1
|
Sein E, Belsi A, Morgenstern C, Terzidou V, Patel RR. The early determinants of career choices for medical students following an obstetrics and gynaecology placement: Mixed methods study. BJOG 2023. [PMID: 38059307 DOI: 10.1111/1471-0528.17732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/28/2023] [Accepted: 10/24/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE To explore the impact of attending a clinical placement in considering a career in obstetrics and gynaecology. DESIGN Mixed methods study. SETTING London Medical School. POPULATION Fifth year medical students attending a clinical placement in obstetrics and gynaecology. METHODS Between January 2021 and January 2022, questionnaires were used and semi-structured focus groups conducted, which were audio-recorded. Descriptive statistics were conducted and a framework analysis on transcribed focus groups. MAIN OUTCOME MEASURE The impact of the clinical placement on career choice. RESULTS Six main themes were identified from the analysis; three contributing to considering a career in obstetrics and gynaecology; pregnancy is not an illness, extraordinary experience of observing childbirth and variable specialty and three themes emerged contributing to not considering a career; lack of work-life balance, high stakes specialty and the emotional toll. Even at an undergraduate level, medical students exhibited concerns about the long-term feasibility of achieving work-life balance and avoiding professional burnout, which was partly attributed to the responsibility of looking after both the woman and their baby. CONCLUSIONS Obstetrics and gynaecology is perceived as an exciting and variable speciality by medical students. Students' experiences on the labour ward during a clinical placement appear to contribute to the consideration of a career in obstetrics and gynaecology. Students should be given opportunities to discuss their concerns about obstetrics, particularly over the potential psychological impact of adverse/traumatic birth events. It is crucial to provide a realistic introduction to obstetrics, to recruit enthusiastic junior doctors who will be resilient to the pressures of the speciality, to avoid burnout and minimise attrition rates.
Collapse
Affiliation(s)
- Eleanor Sein
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Athina Belsi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Vasso Terzidou
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Roshni R Patel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| |
Collapse
|
2
|
Ní hÉalaithe C, Howard A, Corcoran P, McCarthy CM, Horgan M, Bennett D, O'Donoghue K, O'Sullivan S. Factors influencing medical students' decision to pursue a career in obstetrics and gynaecology. PLoS One 2023; 18:e0288130. [PMID: 38051720 DOI: 10.1371/journal.pone.0288130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/20/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION The career intentions of medical students can exert influence on service provision and medical staffing in the health services. It is vital for a specialty's development and sustainability that it has a constant stream of trainees into it annually. An appreciation of how a specialty is viewed by medical students can be used as an opportunity for early intervention in order to improve perception of the specialty and reduce future workforce problems, such as retention and attrition within obstetrics and gynaecology (O&G). We aimed to analyse positive and negative factors of the specialty of O&G as perceived by medical students in order to gain insight into changes that need to be made to improve recruitment and retention into the specialty. METHODS A 70-item structured questionnaire consisting of demographic information and 5-point Likert scale questions relating to O&G was administered to final year medical students in the Republic of Ireland. Data were analysed with descriptive statistics, logistic regression, and odds ratios as appropriate. RESULTS Of 195 medical students approached, 134 completed the questionnaire, a response rate of 68.7%. The majority were female (55.2%, n = 74) and 76.1% of respondents (n = 102) were Direct Entry Medicine students, with the remainder Graduate Entry Medicine students. 30.8% (n = 41) of students who responded scored 6 or more on a 10-point Likert scale when asked about their likelihood of considering a career in O&G. Students' clerkship experience factored heavily into their perception of the specialty and was more likely to be positive if they experienced direct consultant engagement and the opportunity for hands-on experience. Lifestyle factors, litigation and media were found to be deterrents to considering the specialty after graduation. CONCLUSIONS This study demonstrates the importance of good clerkship experience in fostering an interest amongst undergraduates in O&G. Educators and those working within the specialty should showcase the strengths of the specialty during undergraduate education, and work on ameliorating deterrents to ultimately provide a structured approach to improving recruitment into O&G.
Collapse
Affiliation(s)
- Caoimhe Ní hÉalaithe
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Aoife Howard
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Paul Corcoran
- National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland
| | | | - Mary Horgan
- Royal College of Physicians of Ireland, Dublin, Ireland
| | - Deirdre Bennett
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | | |
Collapse
|
3
|
Spain E, Tumelty ME, Hannigan A, Cinnamond K, Cheema A, Cotter A. Factors impacting on the decision of graduate entry medical school students to pursue a career in obstetrics and gynecology in Ireland. BMC MEDICAL EDUCATION 2023; 23:449. [PMID: 37337239 DOI: 10.1186/s12909-023-04425-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Challenges in recruiting appropriately trained obstetricians and gynaecologists have been identified across the world. Given well documented staff shortages within obstetrics and gynaecology in Ireland, it is increasingly important to understand the factors which influence medical students to choose or reject a career in the speciality. The aim of this study was to ascertain the perceptions of final year graduate entry medical students of obstetrics and gynaecology, including the factors which may influence a student's decision to pursue in a career in the speciality. METHODS Paper-based surveys of graduate entry medical students (n = 146) were conducted at the beginning and end of a six week rotation in obstetrics and gynaecology in Ireland. Responses to the surveys pre- and post-rotation were matched and changes in career choices, merits and demerits over time were analysed. All analysis was conducted using SPSS for Windows version 25. RESULTS The responses of 72 students to both questionnaires could be matched (response rate of 49.3%). No male students expressed an interest in obstetrics, gynaecology or both as a first choice of career in the pre rotation survey. Obstetrics as a first choice of career increased from 6.9% pre rotation to 19.4% post rotation (p = 0.04) and this increase was seen in male and female students. Gynaecology as a first choice increased slightly from 1.4 to 4.2% (p = 0.50) and the dual speciality increased from 6.9 to 13.9% (p = 0.23). Students identified many merits of obstetrics pre-rotation with more than 60% identifying it as exciting, interesting fulfilling and challenging. However, incompatibility with family life was cited as a demerit by 72% of respondents and 68.1% identified fear of litigation as a demerit. Participants were less positive overall about the merits of a career in gynaecology with less than 40% viewing it as exciting, fulfilling, and varied. CONCLUSIONS While respondents were positive about the merits of a career in obstetrics and gynecology, concerns remain about work-life balance, career opportunities, and the high-risk nature of the specialty. These concerns should be addressed by the profession and policy makers if they wish to attract sufficient numbers to address anticipated need in the coming years. Gender differences in speciality choice were also evident. If males are to be recruited into obstetrics and gynaecology, consideration should be given to the positive impact of internship.
Collapse
Affiliation(s)
- Eimear Spain
- School of Medicine, University of Limerick, Limerick, Ireland.
| | | | - Ailish Hannigan
- School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Ayesha Cheema
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Amanda Cotter
- School of Medicine, University of Limerick, Limerick, Ireland
- University Maternity Hospital Limerick, Limerick, Ireland
| |
Collapse
|
4
|
Li W, Gillies RM, Liu C, Wu C, Chen J, Zhang X, Cheng B, Dai J, Fu N, Li L, Liu S, Sun H. Specialty preferences of studying-abroad medical students from low- and middle-income countries. BMC MEDICAL EDUCATION 2023; 23:158. [PMID: 36922811 PMCID: PMC10015544 DOI: 10.1186/s12909-023-04123-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study explored the specialty preferences of China-educated international medical students (IMSs), who are mainly from low- and middle-income countries (LMICs) and constitute a potential medical workforce both for their home countries and foreign countries, and the influence of migration intentions on their specialty preferences. METHODS A cross-sectional, questionnaire-based survey was conducted at 5 universities in China. The questionnaire link was distributed electronically among the IMSs at the 5 universities via emails. The questionnaire enquired IMSs' demographic information, migration intentions and their specialty preferences. The Chi-square test was applied to determine the influence of the respondent's gender, intention to practise in the home country and intention to practise in a high-income country on their specialty choices. The Chi-square test was also applied to determine the influence of the respondent's gender, year of study and country of origin on their preferences for generalist-orientated or non-generalist orientated specialties. RESULTS Altogether, 452 IMSs returned their responses, yielding a response rate of 64.1%. Approximately half of the IMSs planned to not return to their home country. The most selected specialty was general surgery and the least selected specialty was physical medicine and rehabilitation. No significant differences were evident in most specialty preferences between those who intended to return home and those who intended to stay abroad. Among the IMSs having intentions of returning to their home country, male students tended to choose a generalist-orientated specialty, while female students tended to choose a non-generalist-orientated specialty. CONCLUSION China-educated IMSs could play important roles in the primary care services as well as other shortage specialties both for their home countries or foreign countries. Therefore, it is recommended that governments in these countries plan migration and recruitment policies that cater for these studying-abroad medical students from LMICs, especially in this challenging time during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Wen Li
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China
- School of Education, The University of Queensland, 4072, Brisbane, Australia
| | - Robyn M Gillies
- School of Education, The University of Queensland, 4072, Brisbane, Australia
| | - Chang Liu
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China
| | - Changhao Wu
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH, Guildford, Surrey, UK
| | - Jiayi Chen
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China
| | - Xiaoning Zhang
- School of Management, Xuzhou Medical University, 221004, Xuzhou, China
| | - Bin Cheng
- School of International Education, Weifang Medical University, 261053, Weifang, China
| | - Jing Dai
- College of International Education, Guilin Medical University, 541199, Guilin, China
| | - Ning Fu
- School of International Education, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Tai'an, China
| | - Lin Li
- Language and Literature School, Hebei North University, 075000, Zhangjiakou, China
| | - Shenjun Liu
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China.
| | - Hong Sun
- School of Basic Medicine, Xuzhou Medical University, Xuzhou, China.
| |
Collapse
|
5
|
Tsai CH, Hsieh CH, Huang JP, Lin PL, Kuo TC, Huang MC. A survey of career-decision factors for obstetrics and gynecology residents in Taiwan. Taiwan J Obstet Gynecol 2021; 60:628-633. [PMID: 34247799 DOI: 10.1016/j.tjog.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The recruitment of obstetrics and gynecology residents has been challenging in Taiwan since 2000. There are a lots factors influencing applying, including career interest and prospects, lifestyle, salary, litigation, stress level, time demands of specialty work and gender consideration. The purpose of this study was to evaluate the factors influencing the career choice of current OB/GYN residents and identify the important factors influencing recruitment. MATERIALS AND METHODS A cross-sectional questionnaire of career-decision factors was sent to all 280 residents during December, 2019. Total 16 factors were rated on a 5-point Likert and were ranking by their average score on the scale. Gender of residents was analyzed for their association with the scores by a two-sample test and two-tailed t test. RESULTS 91 (32.5%) residents responded and 61 were female and 30 were male. The top influencing factor was being interested in clinical expertise with an average score of 4.32. The second factor was having a great sense of accomplishment in saving people with an average score of 3.82, followed by it being easier to become a medical practitioner at 3.77. The lowest scoring factor was fewer hours of work, with an average score of 1.77 and a safer working environment with a score of 2.33 was the second lowest factor. Female residents agreed that it was easier to get specialist certification with a score of 3.0. This score was significantly higher than male doctors at 2.63 with p value of 0.017. CONCLUSION Career interest and prospects were key influencing factors for applying OB/GYN residents. Minimizing the influence of detracting factors like heavy workload and medical litigation was also effective. Enrolling new residents is key to maintaining adequate staffing in specialties in healthcare. Establishing a safer work environment and determining the optimal workload will be the next reforms in the future.
Collapse
Affiliation(s)
- Chin-Han Tsai
- Department of Obstetrics and Gynecology, HsinChu MacKay Memorial Hospital, HsinChu, Taiwan
| | - Ching-Hung Hsieh
- Department of Obstetrics and Gynecology, Lee Women's Hospital, Taichung, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ping-Lun Lin
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tsung-Cheng Kuo
- Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
| | - Ming-Chao Huang
- Department of Obstetrics and Gynecology, HsinChu MacKay Memorial Hospital, HsinChu, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
| |
Collapse
|
6
|
McCarthy CM, O'Sullivan S, Corcoran P, Eogan M, Bennett D, Horgan M, O'Donoghue K. Medicine, media and the law: The effect on training in obstetrics and gynaecology. Eur J Obstet Gynecol Reprod Biol 2020; 257:35-41. [PMID: 33359922 DOI: 10.1016/j.ejogrb.2020.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/12/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
The inextricable link between medicine and the legal profession has flourished in the 21st century, with countless newspaper articles and social media content on medical cases visible at every juncture. This is particularly true in the speciality of obstetrics and gynaecology, with one of the highest rates of litigation of all medical specialities. We aimed to evaluate the influence of media and the legal environment on the career of trainees in obstetrics and gynaecology. Under the auspices of the Irish national training body, we distributed a 26-item questionnaire to doctors-in-training (DIT) working in obstetrics and gynaecology in the Republic of Ireland. Descriptive statistics and Chi-squared analyses were performed on the anonymised data. 151 DIT responded to the questionnaire, with a response rate of 86.2 % (sample size = 175). The majority were female (79.9 %, n = 121), Irish (85.5 %, n = 106) and had no children (67.0 %, n = 83). 86.7 % (n = 131) felt that the media did not have a positive impact on patients receiving care, and, further, unfairly represented the speciality (94.1 %; n = 142). Additionally, DIT felt that medico-legal issues had a negative impact on issues such as retention and recruitment. These two areas were implicated in over three quarters of DIT considering leaving the speciality. This study demonstrates that DIT perceive media scrutiny and litigation to have a negative effect on the speciality of obstetrics and gynaecology. Further support integrated into specialist training, is needed to ensure that trainees are adequately equipped to deal with both mainstream and social media as well as interactions they may have with the legal profession as they progress through their career.
Collapse
Affiliation(s)
- C M McCarthy
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork, Ireland; Rotunda Hospital, Parnell Square, Dublin 1, Ireland.
| | - S O'Sullivan
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - P Corcoran
- National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland
| | - M Eogan
- Rotunda Hospital, Parnell Square, Dublin 1, Ireland
| | - D Bennett
- Medical Education Unit, School of Medicine, University College Cork, Ireland
| | - M Horgan
- Royal College of Physicians of Ireland, Dublin, Ireland
| | - K O'Donoghue
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork, Ireland; Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| |
Collapse
|