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Bah MG, Elahi C, Vaughan KA, Dampha L, Manneh EK, Jabang I, Zainab J, Badiane SB, Thiam AB, Ndiaye PI, Gaye-Sakho M, Nyan O, Roberts CA, Gail R, Dilan E, Lawton MT, Youssoupha S, Jabang JN. History and Current State of Neurosurgery in the Gambia. World Neurosurg 2024; 187:2-10. [PMID: 38575063 DOI: 10.1016/j.wneu.2024.03.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Despite global efforts to improve surgical care access, many low- and middle-income countries, especially in neurosurgery, face significant shortages. The Gambia exemplifies this, with only 1 fully qualified neurosurgeon serving its population of 2.5 million people. This scarcity results in higher morbidity and mortality. OBJECTIVE We aim to document the history and current state of neurosurgery in the Gambia to raise awareness and promote neurosurgery development. METHODS The study reviews the Gambia's health care system, infrastructure, neurosurgical history, workforce, disease burden, and progress, with information derived from reference sources as well as author experience and interviews with key partners in Gambian health care. RESULTS Neurosurgery in the Gambia began in the 1970s, facing constraints due to competing health care demands. Significant progress occurred much later in the early 2010s, marked by the initiation of Banjul Neuro Missions and the establishment of a dedicated neurosurgery unit. We report significant progress with neurosurgical interventions in the past few years showcasing the unit's dedication to advancing neurosurgical care in the Gambia. However, challenges persist, including a lack of trained neurosurgeons, equipment shortages such as ventilators and diagnostic imaging. Financial barriers for patients, particularly related to the costs of computer tomography scans, pose significant hurdles, impacting the timely diagnosis and intervention for neurological conditions. CONCLUSIONS Neurosurgery in the Gambia is progressing, but challenges like equipment scarcity hinder further progress. We emphasize the need for addressing cost barriers, improving infrastructure, and fostering research. Engaging the government and international collaborations are vital for sustained development in Gambian neurosurgery.
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Affiliation(s)
- Momodou G Bah
- Michigan State University College of Human Medicine, Lansing, Michigan, USA.
| | - Cyrus Elahi
- Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Kerry A Vaughan
- Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Lamin Dampha
- Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Ebrima K Manneh
- Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Isaac Jabang
- Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Jallow Zainab
- Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Seydou B Badiane
- Neurosurgery Clinic, University Hospital of Fann, Dakar, Senegal
| | - Alioune B Thiam
- Neurosurgery Clinic, University Hospital of Fann, Dakar, Senegal
| | - Papa I Ndiaye
- Neurosurgery Clinic, University Hospital of Fann, Dakar, Senegal
| | | | - Ousman Nyan
- Department of Internal Medicine, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Charles A Roberts
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Rosseau Gail
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Seattle, Washington, USA
| | - Ellegala Dilan
- Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | | | - John N Jabang
- Department of Neurosurgery (Unit), Edward Francis Small Teaching Hospital, Banjul, The Gambia
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Weiss K, Di Gangi S, Inauen M, Senn O, Markun S. Changes in the attractiveness of medical careers and career determinants during the bachelor's program at Zurich medical schools. BMC MEDICAL EDUCATION 2024; 24:693. [PMID: 38926866 PMCID: PMC11210091 DOI: 10.1186/s12909-024-05693-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/21/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Monitoring the career intentions of medical students during their undergraduate studies could help to address the shortage of physicians, particularly in general practice. This study aimed to investigate changes in medical students' career openness, attractiveness and determinants of medical career choice during their bachelor's studies. METHODS The design was cross-sectional, recruiting all medical students who started a bachelor's program in one of the four different educational tracks in Zurich, Switzerland, in the fall of 2019 (first survey) and completed it in the summer of 2022 (second survey). Students' perceptions of the attractiveness and determinants of different medical career options were assessed using a structured online questionnaire. Absolute changes between the two-time points were reported in percentage points overall and by educational track. Regression analysis was used to examine the association of student characteristics and determinants of career options with the attractiveness of each option. RESULTS We surveyed 354 medical students at the beginning and 433 at the end of the bachelor's program (participation rate: 71.1% and 86.9%, respectively). Overall, the proportion of students open to all proposed medical career options decreased (from 52.8% to 43.8%, p = 0.004). The attractiveness of outpatient gynecology or pediatrics increased (from 27.4% to 43.4%, p < 0.001), whereas the attractiveness of both general and specialized inpatient care decreased (from 47.8% to 40.3%, p = 0.05 and from 71.1% to 61.1%, p = 0.006 respectively). There was an increase in the proportion of students who perceived part-time work, autonomy and relationships with patients as important career determinants (from 47.3% to 64.7%, p < 0.001; from 63.3% to 77.8%, p < 0.001; from 80.8% to 89.3%, p = 0.002 respectively), while the importance of reputation and career opportunities decreased (from 42.6% to 26.2%, p < 0.001; from 79.2% to 63.6%, p < 0.001 respectively). The importance of part-time work and relationships with patients were positively associated with the attractiveness of general practice. CONCLUSIONS During the bachelor's program, the attractiveness of a career in general practice tended to decrease, but the importance of part-time work, autonomy and relationships with patients as career determinants increased. Helping students understand how these determinants relate to general practice may increase their interest in the profession. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Katja Weiss
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
| | - Stefania Di Gangi
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland.
| | - Markus Inauen
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
| | - Stefan Markun
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
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Kane T, Ford J, Al Saady RM, Vranic S, Musa OAH, Suliman S. What Matters Most: Determinants Associated with the Selection of Medical Residencies in Qatar. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:141-151. [PMID: 38434442 PMCID: PMC10909370 DOI: 10.2147/amep.s429758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/20/2023] [Indexed: 03/05/2024]
Abstract
Purpose There have been several studies into medical student career decision making in occidental countries (eg US, UK), but medical career selection in a Middle Eastern context has not been as well studied. This study aims to explore determinants underpinning medical students' residency choice in Qatar. Patients and methods During the Fall semester of the 2022-2023 academic year, all (n=358) medical students from the College of Medicine at Qatar University were invited to participate in an online explorative questionnaire about students' career choices and the factors determining their selection. Results Of the 358 students, 184 responded (51%). Respondents had a mean age of 20 years; the majority were female (73.9%), Qatari (54.3%), unmarried (97.3%), and enrolled in a pre-clerkship year (55.0%). The most important career determinant was specialty-specific factors. The relative importance of other determinants differed by gender and stage of training. Among our respondents, male students were more likely to rate role models and influencers as being important to their choice, while female students and Qatari students overall were more likely to cite societal obligation. Medical students in Qatar seemed to have career preferences in mind upon entry into medical education. Later-year students were more likely to identify the importance of work-life balance and place of practice, but were less likely to rank prestige and income as an important determinant. Conclusion The results of this baseline study suggest that socioeconomic and cultural context influence medical student career decisions.
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Affiliation(s)
- Tanya Kane
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Jason Ford
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | | | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Omran A H Musa
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Shireen Suliman
- Medicine Department, Hamad Medical Corporation, Doha, Qatar
- School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
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Su Q, Hu D, Lin X, Zhao T. Preparing future general practitioners: the effects of individual, familial, and institutional characteristics. BMC MEDICAL EDUCATION 2023; 23:850. [PMID: 37946150 PMCID: PMC10636867 DOI: 10.1186/s12909-023-04857-2] [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: 06/21/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND There is a substantially increasing need for general practitioners (GPs) for future unpredictable pandemic crises, especially at the community-based health services (CBHS) level to protect the vast and varied grassroot-level population in China. Thus, it is crucial to understand the factors that affect Chinese medical students' GP career choices and commitments to CBHS. METHODS Leveraging the self-administered data collected across the country, this study conducted logistic regressions with 3,438 medical students. First, descriptive statistics of outcome variables and independent variables were provided. Then, stepwise logistic regression models were built, starting from adding individual characteristics, and then familial and institutional characteristics. Last, post-estimation was conducted to further assess whether there were significant marginal effects. RESULTS Results showed that women students were 24% less likely to choose GP careers but were 1.25 times more likely to commit to CBHS than their men peers, holding other individual, familial, and institutional characteristics constant. In addition, students who major in GP-orientated were more likely to choose GP careers and commit to CBHS, respectively, than those who major in clinical medicine. Furthermore, familial characteristics like annual income and mother's educational level only significantly predicted commitments to CBHS. Notably, sex-related differences in GP career choices and commitments to CBHS - by different regions - were observed. CONCLUSIONS Understanding the factors that affect medical students' GP career choices sheds light on how medical education stakeholders can make informed decisions on attracting more medical students to GP-orientated majors, which in turn cultivates more GP professionals to meet the nation's demand for GPs. In addition, by understanding the factors that influence medical students' commitment to CBHS, policymakers could make beneficial policies to increase medical students' motivations to the grassroot-level health institutions, and devote to CBHS as gatekeepers for a large population of residents' health.
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Affiliation(s)
- Qiang Su
- Zhejiang Academy of Higher Education, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Dan Hu
- China Center for Health Development Studies, Peking University, Beijing, 100083, China
| | - Xiaoru Lin
- School of Marxism, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Teng Zhao
- Zhejiang Academy of Higher Education, Hangzhou Dianzi University, Hangzhou, 310018, China.
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Al Zubaidi A, AlBuqaish S, Ali A, Ibrahim M, Marei S, Nugud S, Nugud A. Influencing Factors of Future Specialty Choice for Undergraduate Medical Students: An Updated Experience from the UAE. Avicenna J Med 2023; 13:97-103. [PMID: 37435553 PMCID: PMC10332941 DOI: 10.1055/s-0043-1769931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
Background Medical students' career choices determine the prospects of the future medical workforce, thus influencing the delivery of medical care. This study aims to identify and provide information about factors affecting the selection of future specialties among medical students. Methods A cross-sectional study was conducted on students in both preclerkship and clerkship phases at a single institution in the United Arab Emirates. A self-administered questionnaire included questions about demographic data, most preferred specialties, and influential factors. The influential factors were measured using a Likert scale. Results Surgery and internal medicine were the most desired specialties, respectively. Gender has a significant role in influencing career choice. There was no association between preclerkship and clerkship students' career choices. The most influential factors were seeing good treatment outcomes and having abilities for the specialty. Conclusions Surgery and internal medicine were the most preferred specialties, even though significant gender differences existed in specialty choices among these students.
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Affiliation(s)
| | - Salama AlBuqaish
- Neurology Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | - Alaa Ali
- Department of Academic Affairs, Tawam Hospital, Al Ain, United Arab Emirates
| | - Mira Ibrahim
- Department of Internal Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Shoroogh Marei
- Department of Academic Affairs, Tawam Hospital, Al Ain, United Arab Emirates
| | - Shomous Nugud
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed Nugud
- Department of Medical Affairs, Aljalila Children's Speciality Hospital, Dubai, United Arab Emirates
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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.
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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.
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Nadarajah A, Shankar PR, Jayaraman S, Sreeramareddy CT. House officers' specialist career choices and motivators for their choice- a sequential mixed-methods study from Malaysia. BMC MEDICAL EDUCATION 2022; 22:796. [PMID: 36384571 PMCID: PMC9668396 DOI: 10.1186/s12909-022-03845-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Shortage and maldistribution of medical specialists hamper healthcare quality. The specialist career choices of house officers determines the future composition of healthcare systems. We studied house officers'' specialist career choices and motivators for their choice. PARTICIPANTS AND METHODS We conducted online in-depth interviews among seven house officers using an interview guide developed based on a literature review. The transcripts were analyzed. Major themes were identified. A 33-item questionnaire was developed, and the main and sub-themes were identified as motivators for specialist career choice. An online survey was done among 185 house officers. Content validation of motivators for specialist choice was done using exploratory factor analysis. First, second and third choices for a specialist career were identified. Multinomial logistic regression analyses were done to determine the socio-demographic factors and motivators associated with the first choice. RESULTS HOs perceived that specialist training opportunities provide a wide range of clinical competencies through well-structured, comprehensive training programs under existing specialist training pathways. Main challenges were limited local specialist training opportunities and hurdles for 'on-contract' HO to pursue specialist training. Motivators for first-choice specialty were related to 'work schedule', 'patient care characteristics', 'specialty characteristics', 'personal factors', 'past work experience', 'training factors', and 'career prospects.' House officers' first choices were specialties related to medicine (40.5%), surgery (31.5%), primary care (14.6%), and acute care (13.5%). On multivariate analysis, "younger age", "health professional in the family", "work schedule and personal factors", "career prospects" and "specialty characteristics" were associated with the first choice. CONCLUSIONS Medical and surgical disciplines were the most preferred disciplines and their motivators varied by individual discipline. Overall work experiences and career prospects were the most important motivators for the first-choice specialty. The information about motivational factors is helpful to develop policies to encourage more doctors to choose specialties with a shortage of doctors and to provide career specialty guidance.
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Affiliation(s)
- Anuradha Nadarajah
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
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Bongomin F, Olum R, Kajjimu J, Kanyike AM, Atulinda L, Ninsiima D, Wamala NK, Byakika-Kibwika P. Factors Associated with Medical Students' Career Choices Regarding Internal Medicine in Uganda. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1293-1304. [PMID: 36267053 PMCID: PMC9578717 DOI: 10.2147/amep.s381161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is an unmet need for internal medicine physicians in Uganda owing to the growing burden of diseases. This study aimed at evaluating the factors associated with career choices of undergraduate medical students regarding internal medicine in Uganda. METHODS We conducted a cross-sectional study in the first 3 weeks of October 2021 via WhatsApp messenger. Medical students in the 3rd to 5th year of study who had completed internal medicine clinical rotations and pursuing a Bachelor of Medicine and Bachelor of Surgery (MBChB) degree at 7 Ugandan universities (4 public and 3 private) were enrolled. Multivariable logistic regression model was constructed to determine factors associated with a career choice in internal medicine. RESULTS We enrolled 418 participants, median age was 24 (interquartile range (IQR): 23-26) years, 67.7% were male, and 36.1% had a family member or relative who was a doctor. Most of the students (84.0%) were interested in research. The top three most preferred specialties were internal medicine (52.6%), surgery (51.2%), and obstetrics and gynaecology (51.0%). Overall, 186 (44.5%) participants reported plans to pursue a Master of Medicine degree in internal medicine. Interest in research was the only factor independently associated with 2.5-fold higher odds of pursuing a career in internal medicine (adjusted odds ratio: 2.5, 95% CI: 1.4-4.6, p = 0.003). About 73% of the participants strongly agreed that internal medicine requires wide reading. CONCLUSION There is a strong interest to pursue a career in internal medicine among Ugandan medical students. We recommend an increase in training opportunities in Internal Medicine, especially in view of the growing disease burden and increasing population growth.
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Affiliation(s)
- Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Ronald Olum
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jonathan Kajjimu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Linda Atulinda
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Daphine Ninsiima
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nicholas Kisaakye Wamala
- Faculty of Clinical Medicine and Dentistry, Kampala International University, Ishaka, Bushenyi, Uganda
| | - Pauline Byakika-Kibwika
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Bajunirwe F, Semakula D, Izudi J. Career aspirations of specialty among medical students in sub-Saharan Africa: a systematic review and meta-analysis of data from two decades, 2000-2021. BMJ Open 2022; 12:e057020. [PMID: 36028276 PMCID: PMC9422889 DOI: 10.1136/bmjopen-2021-057020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To determine the distribution of career aspirations for the discipline of specialty among undergraduate medical students in sub-Saharan Africa (SSA). DESIGN We searched PubMed/MEDLINE, EMBASE Google Scholar and Google for studies published between 1 January 2000 and 31 June 2021. Two reviewers extracted data from eligible studies, with disagreements resolved through consensus with a third reviewer. The random effects model was used to pool proportions, presented with the corresponding 95% CI. Heterogeneity was assessed using Cochrane's (Q) test but quantified with I2 values. Sources of heterogeneity were checked using meta-regression analysis while publication bias was assessed using funnel plot and Egger's test. SETTING SSA. PARTICIPANTS Undergraduate medical students. OUTCOMES Primary outcome was pooled proportion of career aspirations for the discipline of medical specialty and the secondary outcome was reasons for the specialty selection. RESULTS We identified 789 citations but meta-analysed 32 studies, with an overall sample size of 8231 participants. The most popular career aspiration for the discipline of specialty was surgery (29.5%; 95% CI 25.0% to 34.2%), followed by internal medicine (17.3%, 95% CI 11.7% to 23.7%), and then obstetrics and gynaecology (15.0%, 95% CI 12.3% to 17.9%), and paediatrics (11.3%; 95% CI 9.6% to 13.2%). The less popular medical disciplines of specialty included public health, orthopaedics, ophthalmology, family medicine, pathology, anaesthesiology, dermatology, otolaryngology, psychiatry and emergency medicine. The reasons for the selection of a medical discipline for specialty related to mentor and peer influences, prospect for economic gains, personal factors, long-term career interests and goals and discipline-specific factors. CONCLUSION Surgery is the most preferred career aspiration for medical students in SSA, followed by internal medicine. The choices do not necessarily match the disease burden on the continent and medical schools should consider strengthening career counselling and mentoring in their curriculum. PROSPERO REGISTRATION NUMBER CRD42021260501.
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Affiliation(s)
- Francis Bajunirwe
- Community Health, Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda
| | - Daniel Semakula
- Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jonathan Izudi
- Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
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Khamees A, Awadi S, Al Sharie S, Faiyoumi BA, Alzu'bi E, Hailat L, Al-Keder B. Factors affecting medical student's decision in choosing a future career specialty: A cross-sectional study. Ann Med Surg (Lond) 2022; 74:103305. [PMID: 35145673 PMCID: PMC8818518 DOI: 10.1016/j.amsu.2022.103305] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 11/25/2022] Open
Abstract
Background Diversity in the specialties is essential to provide optimal health care. Future career specialties chosen by the students had great significance for balanced doctor's distribution in different specialties, as it determines the composition of the physician workforce. Therefore, there has been a deeper interest in the issues of career preference among medical students. We aimed to determine and assess the factors perceived to be significantly attractive when choosing a future specialty. Materials and methods A cross-sectional-based study was conducted among undergraduate medical students from all of the medical schools in Jordan from April to September 2021. The data was collected using a structured online questionnaire through social media platforms and completed by 1556 students. The questionnaire consisted of three sections. The first section included the sociodemographic data of the participants, while the other two sections included questions about future specialty and the factors that influence the student's choice. Informed consent was taken from the participants. Results Of the participants, (64%) were female. The mean age of the students was 20.9 years. Regarding the future specialty, 664 students (42.7%) preferred surgery as future specialty (females = 364, males = 300). While 505 students (32.5%) preferred specialty in medicine (females = 365, males = 140). Moreover, 349 students had no decision until now regarding their future specialty (females = 238, males = 111). Generally, the surgical specialty was the most preferred specialty, while the basic science specialty was the least preferred. Specialty in medicine and surgery was the most preferred specialty among females and males respectively. Conclusion Surgery in general was the most popular specialty among medical students. Other common choices were neurosurgery, internal medicine, and pediatrics. The more attractive factors were the appeal of being in the specialty, the influence on patient's lives, the potential for patient interactions and the high income. While the least attractive factor was having a long-term relationship with the patients.
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Kuteesa J, Musiime V, Munabi IG, Mubuuke AG, Opoka R, Mukunya D, Kiguli S. Specialty career preferences among final year medical students at Makerere University College of health sciences, Uganda: a mixed methods study. BMC MEDICAL EDUCATION 2021; 21:215. [PMID: 33863332 PMCID: PMC8052684 DOI: 10.1186/s12909-021-02630-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/25/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND Uganda has an imbalanced distribution of the health workforce, which may be influenced by the specialty career preferences of medical students. In spite of this, there is inadequate literature concerning the factors influencing specialty career preferences. We aimed to determine the specialty career preferences and the factors influencing the preferences among fifth year medical students in the School of Medicine, Makerere University College of Health Sciences (MakCHS). METHODS A sequential explanatory mixed methods study design with a descriptive cross-sectional study followed by a qualitative study was used. A total of 135 final year medical students in MakCHS were recruited using consecutive sampling. Self-administered questionnaires and three focus group discussions were conducted. Quantitative data was analysed in STATA version 13 (StataCorp, College Station, Tx, USA) using descriptive statistics, chi-square tests and logistic regression. Qualitative data was analysed in NVIVO version 12 (QRS International, Cambridge, MA) using content analysis. RESULTS Of 135 students 91 (67.4%) were male and their median age was 24 years (IQR: 24, 26). As a first choice, the most preferred specialty career was obstetrics and gynecology (34/135, 25.2%), followed by surgery (27/135, 20.0%), pediatrics (18/135, 13.3%) and internal medicine (17/135, 12.6%). Non-established specialties such as anesthesia and Ear Nose and Throat (ENT) were not selected as a first choice by any student. Female students had 63% less odds of selecting surgical related specialties compared to males (aOR = 0.37, 95%CI: 0.17-0.84). The focus group discussions highlighted controlled lifestyle, assurance of a good life through better financial remuneration and inspirational specialists as facilitators for specialty preference. Bad experience during the clinical rotations, lack of career guidance plus perceived poor and miserable specialists were highlighted as barriers to specialty preference. CONCLUSION Obstetrics and Gynecology, Surgery, Pediatrics and Internal Medicine are well-established disciplines, which were dominantly preferred. Females were less likely to select surgical disciplines as a career choice. Therefore, there is a need to implement or establish career guidance and mentorship programs to attract students to the neglected disciplines.
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Affiliation(s)
- Job Kuteesa
- Department of Surgery, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Victor Musiime
- Research Department, Joint Clinical Research Centre, Kampala, Uganda
- Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ian G. Munabi
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aloysius G. Mubuuke
- Department of Radiology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robert Opoka
- Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Sarah Kiguli
- Department of Pediatrics, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Ock M, Han YJ, Choi EY, Pyo J, Lee W. Perceptions of Medical Students Regarding Career Counseling in Korea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103486. [PMID: 32429488 PMCID: PMC7277443 DOI: 10.3390/ijerph17103486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022]
Abstract
Current medical school education focuses on acquiring appropriate knowledge with relatively little interest in developing the career selection skills of medical students. We investigated medical students’ perceptions of career problems and the required types of career counseling programs. Five focus group discussions were held with 23 medical students. The consensual qualitative study method was used to analyze the recorded discussion process. The medical students were more influenced by parents and grades than by subjective choices when deciding on admission to medical school. In future career choices, medical students considered the stability and feasibility of the career and expected quality of life. However, there were several opinions that it is essential to understand oneself. Objective and specific career information was lacking, and meeting with the professor was not very helpful for career counseling. Most medical students expected the effectiveness of the career counseling program but hoped the program would proceed with voluntary participation. Medical students wanted a variety of concrete and objective information, such as specialty information for choosing residency training, trainee hospital information, and post-residency training information in the career counseling program. Most medical students are not ready for career-related problems, therefore making it necessary to develop a career counseling program suitable for them.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (E.Y.C.); (J.P.)
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul 05505, Korea
- Correspondence: (M.O.); (Y.-J.H.)
| | - Young-Joo Han
- Korea Counseling Graduate University, Seoul 06722, Korea
- Correspondence: (M.O.); (Y.-J.H.)
| | - Eun Young Choi
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (E.Y.C.); (J.P.)
- Department of Nursing, Graduate School of Chung-Ang University, Seoul 06974, Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (E.Y.C.); (J.P.)
| | - Won Lee
- Department of Nursing, Chung-Ang University, Seoul 06974, Korea;
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Yang Y, Li J, Wu X, Wang J, Li W, Zhu Y, Chen C, Lin H. Factors influencing subspecialty choice among medical students: a systematic review and meta-analysis. BMJ Open 2019; 9:e022097. [PMID: 30850399 PMCID: PMC6429728 DOI: 10.1136/bmjopen-2018-022097] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To characterise the contributing factors that affect medical students' subspecialty choice and to estimate the extent of influence of individual factors on the students' decision-making process. DESIGN Systematic review and meta-analysis. METHODS A systematic search of the Cochrane Library, ERIC, Web of Science, CNKI and PubMed databases was conducted for studies published between January 1977 and June 2018. Information concerning study characteristics, influential factors and the extent of their influence (EOI) was extracted independently by two trained investigators. EOI is the percentage level that describes how much each of the factors influenced students' choice of subspecialty. The recruited medical students include students in medical school, internship, residency training and fellowship, who are about to or have just made a specialty choice. The estimates were pooled using a random-effects meta-analysis model due to the between-study heterogeneity. RESULTS Data were extracted from 75 studies (882 209 individuals). Overall, the factors influencing medical students' choice of subspecialty training mainly included academic interests (75.29%), competencies (55.15%), controllable lifestyles or flexible work schedules (53.00%), patient service orientation (50.04%), medical teachers or mentors (46.93%), career opportunities (44.00%), workload or working hours (37.99%), income (34.70%), length of training (32.30%), prestige (31.17%), advice from others (28.24%) and student debt (15.33%), with significant between-study heterogeneity (p<0.0001). Subgroup analyses revealed that the EOI of academic interests was higher in developed countries than that in developing countries (79.66% [95% CI 70.73% to 86.39%] vs 60.41% [95% CI 43.44% to 75.19%]; Q=3.51, p=0.02). The EOI value of prestige was lower in developed countries than that in developing countries (23.96% [95% CI 19.20% to 29.47%] vs 47.65% [95% CI 34.41% to 61.24%]; Q=4.71, p=0.01). CONCLUSIONS This systematic review and meta-analysis provided a quantitative evaluation of the top 12 influencing factors associated with medical students' choice of subspecialty. Our findings provide the basis for the development of specific, effective strategies to optimise the distribution of physicians among different departments by modifying these influencing factors.
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Affiliation(s)
- Yahan Yang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Jiawei Li
- Zhongshan School of Mathematics, Sun Yat-Sen University, Guangzhou, China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Jinghui Wang
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Wangting Li
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Yi Zhu
- Department of Molecular and Cellular Pharmacology, University of Miami School of Medicine, Miami, Florida, USA
- Cataract, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Chuan Chen
- Department of Molecular and Cellular Pharmacology, University of Miami School of Medicine, Miami, Florida, USA
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Haotian Lin
- Cataract, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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An assessment of critical care capacity in the Gambia. J Crit Care 2018; 47:245-253. [PMID: 30059869 DOI: 10.1016/j.jcrc.2018.07.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/30/2018] [Accepted: 07/20/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Critical illnesses are a major cause of morbidity and mortality in The Gambia, yet national data on critical care capacity is lacking. MATERIALS AND METHODS We surveyed eight of the eleven government-owned health facilities providing secondary and tertiary care in The Gambia's public health sector. At each hospital, a designated respondent completed a questionnaire reporting information on the presence of an intensive care unit, the number of critical care beds where available, monitoring equipment, and the ability to provide basic critical care services at their respective hospitals. RESULTS The response rate was 88% (7/8 hospitals). Only one hospital had a dedicated intensive care unit with eight ICU beds, resulting in an estimated 0.4 ICU beds/100,000 population in the country. All hospitals reported treating more than 50 critically ill patients a month, with trauma, obstetric emergencies, hypertensive emergencies and stroke accounting for the leading causes of admission respectively. The country lacks any trained specialists and resources to diagnose and treat critically ill patients. CONCLUSIONS The Gambia has a very low ICU bed capacity and lacks the human resources and equipment necessary to diagnose and treat the large number of critically ill patients admitted to public hospitals in the country.
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Hur Y, Cho AR, Kwon M. Development of a systematic career coaching program for medical students. KOREAN JOURNAL OF MEDICAL EDUCATION 2018; 30:41-50. [PMID: 29510607 PMCID: PMC5840563 DOI: 10.3946/kjme.2018.80] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/15/2010] [Accepted: 01/16/2018] [Indexed: 05/28/2023]
Abstract
PURPOSE This study aimed to develop a systematic career-coaching program (SCCP) that can be used by medical teaching schools to address a growing need for career-coaching. The program objectives were to help students (1) develop a comprehensive self-understanding of their aptitudes, interests, and personality traits; (2) explore possible career choices and decide on a career path; and (3) develop the competencies needed to prepare for their future careers. METHODS The SCCP was based on the ADDIE (analysis, design, development, implementation, and evaluation) model and decision-making questioning model. Medical professionals, medical education and career counseling experts, and students participated in designing the program. RESULTS The SCCP describes coaching content, tools, operational methods, and appropriate timing, and identifies the professionals and specialists who can offer their expertise in the different coaching phases. It is designed to allow medical schools to offer the program in segments or in its entirety, depending on the curriculum and environment. CONCLUSION The SCCP represents a viable career-coaching program for medical students that can be applied in part or in its entirety, depending on a medical school's curriculum and educational environment.
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Affiliation(s)
- Yera Hur
- Department of Medical Education, Konyang University College of Medicine, Daejeon, Korea
| | - A Ra Cho
- Department of Medical Education, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mihye Kwon
- Department of Internal Rheumatism, Konyang University College of Medicine, Daejeon, Korea
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Rukewe A, Abebe WA, Fatiregun AA, Kgantshang M. Specialty preferences among medical students in Botswana. BMC Res Notes 2017; 10:195. [PMID: 28595593 PMCID: PMC5465444 DOI: 10.1186/s13104-017-2523-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 05/31/2017] [Indexed: 11/26/2022] Open
Abstract
Background With the establishment of a new medical college in Botswana to train generalist-doctors and specialists, we set out to explore the career preferences of medical students, factors that influence their choices and attitude to local postgraduate training. Methods A descriptive cross-sectional questionnaire-based study was conducted among medical students in their third to fifth year, at the Faculty of Medicine, University of Botswana. The structured, self-administered questionnaires which were hand-delivered covered demographic characteristics of responders, career choices, preferred location of specialisation and factors that influenced the choices. Results Of the 143 medical students approached, 116 (81.0%) returned completed questionnaires. Of the responders, 102 (87.9%) intend to pursue postgraduate specialisation against 2 (1.7%) who declined; 12 (10.3%) were undecided. The four most preferred specialties which constituted 68.1% were surgery (28.4%), paediatrics (19.0%), internal medicine (12.9%), obstetrics and gynaecology (7.2%). There was male preference for surgery (p = 0.04), while women were drawn more towards paediatrics and psychiatry (p = 0.04 and p = 0.01, respectively). Personal interest and aptitude was considered the most important factor among most responders (46.2%), followed by enjoyment of the posting (19.8%). A high proportion of responders 80 (69.0%) preferred to specialise abroad for better exposure/opportunities (48.3%), while for 15.5%, their preferred courses are not currently available locally. Conclusion Our findings indicated that while four major specialties are preferred, significant gender differences exist with female students leaning towards non-surgical disciplines. Students prefer specialising abroad on the pretext that foreign centres offer better training opportunities, and many specialist programmes are unavailable locally. Electronic supplementary material The online version of this article (doi:10.1186/s13104-017-2523-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ambrose Rukewe
- Department of Anaesthesia, University of Botswana, Private Bag 00713, Gaborone, Botswana.
| | - W A Abebe
- Department of Anaesthesia, University of Botswana, Private Bag 00713, Gaborone, Botswana
| | - A A Fatiregun
- World Health Organisation, Akure Office, Akure, Ondo State, Nigeria
| | - M Kgantshang
- Department of Anaesthesia, Princess Marina Hospital, Gaborone, Botswana
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Ossai EN, Uwakwe KA, Anyanwagu UC, Ibiok NC, Azuogu BN, Ekeke N. Specialty preferences among final year medical students in medical schools of southeast Nigeria: need for career guidance. BMC MEDICAL EDUCATION 2016; 16:259. [PMID: 27716155 PMCID: PMC5050581 DOI: 10.1186/s12909-016-0781-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 09/27/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training. METHODS A descriptive cross-sectional study was conducted among final year medical students in the six accredited medical schools in southeast Nigeria using self-administered semi-structured questionnaire. Information on reason for studying Medicine, specialty preference and career guidance were obtained. Chi-square test of statistical significance was used in the analysis. RESULTS A total of 457 students participated in the study with a response rate of 86.7 %. The mean age was 25.5 ± 2.9 years and 57.1 % were male. Majority (51 %) opted to study Medicine in-order to save lives while 89.5 % intended to pursue postgraduate medical training. A higher proportion (51.8 %) made the decision during the period of clinical rotation. The five most preferred specialties among the students were Surgery (24.0 %); Paediatrics (18.8 %); Obstetrics and Gynaecology (15.6 %); Internal Medicine (11.0 %) and Community Medicine (6.8 %) while Pathology (2.0 %); Anaesthesia (0.7 %) and Ear, Nose and Throat (0.2 %), were the least preferred. Compared to females, a higher proportion of male students intended to specialise in Surgery (32.3 % vs 13.0 %, p < 0.001) in contrast to Paediatrics (11.2 % vs 28.8 %, p < 0.001). Majority of the students, 74.6 % had no form of career guidance during their stay in medical school and 11.2 % were undecided on choice of specialty. CONCLUSION In spite of the high proportion of students willing to pursue specialist medical training after graduation, most opted for the four core clinical specialities of Surgery, Paediatrics, Obstetrics and Gynaecology and Internal Medicine. Majority of the students made these decisions during clinical rotations. Also, majority had no form of career guidance throughout their stay in medical school. To ensure an equitable distribution of a limited physician workforce in a resource-poor setting, there is need for proper career guidance for the students and this should be in line with the national health needs.
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Affiliation(s)
- Edmund Ndudi Ossai
- Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakaliki, Nigeria
| | - Kenechi Anderson Uwakwe
- Department of Community Medicine, College of Medicine, Imo State University Owerri, Owerri, Nigeria
| | - Uchenna Chidi Anyanwagu
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
- Epidemiology and Public Health Division, School of Medicine, University of Nottingham, Nottingham, UK
| | - Ntat Charles Ibiok
- Department of Community Medicine, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria
| | - Benedict Ndubueze Azuogu
- Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakaliki, Nigeria
| | - Ngozi Ekeke
- German Leprosy and TB Relief Association Enugu, Enugu, Nigeria
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Ng-Sueng LF, Vargas-Matos I, Mayta-Tristán P, Pereyra-Elías R, Montenegro-Idrogo JJ, Inga-Berrospi F, Ancalli F, Bonilla-Escobar F, Diaz-Velez C, Gutierrez-Quezada E, Gomez-Alhach J, Muñoz-Medina CE, Sanchez-Pozo A, Vidal M. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America. PLoS One 2016; 11:e0161000. [PMID: 27519055 PMCID: PMC4982605 DOI: 10.1371/journal.pone.0161000] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.
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Affiliation(s)
- Luis Fernando Ng-Sueng
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Sociedad Científica Estudiantes de Medicina UPC, Lima, Perú
| | - Iván Vargas-Matos
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Percy Mayta-Tristán
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- * E-mail:
| | | | | | | | - Felix Ancalli
- Universidad Nacional Jorge Basadre Grohmann, Tacna, Perú
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Dossajee H, Obonyo N, Ahmed SM. Career preferences of final year medical students at a medical school in Kenya--A cross sectional study. BMC MEDICAL EDUCATION 2016; 16:5. [PMID: 26754206 PMCID: PMC4709906 DOI: 10.1186/s12909-016-0528-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 01/06/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommended physician to population ratio is 23:10,000. Kenya has a physician to population ratio of 1.8:10,000 and is among 57 countries listed as having a serious shortage of health workers. Approximately 52% of physicians work in urban areas, 6% in rural and 42% in peri-urban locations. This study explored factors influencing the choice of career specialization and location for practice among final year medical students by gender. METHODS A descriptive cross-sectional study was carried out on final year students in 2013 at the University of Nairobi's, School of Medicine in Kenya. Sample size was calculated at 156 students for simple random sampling. Data collected using a pre-tested self-administered questionnaire included socio-demographic characteristics of the population, first and second choices for specialization. Outcome variables collected were factors affecting choice of specialty and location for practice. Bivariate analysis by gender was carried out between the listed factors and outcome variables with calculation of odds ratios and chi-square statistics at an alpha level of significance of 0.05. Factors included in a binomial logistic regression model were analysed to score the independent categorical variables affecting choice of specialty and location of practice. RESULTS Internal medicine, Surgery, Obstetrics/Gynaecology and Paediatrics accounted for 58.7% of all choices of specialization. Female students were less likely to select Obs/Gyn (OR 0.41, 95% CI =0.17-0.99) and Surgery (OR 0.33, 95% CI = 0.13-0.86) but eight times more likely to select Paediatrics (OR 8.67, 95% CI = 1.91-39.30). Surgery was primarily selected because of the 'perceived prestige of the specialty' (OR 4.3 95% CI = 1.35-14.1). Paediatrics was selected due to 'Ease of raising a family' (OR 4.08 95% CI = 1.08-15.4). Rural origin increased the odds of practicing in a rural area (OR 2.5, 95% CI = 1.04-6.04). Training abroad was more likely to result in preference for working abroad (OR 9.27 95% CI = 2.1-41.9). CONCLUSIONS The 4 core specialties predominate as career preferences. Females are more likely to select career choices due to 'ease of raising a family'. Rural origin of students was found to be the most important factor for retention of rural health workforce. This data can be used to design prospective cohort studies in an effort to understand the dynamic influence that governments, educational institutions, work environments, family and friends exert on medical students' careers.
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Affiliation(s)
- Hussein Dossajee
- />James P. Grant School of Public Health, 68, Shahid Tajuddin Ahmed Sharani, icddr,b Building (Level-6), Mohakhali, Dhaka 1212 Bangladesh
| | - Nchafatso Obonyo
- />Kenya Medical Research Institute (KEMRI)–Kilifi, P. O. Box 230–80108, Kilifi, Kenya
| | - Syed Masud Ahmed
- />James P. Grant School of Public Health, 68, Shahid Tajuddin Ahmed Sharani, icddr,b Building (Level-6), Mohakhali, Dhaka 1212 Bangladesh
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Alawad AAMA, Khan WS, Abdelrazig YM, Elzain YI, Khalil HO, Ahmed OBE, Adam OAI. Factors considered by undergraduate medical students when selecting specialty of their future careers. Pan Afr Med J 2015; 20:102. [PMID: 26090050 PMCID: PMC4458322 DOI: 10.11604/pamj.2015.20.102.4715] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 11/23/2014] [Indexed: 11/11/2022] Open
Abstract
Introduction Medical students are the source of a country's physicians. Determining how medical students select their areas of specialization is the key to achieve a balanced distribution of doctors among all specialties. The objective is to identify the number of medical students who have decided their postgraduate specialty career, their career specialties preference, and factors that may influence their decision to select a particular specialty. Methods A facility based cross-sectional study was conducted in September 2013 at Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. A self-administered semi-structured questionnaire comprising demographic data and questions about future specialties preferences and factors influencing those preferences was distributed to 887 male and female students, (from first to fifth academic years) recruited in the study. Results Response rate was 73% with 647 questionnaires collected, out of 887 eligible medical students. Of the returned questionnaires, 604 were valid. The majority of students (541, 89.6%) have chosen a specialty. Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties. The least selected specialty was anaesthesiology. A significant association was found between gender and specialty choice using Chi-square test (p = 0.00). There was no association between undergraduate level and specialty choice (p = 0.633). The most common reason for choosing a specific specialty was “Personal Interest” (215, 39.7%) followed by being “Helpful to the community” (144, 26.6%). Conclusion Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties.
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Welbergen L, Pinilla S, Pander T, Gradel M, von der Borch P, Fischer MR, Dimitriadis K. The FacharztDuell: innovative career counselling in medicine. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2014; 31:Doc17. [PMID: 24872852 PMCID: PMC4027802 DOI: 10.3205/zma000909] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 01/20/2014] [Accepted: 02/27/2014] [Indexed: 11/30/2022]
Abstract
Objective: The selection of a future medical specialty is a challenge all medical students face during the course of their studies. Students can choose from more than sixty specialties after graduation. There is usually no structured career counselling program available at German medical faculties. So far only little data on acceptance, formats and effects of different career counselling programs are available. The aim of this study is to describe an innovative format of career counselling for medical students including its evaluation of acceptance and its possible influence on medical specialty preferences. Methods: The need for career counselling became evident after the analysis of mentor-mentee conversations held within the mentoring program of our medical faculty, an online-based survey, an ad-hoc focus group and a pilot event. Panel discussions as an interactive format of presenting related medical specialties were developed and hence held four times under the name “FacharztDuell”. Students evaluated all events separately with a questionnaire and changes in medical specialty choice preferences were documented using an Audience-Response-System (ARS). The FacharztDuell is organized regularly and supported by faculty teaching funds. Results: Among the student body FacharztDuell was well accepted (an average of 300 participants/event) and rated (average grade of 1.8 (SD= 0.7, 1=very good, 6=unsatisfactory, n=424). On average, 77.8% of the participating students considered the FacharztDuell to be a decision support for their future selection of a specialty. Up to 12% of the students changed their medical specialty choice preference throughout the event. Conclusion: FacharztDuell was well accepted by medical students of all semesters and seems to be supportive for their selection of a future medical specialty. However, longitudinal studies are necessary to better understand the decision making process of medical students along their career path. The FacharztDuell is easily transferrable to other faculties with respect to organization, staff and technical resources.
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Affiliation(s)
- Lena Welbergen
- LMU München, Institute for Medical Education, München, Germany
| | - Severin Pinilla
- Ludwig-Maximilians-Universität, Neurologische Klinik und Poliklinik, Klinikum Großhadern, München, Deutschland
| | - Tanja Pander
- LMU München, Institute for Medical Education, München, Germany
| | | | | | - Martin R Fischer
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Konstantinos Dimitriadis
- Ludwig-Maximilians-Universität, Neurologische Klinik und Poliklinik, Klinikum Großhadern, München, Deutschland
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