivation factors were also seen. Preclinical students had a greater willingness to treat compared to clinical students in all cases and with most medical treatments offered. This is attributed mainly to changes along the medical curriculum. Changes in reasons for supplying LSTs were also documented.

The influence of medical school on career choice: A longitudinal study of students’ attitudes toward a career in general surgery

BackgroundLess than 80% of general surgery (GS) residency positions are filled by graduates from allopathic, U.S. medical schools. The aim of this study was to gauge students' interest in pursuing GS throughout their medical school matriculation and explore students’ changing perceptions of the specialty. MethodsStudents at two medical schools were surveyed annually for 4 years. Survey responses regarding interest were compared to actual NRMP match results. ResultsInterest in a GS career was highest at the outset of medical school and declined steadily during the program, which was similar at both schools, including a positive effect on interest from the surgical clerkship. ConclusionsOur findings suggest that experiences during medical school impact students' perceptions of GS; specifically, lifestyle, work environment, and the length of training discouraged pursuit of GS. Perception of a GS's lifestyle and the educational environment are both highly modifiable factors that could increase interest in general surgery amongst graduates.

Social dominance theory and medical specialty choice.

Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social dominance theory, to explain why some students, and not others, are drawn to more prestigious, technique-oriented specialties, based on their desire for hierarchy. We conducted a cross-sectional study among medical students at Institution X (N=359). We examined the link between medical students' characteristics i.e. social dominance orientation (SDO), gender, age, and their career intention. We also examined level of medical students' SDO at different stages of the curriculum. SDO scores were significantly associated with technique-oriented career intentions (OR 1.56; 95% CI [1.18, 2.06]; p=0.001). The effect was independent of gender. Medical students' SDO scores were significantly higher in later stages of the medical curriculum (F=6.79; p=0. 001). SDO is a significant predictor of medical students' career intention. SDO scores are higher in students during the clinical phase of the curriculum. Medical socialization, involving the internalization of implicit and explicit norms, particularly in hospital settings, is likely to underpin our findings. This theory illuminates consistent findings in the literature on specialty prestige and the influence of medical school on career choice.

The influence of medical school and residency training program upon choice of an academic career and academic productivity among otolaryngology faculty in the United States of America: Our experience of 1433 academic otolaryngologists

The influence of medical school and residency training program upon choice of an academic career and academic productivity among otolaryngology faculty in the United States of America: Our experience of 1433 academic otolaryngologists

Medical school and residency influence on choice of an academic career and academic productivity among neurosurgery faculty in the United States

Factors determining choice of an academic career in neurological surgery are unclear. This study seeks to evaluate the graduates of medical schools and US residency programs to determine those programs that produce a high number of graduates remaining within academic programs and the contribution of these graduates to academic neurosurgery as determined by h-index valuation. Biographical information from current faculty members of all accredited neurosurgery training programs in the US with departmental websites was obtained. Any individual who did not have an American Board of Neurological Surgery certificate (or was not board eligible) was excluded. The variables collected included medical school attended, residency program completed, and current academic rank. For each faculty member, Web of Science and Scopus h-indices were also collected. Ninety-seven academic neurosurgery departments with 986 faculty members were analyzed. All data regarding training program and medical school education were compiled and analyzed by center from which each faculty member graduated. The 20 medical schools and neurosurgical residency training programs producing the greatest number of graduates remaining in academic practice, and the respective individuals' h-indices, are reported. Medical school graduates of the Columbia University College of Physicians and Surgeons chose to enter academics the most frequently. The neurosurgery training program at the University of Pittsburgh produced the highest number of academic neurosurgeons in this sample. The use of quantitative measures to evaluate the academic productivity of medical school and residency graduates may provide objective measurements by which the subjective influence of training experiences on choice of an academic career may be inferred. The top 3 residency training programs were responsible for 10% of all academic neurosurgeons. The influence of medical school and residency experiences on choice of an academic career may be significant.

Influence of medical school applicantsʼ demographic and cognitive characteristics on interviewersʼ ratings of noncognitive traits

Interviews are commonly used to measure noncognitive traits of medical school applicants. The present study investigated the influence of knowledge of applicants' cognitive abilities on interviewers' ratings of noncognitive traits. Academic and demographic predictors of interview ratings of applicants' noncognitive traits were examined at the Medical University of South Carolina College of Medicine during two years: 1992, when applicants' Medical College Admission Test (MCAT) total scores and undergraduate grade-point averages (GPAs) were available to interviewers; and 1993, when MCAT and GPA data were not available. In 1992, 226 applicants met study criteria (i.e., they received ratings from three interviewers in addition to having MCAT and GPA data on file); in 1993, 245 applicants met the criteria. Step-wise regression analyses were conducted to measure the influences of seven independent variables on applicants' interview ratings. Two-way analyses of variances and t-tests were used to determine the effects of gender of applicants and interviewers. Cronbach's alpha coefficients were used as measures of interviewers' reliability. GPA was the best predictor for both years but accounted for double the amount of variance in interview ratings in 1992 (15.7%) compared with 1993 (7.4%). The reliability coefficients for the interviewers were .496 for 1992 and .473 for 1993. If the goal of the medical school admission interview is to assess noncognitive traits independently from academic skills, the authors recommend that MCAT and GPA data not be available to interviewers during interviews. The authors also found that gender and race influenced interview ratings in accordance with affirmative-action goals. Finally, the authors found that interview scores were only moderately reliable across different interviewers. They discuss ways to increase their reliability.

Surgeons' personalities: the influence of medical school.

Does medical school shape surgeons' personalities? This research retrospectively compares personality test results of 17 surgical and 44 non-surgical specialists trained at the same medical school. Fifty-five standardized personality measures at two developmental periods (the outset and the conclusion of medical school) revealed no pronounced differences between surgeons and other specialists. Interviews with 30 academic doctors (10 surgeons, 10 anaesthesiologists and 10 psychiatrists) explore the apparent discrepancy between personality tests scores and commonly held opinions that surgeons' personalities differ from other doctors.

Primary knowledge, medical education and consultant expertise.

We have studied the knowledge of students and clinicians that they actually used to follow up four problems in general medicine. Some unexpected similarities and differences in their readily accessible or primary knowledge were found in groups from first-year clinical medical students to consultants. There is no linear increase in the quantity of primary knowledge with experience, but qualitative changes are very much more important. At all levels individuals show a remarkable dissimilarity in the knowledge they use to solve clinical problems, so that the bulk of personal knowledge used is individual. Comparatively rarely do people use the same knowledge to solve any one clinical problem. However, there is evidence of a general tendency towards increasing uniformity in knowledge as a result of the medical school years. After houseman level, individuality increases again. These changes result in consultants achieving an identical profile to first-year clinical medical students in terms of the extent to which their primary knowledge bases are held individually or in common. These findings suggest that consultant expertise is actually based on individual experience rather than a common core of knowledge. The influence of medical school in providing such a common knowledge base is (1) limited and (2) reversed by clinical practice. The results suggest the necessity for increased vocational and practice-oriented components in medical education, particularly in postgraduate education.