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Thomas A, Kinston R, Yardley S, McKinley RK, Lefroy J. How do medical schools influence their students' career choices? A realist evaluation. MEDICAL EDUCATION ONLINE 2024; 29:2320459. [PMID: 38404035 PMCID: PMC10898266 DOI: 10.1080/10872981.2024.2320459] [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: 08/22/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION The career choices of medical graduates vary widely between medical schools in the UK and elsewhere and are generally not well matched with societal needs. Research has found that experiences in medical school including formal, informal and hidden curricula are important influences. We conducted a realist evaluation of how and why these various social conditions in medical school influence career thinking. METHODS We interviewed junior doctors at the point of applying for speciality training. We selected purposively for a range of career choices. Participants were asked to describe points during their medical training when they had considered career options and how their thinking had been influenced by their context. Interview transcripts were coded for context-mechanism-outcome (CMO) configurations to test initial theories of how career decisions are made. RESULTS A total of 26 junior doctors from 12 UK medical schools participated. We found 14 recurring CMO configurations in the data which explained influences on career choice occurring during medical school. DISCUSSION Our initial theories about career decision-making were refined as follows: It involves a process of testing for fit of potential careers. This process is asymmetric with multiple experiences needed before deciding a career fits ('easing in') but sometimes only a single negative experience needed for a choice to be ruled out. Developing a preference for a speciality aligns with Person-Environment-Fit decision theories. Ruling out a potential career can however be a less thought-through process than rationality-based decision theories would suggest. Testing for fit is facilitated by longer and more authentic undergraduate placements, allocation of and successful completion of tasks, being treated as part of the team and enthusiastic role models. Informal career guidance is more influential than formal. We suggest some implications for medical school programmes.
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Affiliation(s)
| | | | - Sarah Yardley
- Marie Curie Palliative Care Research Department, University College London, London, UK
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Chandra S, Olaf M, Fix M, Bord S, Katirji L, Dixon W, Pasirstein M, Schrepel C, Scott KR. The Influence of COVID on Emergency Medicine Career Choice: A Survey of Medical Students. Cureus 2024; 16:e59055. [PMID: 38800319 PMCID: PMC11128144 DOI: 10.7759/cureus.59055] [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] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background The COVID-19 pandemic has led to substantial changes in the delivery of healthcare and medical education. Little is known about how the pandemic has altered medical students' perceptions in regard to career choice. Methods The authors developed and implemented a multi-center survey that evaluated medical students' preferred career choice before and during the coronavirus pandemic, as well as the influence of pandemic-related factors on that choice. The survey was distributed to all levels of medical students (MS) at nine medical schools across the country from November 2020 to January 2021 and represented a convenience sample. Preferred career choice was assessed through the use of a Likert scale and additional factors affecting career choice were solicited. The degree of interest before and during the pandemic, as well as factors influencing the shift, were treated as ordinal variables and compared using chi-squared testing. Cohen's Kappa statistic was calculated to assess the degree of shifts of interest in Emergency Medicine among students. The study was deemed exempt by the Institutional Review Board at the host institution, Sidney Kimmel Medical College at Thomas Jefferson University, and all participating sites. Results A total of 1431 of 6710 (21.3%) eligible students completed the survey. The COVID pandemic was cited as a reason for a changed interest in specialty by 193 (13.5%) students. The most common reason for specialty change was the students' clinical experience, followed by a desire to be on the front lines, and personal/family health concerns. There was a significant association between career change and degree of interest among students interested in emergency medicine (EM) as their future specialty before the COVID pandemic as well as during the COVID pandemic. Living with an immunocompromised individual had a significant association with a reduced interest in EM. There was a significant association between EM rotation completion and how interested students were in EM as their future specialty before the COVID pandemic and during the COVID pandemic. Among EM-interested students whose specialty interest was changed by the COVID pandemic, 34 (41.5%) became less favorable to EM, 28 (34.2%) stayed the same, and 20 (24.4%) students became more favorable to EM. Conclusions The impact of COVID-19 on medical students' career choice is a complicated matter that involves both personal and professional factors. It appears that there is a trend towards less interest in the field of EM with multifactorial influences, some of which are related to the COVID-19 pandemic.
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Affiliation(s)
- Shruti Chandra
- Emergency Medicine, Thomas Jefferson University, Philadelphia, USA
| | - Mark Olaf
- Emergency Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Megan Fix
- Emergency Medicine, University of Utah School of Medicine, Salt Lake City, USA
| | - Sharon Bord
- Emergency, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Linda Katirji
- Emergency Medicine, University of Kentucky, Lexington, USA
| | - William Dixon
- Emergency Medicine, Stanford University Hospital, Palo Alto, USA
| | - Michael Pasirstein
- Emergency Medicine, Sidney Kimmel Medical College Thomas Jefferson University, Philadelphia, USA
| | - Caitlin Schrepel
- Emergency Medicine, University of Washington School of Medicine, Seattle, USA
| | - Kevin R Scott
- Emergency Medicine, University of Pennsylvania Health System, Philadelphia, USA
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Iktidar MA, Sakib MM, Munni UR, Rimti FH, Yousuf R, Majumder K, Saha T, Golpo FL, Sayed MSU, Monsur S, Al Galib A, Hossain MK, Shupti SA, Nawar N, Mazumder S, Hasan MT. Medical students' career preferences in Bangladesh. BMC MEDICAL EDUCATION 2024; 24:81. [PMID: 38263095 PMCID: PMC10804597 DOI: 10.1186/s12909-024-05050-9] [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: 06/26/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
AIM This study aimed to investigate the career preferences among Bangladeshi medical students, identify the factors that influence their present choices, and additionally report the role of gender and academic year behind their decisions. METHODS This cross-sectional study conducted in Bangladesh from August 2022 to April 2023 included 801 medical students conveniently selected from medical colleges in eight divisions. Data were collected using a web-based survey and analysed using STATA version 16.0. Statistical tests included the Kolmogorov-Smirnov test, arithmetic mean, standard deviation, frequency, and Kruskal-Wallis H test. The response rate was 94.6%, and the CHERRIES guideline was followed for reporting the results. RESULT The majority of the participants were female (64.42%) and under the age of 23 years (58.8%). The study revealed that medicine was the preferred career choice for the majority of students (65%), with surgery being the most popular first choice (30.21%) among them. Female medical students showed a significantly higher preference for gynaecology & obstetrics (p < 0.001), while male students had a significantly higher tendency to choose general practice (p = 0.002). There is a significant gender difference (p < 0.05) in the career preference factors, including professional prestige, role model influence, easy money, family time, promotion opportunities, income for lifestyle, and research opportunities. Academic year differences were also observed, with increasing interest in medicine and public health (p < 0.001), a decrease in interest in surgery (p < 0.001), and a decline in preference for non-medical careers as students progressed through their MBBS life (p < 0.05). CONCLUSION Overall, medicine was the most popular speciality choice, however, male students preferred general practice and female students preferred gynaecology and obstetrics more. Personal passion, opportunities for contribution to society, professional prestige, having a direct dealing with patients, and income will allow an enjoyable lifestyle were the most important factors in the choice of their career.
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Affiliation(s)
- Mohammad Azmain Iktidar
- Directorate General of Health Services, Dhaka, Bangladesh.
- Department of Public Health, North South University, Plot # 15, Block # B, Bashundhara R/A, 1229, Dhaka, Bangladesh.
- School of Research, Chattogram, Bangladesh.
| | - Md Muid Sakib
- Chattogram Medical College, 57 K.B. Fazlul Kader Road, 4203, Chattogram, Bangladesh
| | | | - Fahmida Hoque Rimti
- Chattogram Medical College, 57 K.B. Fazlul Kader Road, 4203, Chattogram, Bangladesh
| | - Renessa Yousuf
- School of Research, Chattogram, Bangladesh
- Chattogram Medical College, 57 K.B. Fazlul Kader Road, 4203, Chattogram, Bangladesh
| | - Koushik Majumder
- Chattogram Medical College, 57 K.B. Fazlul Kader Road, 4203, Chattogram, Bangladesh
| | - Tirtha Saha
- Rajshahi Medical College and Hospital, 6000, Rajshahi, Bangladesh
| | | | - Md Samee U Sayed
- Chattogram Medical College, 57 K.B. Fazlul Kader Road, 4203, Chattogram, Bangladesh
| | - Sabrina Monsur
- Dhaka Medical College Hospital, 1000, Ramna, Dhaka, Bangladesh
| | - Asadul Al Galib
- Sir Salimullah Medical College and Mitford Hospital, 1100, Mitford, Dhaka, Bangladesh
| | - Md Kamran Hossain
- IBN Sina Medical College and Hospital, 1216, Kallyanpur, Dhaka, Bangladesh
| | - Sigma Alam Shupti
- Mymensingh Medical College and Hospital, Chorpara, Mymensingh, Bangladesh
| | - Noshin Nawar
- School of Research, Chattogram, Bangladesh
- University of Chittagong, Chattogram, Bangladesh
| | - Sudeshna Mazumder
- Chattogram Medical College, 57 K.B. Fazlul Kader Road, 4203, Chattogram, Bangladesh
| | - M Tasdik Hasan
- Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia
- Department of Public Health, State University of Bangladesh (SUB), Dhaka, Bangladesh
- Public Health Foundation, Bangladesh (PHF, BD), Dhaka, Bangladesh
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Gjessing S, Risør T, Kristensen JK. Medical trainees' speciality considerations at their transition from under- to postgraduate education: a descriptive, cross-sectional study. EDUCATION FOR PRIMARY CARE 2024; 35:13-21. [PMID: 38431883 DOI: 10.1080/14739879.2024.2312939] [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: 04/14/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE This paper aims to provide knowledge on medical trainees' considerations about specialisation as they move from undergraduate to postgraduate medical education; especially their interest in general practice compared to other specialities. METHOD We developed and content-validated a questionnaire to examine medical trainees' speciality considerations and conducted a descriptive, cross-sectional study. All medical trainees initiating their internship in Denmark in 2022 (N = 1,188) were invited to participate in the study. Medical specialities were categorised as hospital service specialities, internal medicine specialities, primary care, psychiatry specialities and surgery and emergency specialities. Descriptive statistics were used to describe the cohort and examine the participants' speciality considerations by assigning them to one of the following three orientations: committed, undecided or non-committed to a speciality. RESULTS The response rate was 38.8% (n = 461), and participants' mean age was 27.4 years with a majority of females (68.1%). Nearly 25% of the participants had general practice as speciality preference, and only 13.9% had excluded general practice for future specialisation. Overall, around half of the participants had general practice as a first, second or third preference for specialisation. CONCLUSION Danish medical trainees show considerable interest in general practice at the time of their transition from undergraduate to postgraduate education. However, to meet future demands on the primary care, further recruitment of general practitioners is still needed. This knowledge of the specialities' recruitment potential will likely be of interest to medical educators and healthcare planners alike.
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Affiliation(s)
- Sofie Gjessing
- Centre for General Practice, Aalborg University, Aalborg East, Denmark
| | - Torsten Risør
- Section for General Practice & Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
- Section for General Practice, Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
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Bechara JP, Shah PP, Lindor K. The power of rotation schedules on the career selection decisions of medical students. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1509-1522. [PMID: 37131109 PMCID: PMC10153029 DOI: 10.1007/s10459-023-10227-w] [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: 11/03/2022] [Accepted: 03/26/2023] [Indexed: 05/04/2023]
Abstract
Choosing a career pathway in medicine is a high stakes decision for both medical students and the field of medicine as a whole. While past research has examined how characteristics of the medical student or specialties influence this decision, we introduce temporal elements as novel variables influencing career selection decisions in medicine. Specifically, we investigate how timing and duration of residency options, based on a rotation schedule that medical students have limited control over, influence their career selection decisions. An archival study investigating 5 years of medical student rotation schedules (N = 115) reveals that clinical rotation options appearing earlier and more often in the schedule were more likely to be selected. Moreover, timing and duration of exposure interacted such that residency options appearing later in the schedules were more likely to be selected if they also appeared more often. Conditional logistic regressions using student fixed-effects to control for idiosyncratic medical student differences (i.e., gender, & debt, etc.), and residency fixed-effects to control for idiosyncratic residency differences (income, and lifestyle, etc.), revealed the rotation schedule had a significant impact on residency selection decisions even when controlling for factors typically influencing this decision. Medical students' career decisions are influenced by when and how long different choice options appear in their rotation schedule, especially when they have limited influence over this schedule. The results have implications for healthcare policy by highlighting a tool for adjusting physician workforce composition by broadening exposure to a greater array of career options.
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Affiliation(s)
- John P Bechara
- Department of Organization Studies, Tilburg University, Simon Building, PO Box 90153, Tilburg, 5000 LE, The Netherlands.
| | - Priti Pradhan Shah
- Work and Organizations, Carlson School of Management, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - Keith Lindor
- Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
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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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Hull W, Jewell E, Shabir S, Borrows R. Nephrophobia: a retrospective study of medical students' attitudes towards nephrology education. BMC MEDICAL EDUCATION 2022; 22:667. [PMID: 36085042 PMCID: PMC9461189 DOI: 10.1186/s12909-022-03713-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 03/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nephrology is a subject which is challenged by a lack of applicants for trainee places. This study addresses the attitudes of medical students towards the subject and explores the causes of this lack of interest amongst potential specialty trainees. METHODS Students were asked to complete a survey ranking their attitudes towards nephrology and other specialties. This data was collated and analysed to show trends and allow comparison of the attitudes towards each specialty. RESULTS Students felt that along with geriatrics, their least favourite subject was nephrology. Students felt unconfident in diagnosing, managing and understanding chronic conditions more so than acute conditions. Nephrology was consistently amongst the least popular subject for all areas of diagnosis, management and pathophysiology. Renal anatomy was the only area of nephrology that students felt confident in. The less popular specialties of nephrology and geriatrics had the greatest room for improvement when directly instructed in specialty medical training. CONCLUSIONS Nephrology remains a problematic and unpopular specialty for medical students, driving their unwillingness to consider it as a future career route. This study identifies areas of misconception amongst medical students toward the specialty and highlights areas for improvement in renal training for students.
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Affiliation(s)
- William Hull
- Department of Renal Medicine Queen, Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH, UK.
- University of Birmingham Medical School, Vincent Drive, Birmingham, B15 2TT, UK.
- North Middlesex University Hospitals, Sterling Way, London, N18 1QX, UK.
| | - Emilia Jewell
- University of Birmingham Medical School, Vincent Drive, Birmingham, B15 2TT, UK
| | - Shazia Shabir
- Department of Renal Medicine Queen, Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH, UK
| | - Richard Borrows
- Department of Renal Medicine Queen, Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH, UK
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Sapoutzis N, Schneider A, Brandhuber T, Berberat PO, Wijnen-Meijer M. Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study. BMC MEDICAL EDUCATION 2022; 22:622. [PMID: 35978341 PMCID: PMC9382807 DOI: 10.1186/s12909-022-03688-x] [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: 02/09/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In many countries, not enough students are interested to work as general practitioners in rural areas. To solve this problem, several, sometimes partly extracurricular, programs have been developed. Most of these programs are based on continuity, which means that students stay in a rural region for an extended period of time, by completing clerkships. Although the effects of these programs are positive, it is often difficult to motivate students to participate. The purpose of the present study is to get insight into the reasons why students choose not to participate in these programs. METHODS We carried out a questionnaire study among medical students in the clinical phase of the Technical University of Munich in Germany. First, we asked the students whether they actively informed themselves about the program which aims to reduce the shortage of general practitioners in rural areas in Bavaria. Furthermore, the questionnaire focused on the reasons for not participating in this program. RESULTS Based on the answers of 442 students from study years 3-6, the most frequently chosen reason for not participating in the program is "identification with another discipline" with 61.0%, directly followed by "not willing to commit long-term" (56.1%). In third place is "personal connections to another region" with 30.5%. In the open comments, we find the same reasons: many students do not want to commit to a certain direction too early. In addition, students indicate that the number of regions where this program is offered is too limited for them. CONCLUSIONS Offering programs to prepare and motivate students for work as general practitioners in rural areas can contribute to increasing the pool of future general practitioners. To encourage students to participate in such a program, it is important to consider the motives of students. Many students who might be interested in general practice do not choose to take part in such a program because they do not want to commit to a particular specialty or region at an early stage. It is important to take these insights into account when designing and implementing these programs.
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Affiliation(s)
- Nikolaos Sapoutzis
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
- Public Health Department Hochtaunuskreis, Bad Homburg vor der Höhe, Germany
| | - Antonius Schneider
- Technical University of Munich, School of Medicine, Institute of Family Medicine and Health Services Research, Munich, Germany
| | - Tom Brandhuber
- Technical University of Munich, School of Medicine, Institute of Family Medicine and Health Services Research, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany.
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Nadarajah A, Ramasamy S, Shankar PR, Sreeramareddy CT. Development and validation of motivators for medical specialist career choice questionnaire (MMSCCQ) - a methodological study. BMC MEDICAL EDUCATION 2022; 22:474. [PMID: 35718765 PMCID: PMC9206890 DOI: 10.1186/s12909-022-03523-3] [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: 10/05/2021] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION A validated instrument to assess the motivating factors influencing junior doctors' medical specialist career choices is not available. The Motivators for Medical Specialist Career Choice Questionnaire (MMSCCQ) was developed and validated in the present study. METHODS An exploratory sequential mixed-methods study was conducted among house officers (HO) of a tertiary care hospital. A literature review was used to construct an interview guide. Seven HOs participated in an online, one-on-one audio-recorded in-depth interview (IDI). Seven sub-themes and 33 codes identified by thematic analyses were used to develop the MMSCCQ. The importance of each motivator was rated on a five-point Likert scale. The MMSCCQ was pretested, and a random sample of 262 house officers was invited to participate in an online survey. Psychometric evaluation was done using reliability statistics, and exploratory and confirmatory factor analyses. RESULTS The seven main themes identified by thematic analyses were labeled as factors related to 'work schedule and personal life,' 'training opportunities', 'past work experiences', 'specialty characteristics', 'career prospects', 'patient care characteristics', and 'social factors.' The highest ratings were given to "previous job experience" and "patient care traits. "The response rate was 71%, the mean age of the 185 HOs was 26.7 years (SD = 1.6). Females made up 63.8% of the population. The internal consistency for the overall questionnaire measured by Cronbach's alpha was 0.85. Each construct demonstrated an acceptable internal consistency. Twenty-six of 33 items were maintained after an exploratory factor analysis was conducted, yielding 7 constructs with a 64.9% variance. Confirmatory factor analyses established the construct validity. CONCLUSION The MMSCCQ has acceptable reliability and construct validity. Further studies are needed to test psychometric properties in different settings.
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Affiliation(s)
- Anuradha Nadarajah
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Shamala Ramasamy
- Department of Psychology, International Medical University, Kuala Lumpur, Malaysia
| | | | - Chandrashekhar T Sreeramareddy
- Department of Community Medicine, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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An evaluation of a student led career profiling project to support the exploration of a career in general practice and other specialties. BJGP Open 2022; 6:BJGPO.2022.0002. [PMID: 35504725 DOI: 10.3399/bjgpo.2022.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/08/2022] [Accepted: 04/26/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Choosing medical careers is complex but the undergraduate period is formative. St. George's University of London (SGUL) students called for greater careers information. AIM To develop & evaluate students' careers resources. DESIGN & SETTING A quality improvement student staff project at SGUL. METHOD A "Plan, Do, Study, Act" (PDSA) cycle was completed. For the "Plan" element we surveyed students' career intentions and information preferences. For the "Do" element, video interviews with clinicians and infographic posters were produced and published on SGUL's virtual learning environment. For the "Study" element, feedback questionnaires were thematically analysed using Kirkpatrick's framework. For the "Act" element the model was rolled out across SGUL programmes. RESULTS (Plan) 79 students ranked interest in specialties, with GP second most popular. Students were unconfident how to pursue careers and wanted more information. (Do) 13 careers videos & infographics were created for 10 specialties. The (Study) questionnaire showed changes across 3 of Kirkpatrick's levels. Level 1 (Response) students found resources helpful & accessible. Level 2 (Learning) students reported increased understanding of careers. Level 3 (Transfer) students planned using checklists and made career comparisons by specialty. Level 4 (Results) students' career choices were not demonstrated but there were tentative proxy measures such as copying and modelling career routes and choices. (Act) involved rolling out and regularly updating resources. CONCLUSION This PDSA model enabled development of resources by students mapped to students' needs. We demonstrated changes in relation to students' response, learning and transfer, with tentative suggestions of impact on career choice.
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N’CHO-MOTTOH MPB, COULIBALY I, BOKA B, BAMBA-KAMAGATE D, EKOU A, AUBREGE A. [Career choice of ivorian medical students at the end of curriculum: influencing factors and aspirations]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.v2i1.2022.202. [PMID: 35685833 PMCID: PMC9128462 DOI: 10.48327/mtsi.v2i1.2022.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/31/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The implantation of health structures in Côte d'Ivoire to improve geographical accessibility to care remains unequal between rural and urban areas. The medical student has to decide on his or her career choice in this context, while also taking into account personal preferences. The aim of our study was to evaluate the factors influencing the speciality choice of medical students at the faculty of medicine of Félix Houphouët-Boigny University in Abidjan. METHODOLOGY Medical students enrolled in the 6th year completed an anonymous self-administered questionnaire. The questionnaire was in paper format and was divided into three parts: socio-demographic criteria; speciality choice; and factors influencing career choice. Students were asked to rate the extent to which they perceived each of the 24 items as influencing their career choice using a Likert scale ranging from 1 (no influence) to 5 (strong influence). The factors were compared according to the speciality choice (medical or surgical). RESULTS The 3 most chosen specialties were: cardiology (17.9%), gynaecology-obstetrics (15.7%) and paediatrics (9.6%). The desire to take the internship competition was more frequent among students who chose a surgical speciality (p = 0.02). The choice of a medical speciality was more influenced by the willingness to work part-time (p = 0.04). Students who choose a medical speciality were more guided by social commitment than those who chose a surgical speciality (p = 0.04). In contrast, the latter were more influenced by prestige among colleagues (p = 0.04) and immediate postoperative outcomes (p = 0.01). CONCLUSION The efficient equipment of health structures could contribute to the development of other less chosen specialities by making them more attractive. A reorganisation of the system with the deployment of teachers in regional hospitals with a minimum of equipment is indispensable in order to allow a "decentralization" of the specialization curriculum, especially for the surgical specialties.As for the aspiration to part-time work, it can be explained by the need to reconcile family and professional life, but also by a sometimes unspoken project to develop a lucrative extra-medical activity in order to make up insufficient wages.
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Affiliation(s)
| | - Iklo COULIBALY
- Institut de Cardiologie d’Abidjan, BP V 206, Abidjan, Côte-d’Ivoire
| | - Bénédicte BOKA
- Institut de Cardiologie d’Abidjan, BP V 206, Abidjan, Côte-d’Ivoire
| | | | - Arnaud EKOU
- Institut de Cardiologie d’Abidjan, BP V 206, Abidjan, Côte-d’Ivoire
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York MK, Pourali SP, Hanna ES, Day ME, Rehman S, Fleming AE, Pilla M, Brown CM. Exploring Careers in Medicine: Implementation and Perceived Value of a Multi-Specialty Elective. MEDICAL SCIENCE EDUCATOR 2021; 31:1351-1359. [PMID: 34457977 PMCID: PMC8368157 DOI: 10.1007/s40670-021-01311-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Choosing a medical specialty is one of the most crucial and difficult decisions made during medical school. Given that specialty exposure is among the most important factors in decision-making, the Careers in Medicine (CiM) multi-specialty elective was designed to provide clerkship students an avenue to explore three or more specialties of interest during a single elective. METHODS A cross-sectional study was conducted at Vanderbilt University School of Medicine using anonymous surveys and de-identified written reflections submitted by students enrolled in the CiM course between August 2015 and June 2018. Data were analyzed using a mixed-methods approach. RESULTS The majority of students reported the elective guided them in ruling out (80%) and ruling in (65%) specialties. About half (51%) of students decided between the procedural versus critical-thinking dichotomy. Finally, 80% of students reported that they would take the course again rather than a focused elective. Major themes identified from student reflections included course attributes, specialty impacts, and student values. DISCUSSION Implementation of a multi-specialty elective during the clerkship year was an effective way to help students understand their career values, gain early exposure to specialties not featured in core clinical curriculums, and determine future fields of interest. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01311-0.
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Affiliation(s)
| | | | - Eriny S. Hanna
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Melissa E. Day
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | - Saad Rehman
- Department of Medicine, Massachusetts General Hospital, Boston, USA
| | - Amy E. Fleming
- Vanderbilt University School of Medicine, Nashville, TN USA
| | - Michael Pilla
- Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, USA
| | - Charlotte M. Brown
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA
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Zelesniack E, Oubaid V, Harendza S. Final-year medical students' competence profiles according to the modified requirement tracking questionnaire. BMC MEDICAL EDUCATION 2021; 21:319. [PMID: 34088296 PMCID: PMC8178874 DOI: 10.1186/s12909-021-02728-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Undergraduate medical education is supposed to equip medical students with basic competences to select any specialty of their choice for postgraduate training. Medical specialties are characterized by a great diversity of their daily work routines and require different sets of competence facets. This study examines the self-assessed competence profiles of final-year undergraduate medical students and their specialty choice for postgraduate training. Students' profiles, who wish to choose anaesthesiology, internal medicine, or paediatrics, are compared with the physicians' competence profiles from these three disciplines. METHODS In this study, 148 volunteer final-year undergraduate medical students completed the modified requirement-tracking (R-Track) questionnaire for self-assessment of their competence profiles. The R-Track questionnaire contains 63 competence facets assigned to six areas of competence: "Mental abilities", "Sensory abilities", "Psychomotor & multitasking abilities", "Social interactive competences", "Motivation", and "Personality traits". The expression of the different competence facets had to be assessed on a 5-point Likert scale (1: "very low" to 5: "very high"). Additionally, socio-demographic data and the participants' first choice of a medical speciality for postgraduate education were collected. We used analysis of variance (ANOVA) for mean score comparison of subgroups and least significant difference (LSD) tests for post hoc analysis. RESULTS The competence area with the highest rating was "Motivation" (3.70 ± 0.47) while "Psychomotor & multitasking abilities" received the lowest rating (3.34 ± 0.68). Individual facets of competence ranked from "In need of harmony" (4.36 ± 0.72), followed by "Tactfulness" (4.26 ± 0.64), and "Cooperation/Agreeableness" (4.24 ± 0.53) to "Risk orientation" (2.90 ± 0.92), "Mathematical reasoning" (2.87 ± 1.25), and "Sanctioning" (2.26 ± 0.93). The students' competence profiles showed 100 % congruence with physicians' competence profiles of the postgraduate specialty of their choice for internal medicine, 33.3 % for paediatrics, and 0 % for anaesthesiology. CONCLUSIONS Undergraduate medical students could define their competence profiles with the modified R-Track questionnaire and compare them with the profile of their desired specialty for postgraduate training to discover possible learning gaps or to detect good specialty matches. A combination of students' competence self-assessment with an external assessment of students' facets of competence could provide curricular planners with useful information how to design learning opportunities for specific facets of competence.
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Affiliation(s)
- Elena Zelesniack
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | | | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
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6th year medical students' future specialty preferences: A cross-sectional study. Ann Med Surg (Lond) 2021; 66:102373. [PMID: 34040768 PMCID: PMC8141496 DOI: 10.1016/j.amsu.2021.102373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studying career preferences can help in designing and improving health service systems. Determining the preferred specialty and understanding the compulsion affecting specialty choice will provide clues to influence such choice in the future to shift the balance of specialties among practitioners. The current study aimed to determine medical students' preferable specialty choices and the factors influencing their choices and their attitude towards postgraduate medical education in Jordan and abroad. MATERIALS AND METHODS The descriptive cross-sectional study design included 6th-year medical students in medical faculties in Jordan. An online questionnaire was created on Google Forms and posted on platforms accessible by medical students at level six. Numbers and percentages were presented for all variables. Frequency distributions were also presented. Chi-square distribution was used to measure the association between categorical data. Alpha level of 0.05 was used. RESULTS Most students 188 (74.3%) preferred to continue their post-graduate training abroad, while only 65 (25.7%) favored Jordan. 150 (59.3%) of the respondents are interested in the medical - non-surgical - specialties. The most important factor that encouraged the students to choose a specialty was Job opportunity (32.5%) followed by the number of years required to complete the training and the expected income (27.7%) each. CONCLUSION Supportive steps should be undertaken to motivate medical graduates toward the needed specialties. Moreover, local Specialty training programs need to be -reevaluated to ensure proper post graduate medical learning.
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Zhang YJ, Yuan K, Chang SH, Yan W, Que JY, Deng JH, Gong YM, Luo JM, Yang SC, An CX, Kang YM, Xu HS, Wang YM, Zhang LF, Zhang WF, Song YL, Xu DW, Liu HZ, Wang WQ, Liu CX, Yang WQ, Zhou L, Zhao JB, Yu MY, Chen JY, Tang H, Peng J, Zhang XJ, Xu Y, Zhang N, Kuang L, Li ZJ, Wang YH, Shi J, Ran MS, Bao YP, Shi L, Lu L. Career choice and influential factors among medical students majoring in psychiatry in China. BMC MEDICAL EDUCATION 2021; 21:183. [PMID: 33766012 PMCID: PMC7992123 DOI: 10.1186/s12909-021-02622-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/16/2021] [Indexed: 06/10/2023]
Abstract
BACKGROUND The undergraduate program of psychiatry has been widely established in recent years to improve the education and recruitment of psychiatrists in China. We aim to investigate the career choice of medical students majoring in psychiatry in China and the influential factors. METHOD This multicenter study was conducted in 26 medical schools in China from May to October of 2019. Participants included 4610 medical students majoring in psychiatry and 3857 medical students majoring in clinical medicine. Multivariable logistic regression was used to investigate the influential factors of students' choices of psychiatry at matriculation and as a career. RESULTS 44.08% of psychiatry majored students gave psychiatry as a first choice at matriculation, and 56.67% of them would choose psychiatry as a career, which was in sharp contrast to the proportion of clinical medicine majored students who would choose psychiatry as a career (0.69%). Personal interest (59.61%), suggestions from family members (27.96%), and experiencing mental problems (23.19%) were main reasons for choosing psychiatry major at matriculation. Personal interest (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.87-2.40), experiencing a psychiatry clerkship (OR = 1.99, 95% CI = 1.28-3.08), being female (OR = 1.50, 95% CI = 1.30-1.68), experiencing mental problems (OR = 1.33, 95% CI = 1.28-1.56), and suggestions from family members (OR = 1.25, 95% CI = 1.08-1.46) correlated positively with students' choice of psychiatry as career. Students who lacked psychiatry knowledge (OR = 0.49, 95% CI = 0.29-0.85) or chose psychiatry because of lower admission scores (OR = 0.80, 95% CI = 0.63-0.97) were less likely to choose psychiatry as a career. CONCLUSION More than half of psychiatry majored medical school students planned to choose psychiatry as their career, whereas very few students in the clinic medicine major would make this choice. Increasing students' interest in psychiatry, strengthening psychiatry clerkships, and popularizing psychiatric knowledge are modifiable factors to increase the psychiatry career intention. The extent to which medical students' attitudes toward psychiatry can be changed through medical school education and greater exposure to psychiatry will need further investigation.
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Affiliation(s)
- Ying-Jian Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Su-Hua Chang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Jian-Yu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Jia-Hui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG, McGovern Institute for Brain Research, Beijing, China
| | - Jia-Ming Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Shi-Chang Yang
- Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Cui-Xia An
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of Hebei Medical University, Brain Ageing and Cognitive Neuroscience Laboratory, Hebei Medical University, Shijiazhuang, China
| | - Yi-Min Kang
- School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Hua-Shan Xu
- School of Mental Health, Bengbu Medical College, Anhui, China
| | - Yi-Ming Wang
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Li-Fang Zhang
- Department of Neurology, Changzhi People's Affiliated Hospital of Changzhi Medical College, Changzhi, Shanxi, China
| | - Wen-Fang Zhang
- Mental Health Department of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Yin-Li Song
- Department of Pathology, Daqing Campus of Harbin Medical University, Daqing, China
| | - Dong-Wu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huan-Zhong Liu
- Chaohu Hospital of Anhui Medical University, Anhui, China
| | | | | | - Wen-Qiong Yang
- Department of Neurology, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Liang Zhou
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jiu-Bo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Miao-Yu Yu
- Department of Mental Health, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jun-Yu Chen
- Shenzhi Department, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Hong Tang
- Department of Psychology, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Juan Peng
- Teaching and Research Section of Psychology, School of Management, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiu-Jun Zhang
- North China University of Science and Technology Tangshan, Hebei, China
| | - Yong Xu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Ning Zhang
- Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li Kuang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhan-Jiang Li
- Department of Clinical Psychology, National Clinical Research Center for Mental Disorders, Beijing, China
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Hua Wang
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China.
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China.
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Zelesniack E, Oubaid V, Harendza S. Defining competence profiles of different medical specialties with the requirement-tracking questionnaire - a pilot study to provide a framework for medial students' choice of postgraduate training. BMC MEDICAL EDUCATION 2021; 21:46. [PMID: 33435986 PMCID: PMC7801870 DOI: 10.1186/s12909-020-02479-6] [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: 09/15/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The medical specialties are characterised by a great diversity in their daily work which requires different sets of competences. A requirement analysis would help to establish competence profiles of the different medical specialities. The aim of this pilot study was to define competence profiles for individual medical specialties. This could provide a framework as support for medical graduates who wish to choose a medical specialty for their postgraduate training. METHODS In February 2020, physicians were invited via the State Chamber of Physicians' monthly journal to electronically fill out the requirement tracking (R-Track) questionnaire. It contains 63 aspects assigned to six areas of competence: "Mental abilities", "Sensory abilities", "Psychomotor and multitasking abilities", "Social interactive competences", "Motivation", and "Personality traits". The expression of the different aspects was assessed on a 5-point Likert scale (1: "very low" to 5: "very high"). Sociodemographic data and information about the current workplace (hospital or practice) were also collected. RESULTS In total, 195 practicing physicians from 19 different specialities followed the invitation by the State Chamber of Physicians to participate in this survey. For almost all medical specialties, the competence area "Motivation" reached rank 1. "Psychomotor and multitasking abilities" received high ranks among specialties performing surgical activities, while "Social interactive competences" and "Personality traits" were highly rated by specialties with an intense level of patient-physician-interaction. "Mental abilities" were only rated highly by radiologists (rank 2) and physiologists (rank 3) while "Sensory abilities" were generally rated very low with the expression (rank 4) for anaesthesiology and ENT. CONCLUSIONS In this pilot study, a first outline of competences profiles for 17 medical specialties were defined. The specific "Motivation" for a medical specialty seemed to play the greatest role for most specialties. This first specialty specific competence framework could provide a first insight into specific competences required by medical specialties and could serve medical graduate as a decision aid when looking for a medical specialty for their postgraduate training.
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Affiliation(s)
- Elena Zelesniack
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | | | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
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Carroll AL, Chan A, Steinberg JR, Bryant TS, Marin-Nevarez P, Anderson TN, Bereknyei Merrell S, Lau JN. Medical Student Values Inform Career Plans in Service & Surgery-A Qualitative Focus Group Analysis. J Surg Res 2020; 256:636-644. [PMID: 32810664 DOI: 10.1016/j.jss.2020.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/15/2020] [Accepted: 07/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Diversifying the surgical workforce is a critical component of improving care for underserved patients. To recruit surgeons from diverse backgrounds, we must understand how medical students choose their specialty. We investigate how preclinical students contemplate entering a surgical field. MATERIALS AND METHODS We conducted semistructured focus groups during two iterations of a seminar class called Service Through Surgery. Discussion goals included identifying student values and assessing how they inform early career decisions. We used a systematic, collaborative, and iterative process for transcript analysis, including developing a codebook, assessing inter-rater reliability, and analyzing themes. RESULTS Twenty-four preclinical medical students from diverse backgrounds participated in seven focus groups; most were women (16; 67%), in their first year of medical school (19; 79%), and interested in surgery (17; 71%). Participants ranked professional fulfillment, spending time with family, and serving their communities and/or underserved populations among their most important values and agreed that conducting groundbreaking research, working long hours, and finding time for leisure activities were the least important. We constructed a framework to describe student responses surrounding their diverse visions for service in future surgical careers through individual doctoring interactions, roles in academia, and broader public service. CONCLUSIONS Our framework provides a basis for greater understanding and study of the ways in which preclinical medical students think about their personal values and visions for service in potential future surgical careers. This research can guide early interventions in medical education to promote diversity and care for the underserved in surgery.
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Affiliation(s)
- Anna L Carroll
- Stanford University School of Medicine, Stanford, California.
| | - Antonia Chan
- Stanford University School of Medicine, Stanford, California
| | | | - Tyler S Bryant
- Stanford University School of Medicine, Stanford, California
| | | | - Tiffany N Anderson
- Department of Surgery, Stanford Surgery ACS Education Institute/Goodman Surgical Education Center, Stanford University, Stanford, California
| | - Sylvia Bereknyei Merrell
- Department of Surgery, Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford University, Palo Alto, California
| | - James N Lau
- Stanford University School of Medicine, Stanford, California; Department of Surgery, Stanford Surgery ACS Education Institute/Goodman Surgical Education Center, Stanford University, Stanford, California
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Eden AR, Barreto T, Hansen ER. Experiences of new family physicians finding jobs with obstetrical care in the USA. Fam Med Community Health 2020; 7:e000063. [PMID: 32148712 PMCID: PMC6910746 DOI: 10.1136/fmch-2018-000063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/20/2019] [Accepted: 02/22/2019] [Indexed: 11/04/2022] Open
Abstract
Objective This study aimed to explore how new family medicine graduates who want to include obstetrics in their scope of practice identify and select jobs and to understand how employment influences scope of practice in family medicine, particularly the ability to provide maternity care and deliver babies. Design Mixed-methods study including a survey and qualitative interviews conducted in 2017. Setting We electronically surveyed US family physicians and followed up with a purposeful subsample of these physicians to conduct in-depth, semistructured telephone interviews. Participants 1016 US family medicine residency graduates 2014-2016 who indicated that they intended to deliver babies in practice completed a survey; 56 of these were interviewed. Main outcome measures The survey measured the reasons for not doing obstetrics as a family physician. To identify themes regarding finding family medicine jobs with obstetrics, we used a team-based, immersion-crystallisation approach to analyse the transcribed qualitative interviews. Results Survey results (49% response rate) showed that not finding a job that included obstetrics was the primary reason newly graduated family physicians who intended to do obstetrics were not doing so. Qualitative interviews revealed that family physicians often find jobs with obstetrics through connections or recruitment efforts and make job decisions based on personal considerations such as included geographical preferences, family obligations and lifestyle. However, job-seeking and job-taking decisions are constrained by employment-related issues such as job structure, practice characteristics and lack of availability of family medicine jobs with obstetrics. Conclusions While personal reasons drove job selection for most physicians, their choices were constrained by multiple factors beyond their control, particularly availability of family medicine jobs allowing obstetrics. The shift from physician as practice owner to physician as employee in the USA has implications for job-seeking behaviours of newly graduating medical residents as well as for access to healthcare services by patients; understanding how employment influences scope of practice in family medicine can provide insight into how to support family physicians to maintain the scope of practice they desire and are trained to provide, thus, ensuring that families have access to care.
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Affiliation(s)
- Aimee R Eden
- Department of Research and Policy, American Board of Family Medicine, Lexington, Kentucky, USA
| | - Tyler Barreto
- Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Elizabeth Rose Hansen
- Department of Research and Policy, American Board of Family Medicine, Lexington, Kentucky, USA
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McEwen-Smith L, Price MJ, Fleming G, Swanwick T, Hirsch C, Yahyouche A, Ward J, Buckley S, Shamim A, Paudyal V. National recruitment scheme for pre-registration pharmacist training in England and Wales: a mixed method evaluation of experiences of applicant pharmacy students. BMC MEDICAL EDUCATION 2019; 19:453. [PMID: 31801519 PMCID: PMC6894328 DOI: 10.1186/s12909-019-1883-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 11/20/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND A national pre-registration pharmacist training recruitment scheme, which replaces local recruitment models, was introduced in England and Wales in 2017. The national recruitment system allows pharmacy students to apply for the 52 weeks training programmes (mandatory requirement for registration as a pharmacist), through a single application system prior to undertaking a nationally administered assessment. This study aimed to explore experiences of pharmacy students on the national recruitment scheme, particularly their views on the selection methodology, application process, and offer outcomes. METHODS This mixed method study involved a) an online survey of all (approximate n = 2800) year 4 (final year of MPharm degree) pharmacy students in England and Wales and b) a qualitative focus group with four students. The study population was eligible to participate in the 2017/18 national recruitment scheme. Survey respondents were invited to participate in a focus group. Quantitative data were analysed using descriptive and inferential analysis. Qualitative data were analysed using the framework technique. Participation was voluntary. Ethical approval from University of Birmingham was obtained. RESULTS A total of 307 completed surveys were returned (approximate response rate 11%). Respondents were generally satisfied with the application process and commended the fairness of the selection methodology and convenience in allowing them to apply to multiple training providers. Most survey respondents (n = 181, 72.9%) were either satisfied or highly satisfied with the training programme they were offered based on their assessment performances. Three themes and eight sub-themes obtained from the analysis of over 200 open comments data from the survey and transcript of a focus group with four participants. Results suggested the need to widen the timeframe available for applicants to shortlist their preferred employers, improve the method of programme listing in the application system, and consideration of prior achievements including academic performances and placement experiences to be included in the selection methodology. CONCLUSIONS Experiences of pharmacy students on the national recruitment scheme suggest that respondents considered the selection methodology to be fair. Student engagement and satisfaction with the recruitment system can be maximised through improved listing of employers and widening the timescales for students to shortlist their preferred employers during application process. Inclusion of University achievements in the selection methodology will require consideration of evidence based approaches. Low response rate limits generalisation of findings.
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Affiliation(s)
- Laura McEwen-Smith
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
- NHS Health Education England, London, UK
| | - Malcolm James Price
- Institute of Applied Health Research (Biostatistics), University of Birmingham, Birmingham, UK
| | | | | | - Christine Hirsch
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
| | - Asma Yahyouche
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
| | - Jonathan Ward
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
| | - Sharon Buckley
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
| | - Atif Shamim
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
| | - Vibhu Paudyal
- School of Pharmacy, University of Birmingham, B15 2TT, Birmingham, UK
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Olsson C, Järnbert-Pettersson H, Ponzer S, Dahlin M, Bexelius T. Swedish doctors choice of medical speciality and associations with cultural capital and perceived status: a cross-sectional study. BMC MEDICAL EDUCATION 2019; 19:244. [PMID: 31272433 PMCID: PMC6610830 DOI: 10.1186/s12909-019-1691-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 06/27/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Many western countries have problems recruiting and retaining medical specialists. In Sweden there is a lack of primary care doctors and psychiatrists. Despite much research on the topic the shortage remains. We therefore set out to analyse choice of medical speciality using Bourdieu's theoretical concepts; cultural capital, social background and perceived status. METHODS A cross-sectional questionnaire-based study of 399 alumni from the Medical School at Karolinska Institutet, Stockholm was performed. The response rate was 72% (n = 286); 262 of the respondents were in training to become specialists. Specialties were categorized as primary care, psychiatry, internal medicine, and surgical and hospital service specialties. To study the associations between medical specialties and cultural capital, we used multinomial regression analyses. Variables that showed a significant association with medical specialties were included in an adjusted multivariable model. These results were presented as odds ratios: the odds that a particular speciality is chosen in comparison to a choice of surgery as a speciality, based on perceptions of high status. RESULTS The results were analysed using Bourdieu's theoretical concepts of cultural capital, in the form of educational capital and social prestige. We found distinctive differences in perceived status for the examined speciality groups, ranging from 70% high status for surgery down to 6% high status for geriatrics and primary care. Perceived status was also associated with respondents' own speciality choice, presented as an odds ratio. Our data did not show any associations between speciality choice and educational capital. We also included sociodemographic data. CONCLUSION The field of medicine is according to Bourdieu an arena for power struggles. Knowledge of the distinctive differences in perceived status between medical specialties can be an asset particularly in relation to recruitment and retainment of specialist doctors. Our results could be used to identify specialities where perceptions of low status may be contributing to a shortage of specialists.
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Affiliation(s)
- Caroline Olsson
- Department of Clinical Science and Education, Karolinska Institutet, Forskningscentrum, Sjukhusbacken 10, Södersjukhuset, SE-118 46 Stockholm, Sweden
| | - Hans Järnbert-Pettersson
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sari Ponzer
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Marie Dahlin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, S:t Görans Hospital, Vårdvägen 1, SE-112 81 Stockholm, Sweden
| | - Tomas Bexelius
- Department of Women’s and Children’s Health, Childhood Cancer Research Unit and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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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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Stark E, Christensen JD, Schmalz NA, Uijtdehaage S. Evaluation of a Curricular Addition to Assist Medical Students in Specialty Selection. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2018; 5:2382120518788867. [PMID: 30083614 PMCID: PMC6066807 DOI: 10.1177/2382120518788867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 06/21/2018] [Indexed: 05/18/2023]
Abstract
Early hands-on experience with surgical procedures may help medical students make better-informed choices if considering a surgical specialty. Here, we evaluate a curricular addition in surgical anatomy, formally exposing second-year students to different surgical subspecialties. Students met with surgeons for 7 weeks (one afternoon per week) and practiced surgical procedures on human cadavers with supervision. About a quarter of the participants reported a change in their top choice of specialty upon completing the course, and about half of the students reported changes in their second and third choices. At the time of graduation, 85% of those surveyed reported participation in the course impacted their final choice of specialty. These results demonstrate such a course helped medical students select a specialty during early training.
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Affiliation(s)
- Elena Stark
- Department of Pathology and Laboratory
Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Elena Stark, Department of Pathology, School
of Medicine at UCLA, 10833 Le Conte Ave. CHS 50-060, Los Angeles CA 90095, USA.
| | - John D Christensen
- Department of Pathology and Laboratory
Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Naomi A Schmalz
- Department of Anatomy and Cell Biology,
School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Sebastian Uijtdehaage
- Department of Medicine, Uniformed
Services University of the Health Sciences, Bethesda, MD, USA
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Hoseinnejad H, Kohan N, Mirzaee A. Evaluating validity of current criteria for judgment passing ER rotation among internee medical students. Ann Med Surg (Lond) 2017; 20:92-96. [PMID: 28761637 PMCID: PMC5522913 DOI: 10.1016/j.amsu.2017.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/13/2017] [Accepted: 06/13/2017] [Indexed: 12/03/2022] Open
Abstract
Background Passing the emergency medicine internship is an essential process for all graduates of medical schools. The main purpose of this study was to evaluate validity of current criteria for judgment passing ER rotation among internee medical students. Methods In this cross-sectional study, a total of 200 students in the emergency departments (ED) of the teaching hospitals at Tehran University of Medical Sciences (TUMS) were included. The data were gathered using by a valid self-assessment questionnaire including demographic information and 12-items about the students' level of confidence with the skills and procedures under study. Statistical analyses were done using SPSS (version 22). Results 200 medical students participated in this study. A Univariate analysis showed a significant correlation between successfuly completions of training in emergency medicine (passing emergency medicine in past rotations) with some items in self-assessment questionnaire same as knowledge of interns in managing emergency situations (p = 0.009). The Spearman test demonstrated a significant correlation between the duration of emergency training (number of months which interns spent on the emergency training) with the some items in self-assessment questionnaire same as importance of emergency medicine training (p = 0.019). Conclusions According to association between successfully completions of training in emergency medicine and self-assessment questionnaire, it seems current criteria for judgment passing emergency medicine rotation is valid as well as we recommended using self-assessment for evaluating validity of such testes. Previous studies have shown that the results of clinical tests in emergency medicine and other clinical education courses do not correlate accurately with a medical student's degree of confidence in performing tasks and their readiness for future career. Validity and authenticity of clinical test in emergency medicine and other clinical education course must be evaluated to ensure that these examinations predict whether the students who pass have greater skills and confidence when compared to the ones who fail the rotation. Self-assessment is an effective tool for evaluating validity of clinical tests.
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Affiliation(s)
- Hooman Hoseinnejad
- Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Kohan
- Medical Graduates, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Corresponding author. Education Development Center, Medical Education Department, Hojjat-Doost Alley, Naderi St., Keshavarz Blvd., Tehran, Iran.Education Development CenterMedical Education DepartmentHojjat-Doost AlleyNaderi St.Keshavarz Blvd.TehranIran
| | - Akram Mirzaee
- Department of Medical Education, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Sievert M, Zwir I, Cloninger KM, Lester N, Rozsa S, Cloninger CR. The influence of temperament and character profiles on specialty choice and well-being in medical residents. PeerJ 2016; 4:e2319. [PMID: 27651982 PMCID: PMC5018665 DOI: 10.7717/peerj.2319] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/13/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Multiple factors influence the decision to enter a career in medicine and choose a specialty. Previous studies have looked at personality differences in medicine but often were unable to describe the heterogeneity that exists within each specialty. Our study used a person-centered approach to characterize the complex relations between the personality profiles of resident physicians and their choice of specialty. METHODS 169 resident physicians at a large Midwestern US training hospital completed the Temperament and Character Inventory (TCI) and the Satisfaction with Life Scale (SWLS). Clusters of personality profiles were identified without regard to medical specialty, and then the personality clusters were tested for association with their choice of specialty by co-clustering analysis. Life satisfaction was tested for association with personality traits and medical specialty by linear regression and analysis of variance. RESULTS We identified five clusters of people with distinct personality profiles, and found that these were associated with particular medical specialties Physicians with an "investigative" personality profile often chose pathology or internal medicine, those with a "commanding" personality often chose general surgery, "rescuers" often chose emergency medicine, the "dependable" often chose pediatrics, and the "compassionate" often chose psychiatry. Life satisfaction scores were not enhanced by personality-specialty congruence, but were related strongly to self-directedness regardless of specialty. CONCLUSIONS The personality profiles of physicians were strongly associated with their medical specialty choices. Nevertheless, the relationships were complex: physicians with each personality profile went into a variety of medical specialties, and physicians in each medical specialty had variable personality profiles. The plasticity and resilience of physicians were more important for their life satisfaction than was matching personality to the prototype of a particular specialty.
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Affiliation(s)
- Martin Sievert
- Department of Psychiatry, Washington University in St. Louis , Saint Louis , MO , United States
| | - Igor Zwir
- Department of Psychiatry, Washington University in St. Louis , Saint Louis , MO , United States
| | | | - Nigel Lester
- Department of Psychiatry, Washington University in St. Louis , Saint Louis , MO , United States
| | - Sandor Rozsa
- Department of Psychiatry, Washington University in St. Louis , Saint Louis , MO , United States
| | - C Robert Cloninger
- Departments of Psychiatry, Psychology, Genetics, Washington University in St Louis , Saint Louis , MO , United States
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Lepièce B, Reynaert C, van Meerbeeck P, Dory V. Social dominance theory and medical specialty choice. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:79-92. [PMID: 25991046 DOI: 10.1007/s10459-015-9612-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 05/09/2015] [Indexed: 06/04/2023]
Abstract
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.
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Affiliation(s)
- Brice Lepièce
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium.
| | - Christine Reynaert
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium
| | - Philippe van Meerbeeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium
| | - Valérie Dory
- Faculty of Medicine, Centre for Medical Education, McGill University, Montréal, Canada
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Querido SJ, Vergouw D, Wigersma L, Batenburg RS, De Rond MEJ, Ten Cate OTJ. Dynamics of career choice among students in undergraduate medical courses. A BEME systematic review: BEME Guide No. 33. MEDICAL TEACHER 2016; 38:18-29. [PMID: 26372112 DOI: 10.3109/0142159x.2015.1074990] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Due to the lack of a theoretically embedded overview of the recent literature on medical career decision-making, this study provides an outline of these dynamics. Since differences in educational routes to the medical degree likely affect career choice dynamics, this study focuses on medical career decision-making in educational systems with a Western European curriculum structure. METHODS A systematic search of electronic databases (Medline, Embase) was conducted from January 2008 to November 2014. A panel of seven independent reviewers performed the data extraction, quality assessment and data synthesis using the Bland-Meurer model of medical specialty choice as a reference. RESULTS Fifty-seven studies met the inclusion criteria for the review. Factors associated with specialty preference or career choice can be classified in five main categories: (1) medical school characteristics (e.g., curriculum structure), (2) student characteristics (e.g., age, personality), (3) student values (e.g., personal preference), (4) career needs to be satisfied (e.g., expected income, status, and work-life balance), and (5) perception of specialty characteristics (e.g., extracurricular or curricular experiences). Especially career needs and perceptions of specialty characteristics are often associated with medical career decision-making. CONCLUSION Our results support that medical career decisions are formed by a matching of perceptions of specialty characteristics with personal needs. However, the process of medical career decision-making is not yet fully understood. Besides identifying possible predictors, future research should focus on detecting interrelations between hypothesized predictors and identify the determinants and interrelations at the various stages of the medical career decision-making process.
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Affiliation(s)
- Sophie J Querido
- a Royal Dutch Medical Association , the Netherlands
- b Universiteit Utrecht, Center for Research and Development of Education , the Netherlands
| | - David Vergouw
- c Netherlands Institute for Health Services Research (Nivel) , the Netherlands
| | | | - Ronald S Batenburg
- c Netherlands Institute for Health Services Research (Nivel) , the Netherlands
| | | | - Olle T J Ten Cate
- b Universiteit Utrecht, Center for Research and Development of Education , the Netherlands
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Burns ST. Predictive Validity of Person Matching at the Scale and Discriminant Analysis Levels. JOURNAL OF EMPLOYMENT COUNSELING 2015. [DOI: 10.1002/joec.12023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Stephanie T. Burns
- Department of Counselor Education and Counseling Psychology; Western Michigan University
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Deutsch T, Lippmann S, Frese T, Sandholzer H. Who wants to become a general practitioner? Student and curriculum factors associated with choosing a GP career--a multivariable analysis with particular consideration of practice-orientated GP courses. Scand J Prim Health Care 2015; 33:47-53. [PMID: 25761999 PMCID: PMC4377739 DOI: 10.3109/02813432.2015.1020661] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Because of the increasing shortage of general practitioners (GPs) in many countries, this study aimed to explore factors related to GP career choice in recent medical graduates. Particular focus was placed on the impact of specific practice-orientated GP courses at different stages of the medical undergraduate curriculum. DESIGN Observational study. Multivariable binary logistic regression was used to reveal independent associations with career choice. SETTING Leipzig Medical School, Germany. SUBJECTS 659 graduates (response rate = 64.2%). MAIN OUTCOME MEASURE Choice of general practice as a career. RESULTS Six student-associated variables were found to be independently related to choice of general practice as a career: age, having family or friends in general practice, consideration of a GP career at matriculation, preference for subsequent work in a rural or small-town area, valuing the ability to see a broad spectrum of patients, and valuing long-term doctor-patient relationships. Regarding the curriculum, after adjustment independent associations were found with a specific pre-clinical GP elective (OR = 2.6, 95% CI 1.3-5.3), a four-week GP clerkship during the clinical study section (OR = 2.6, 95% CI 1.3-5.0), and a four-month GP clinical rotation during the final year (OR = 10.7, 95% CI 4.3-26.7). It was also found that the work-related values of the female participants were more compatible with those of physicians who opt for a GP career than was the case for their male colleagues. CONCLUSION These results support the suggestion that a practice-orientated GP curriculum in both the earlier and later stages of undergraduate medical education raises medical schools' output of future GPs. The findings are of interest for medical schools (curriculum design, admission criteria), policy-makers, and GPs involved in undergraduate medical education. More research is needed on the effectiveness of specific educational interventions in promoting interest in general practice as a career.
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Affiliation(s)
- Tobias Deutsch
- Department of Primary Care, Leipzig Medical School, Leipzig, Germany
| | - Stefan Lippmann
- Department of Primary Care, Leipzig Medical School, Leipzig, Germany
| | - Thomas Frese
- Department of Primary Care, Leipzig Medical School, Leipzig, Germany
| | - Hagen Sandholzer
- Department of Primary Care, Leipzig Medical School, Leipzig, Germany
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Bradner M, Crossman SH, Vanderbilt AA, Gary J, Munson P. Career advising in family medicine: a theoretical framework for structuring the medical student/faculty advisor interview. MEDICAL EDUCATION ONLINE 2013; 18:21173. [PMID: 23948497 PMCID: PMC3756303 DOI: 10.3402/meo.v18i0.21173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 05/21/2013] [Indexed: 05/14/2023]
Abstract
BACKGROUND There are unique challenges to recruiting students into the specialty of family medicine within academic medical centers. METHODS At Virginia Commonwealth University, we developed an advising framework to help students address institutional and personal obstacles to choosing family medicine as a career. RESULTS The role of a faculty advisor is not to direct the student to a career choice but rather to foster a mentor relationship and help the student come to his or her own realizations regarding career choice. The faculty advisor/medical student interview is conceptualized as five discussion topics: self-knowledge, perception, organizational voice, cognitive dissonance, and anticipatory counseling. CONCLUSION This framework is intended to assist faculty in their efforts to encourage students to consider a career in family medicine.
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Affiliation(s)
- Melissa Bradner
- Department of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA.
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Choice of speciality amongst first-year medical students in the Nelson R. Mandela School of Medicine, University of KwaZulu-Natal. Afr J Prim Health Care Fam Med 2013. [PMCID: PMC4709604 DOI: 10.4102/phcfm.v5i1.513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Trends in career choice amongst medical graduates have considerable implications for the percentage of the workforce available for training. Objective To investigate and review factors affecting career choice by undergraduate first-year medical students. Method This was a cross-sectional study using a closed-ended, semi-structured survey instrument. Two hundred and four questionnaires were administered to all first-year medical students at the Nelson R. Mandela School of Medicine in the first term of the 2012 academic session. Results The questionnaire was completed by 167 out of 204 students (81.8% response rate). Most of the respondents were South Africans (91%) and blacks (72%), with a higher proportion of women to men (2:1). The majority (86%) intended to undertake their postgraduate training in surgical specialties (53%), general surgery (50%) and cardiology (46%). Few were interested in an academic career in basic sciences (27.6%), either because they were not interested in research and/or teaching (48%), not clinically-orientated (20%), or found it to be an unattractive choice (12.3%). The top perceived career-related factors favouring choice of speciality were personal interest and benefits to patients as many (83%) respondents still viewed the medical profession as having a bright future in South Africa. Conclusions Our study highlighted the fact that self and patient interests were strong determinants of speciality choices by the students and the role of parents and practice in rural areas were considered least as potential influencing factors. This would appear to be a good indicator that the healthcare sector may be boosted in the future by doctors who are wholeheartedly committed to the service of the communities with the greatest disease burden.
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Xu X, Wang Z, Pan H, Yang P, Yu J. One-week experience in the general surgery outpatient clinic for preclinical medical students. JOURNAL OF SURGICAL EDUCATION 2012; 69:599-604. [PMID: 22910156 DOI: 10.1016/j.jsurg.2012.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 04/07/2012] [Accepted: 05/07/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To evaluate whether the early introduction of observership in general surgery outpatient clinic for preclinical students could increase their interest in general surgery and ease their concerns, and to assess its potential effect on their careers in general surgery. STUDY DESIGN A structured observership program was conducted at the Peking Union Medical College. A total of 83 preclinical students were observed in the general surgery outpatient clinic. Students were given a format survey before and after the observership. RESULTS All students completed the early observing experience in general surgery. All students thought it worthwhile and recommended more such observership. Students had more interest in general surgery and higher possibility in choosing general surgery as a career. Their level of comfort and confidence in future clerkship was also improved. Most of the students thought the observership could improve their communication with surgeon teachers and patients. CONCLUSIONS The observership in general surgery outpatient clinic for preclinical medical students can increase their interest and career possibility in general surgery. It can also significantly boost their confidence and comfort in their future surgical clerkship and improve communication with surgeon teachers and patients.
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Affiliation(s)
- Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People's Republic of China
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Scott I, Gowans M, Wright B, Brenneis F. Stability of medical student career interest: a prospective study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:1260-1267. [PMID: 22836853 DOI: 10.1097/acm.0b013e31826291fa] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE To examine the stability and switching patterns of student career interests over the course of medical school. METHOD From 2001 through 2004, during the first two weeks of classes, a survey on career interest was distributed to first-year students in 15 classes at eight Canadian medical schools. Students indicated interest in eight broad career paths (emergency medicine, family medicine, internal medicine, obstetrics-gynecology, pediatrics, psychiatry, surgery, and "other") and ranked their top three. Following these students' residency match three to four years later, student residency career choice was linked to their career interest at medical school entry. For students whose career interests switched be-tween medical school entry and exit, switching patterns were examined in terms of careers' matching difficulty scores (MDSs). RESULTS Of 1,941 eligible students, 1,542 contributed to the final analysis. Family medicine, internal medicine, and surgery had the greatest student interest at both the beginning and end of medical school. Family medicine, surgery, obstetrics-gynecology, psychiatry, and "other" careers showed a net gain of student interest during medical school with the remaining careers showing a loss of interest. The most stable careers were family medicine, surgery, and internal medicine. The least stable were pediatrics and obstetrics-gynecology. Students tended to switch between careers with similar MDSs. CONCLUSIONS Student career choice is relatively stable with a number of careers showing approximately 50% of stability from the entrance to the exit of medical school. Students tend to switch to careers with similar MDS, but some specific switching patterns exist.
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Affiliation(s)
- Ian Scott
- Undergraduate Family Medicine Programs, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
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van Tongeren-Alers M, van Esch M, Verdonk P, Johansson E, Hamberg K, Lagro-Janssen T. Are new medical students' specialty preferences gendered? Related motivational factors at a Dutch medical school. TEACHING AND LEARNING IN MEDICINE 2011; 23:263-8. [PMID: 21745062 DOI: 10.1080/10401334.2011.586928] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know importance stipulated to motivational factors. AIM Our study investigates new medical students' early specialization preferences and motivational factors. METHODS New students at a Dutch medical school (n = 657) filled in a questionnaire about specialty preferences (response rate = 94%; 69.5% female, 30.5% male). The students chose out of internal medicine, psychiatry, neurology, pediatrics, surgery, gynecology and family medicine, "other" or "I don't know." Finally, they valued ten motivational factors. RESULTS Forty percent of the medical students reported no specialty preference yet. Taken together, female medical students preferred pediatrics and wished to combine work and care, whereas male students opted for surgery and valued career opportunities. CONCLUSIONS Gender-driven professional preferences in new medical students should be noticed in order to use competencies. Changes in specialty preferences and motivational factors in pre- and post graduates should further assess the role of medical education.
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Affiliation(s)
- Margret van Tongeren-Alers
- Department of Primary and Community Care, Women’s Studies Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
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Indyk D, Deen D, Fornari A, Santos MT, Lu WH, Rucker L. The influence of longitudinal mentoring on medical student selection of primary care residencies. BMC MEDICAL EDUCATION 2011; 11:27. [PMID: 21635770 PMCID: PMC3128853 DOI: 10.1186/1472-6920-11-27] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 06/02/2011] [Indexed: 05/16/2023]
Abstract
BACKGROUND The number of students selecting careers in primary care has declined by 41% in the last decade, resulting in anticipated shortages. METHODS First-year medical students interested in primary care were paired with primary care mentors. Mentors were trained, and mentors and students participated in focus groups at the end of each academic year. Quantitative and qualitative results are presented. RESULTS Students who remained in the mentoring program matched to primary care programs at 87.5% in the first year and 78.9% in the second year, compared to overall discipline-specific match rates of 55.8% and 35.9% respectively. Students reported a better understanding of primary care and appreciated a relationship with a mentor. CONCLUSIONS A longitudinal mentoring program can effectively support student interest in primary care if it focuses on the needs of the students and is supportive of the mentors.
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Affiliation(s)
- Diane Indyk
- Department of Pediatrics, Jacobi Medical Center of Einstein College of Medicine, Bronx, NY, USA
| | - Darwin Deen
- Department of Medicine, Sophie Davis School of Biomedical Education, City College of New York, NY, USA
| | - Alice Fornari
- Office of Faculty Development, Hofstra University School of Medicine in partnership with North Shore-Long Island Jewish Healthy, Long Island, NY, USA
| | - Maria T Santos
- Department of Family Medicine, Einstein College of Medicine, Bronx, NY, USA
| | - Wei-Hsin Lu
- Office of the Dean, Stony Brook University School of Medicine, Long Island, NY, USA
| | - Lisa Rucker
- Department of Medicine, Jacobi Medical Center of Einstein College of Medicine, Bronx, NY, USA
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Warschkow R, Steffen T, Spillmann M, Kolb W, Lange J, Tarantino I. A comparative cross-sectional study of personality traits in internists and surgeons. Surgery 2010; 148:901-7. [DOI: 10.1016/j.surg.2010.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 03/05/2010] [Indexed: 10/19/2022]
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Bennett KL, Phillips JP. Finding, recruiting, and sustaining the future primary care physician workforce: a new theoretical model of specialty choice process. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:S81-8. [PMID: 20881711 DOI: 10.1097/acm.0b013e3181ed4bae] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND Despite decades of research, interventions to increase the rate of medical students choosing primary care specialties have not been widely successful. METHOD A systematic literature review incorporating a secondary data analysis. A model was developed by applying decision-making theories to the pertinent literature and incorporating systematic feedback from colleagues and experts. RESULTS The model illustrates multiple pathways to specialty choice. Students can be characterized as those who maintain a commitment to primary care throughout medical school, those who are never interested in primary care, and those who change preferences. Multiple categories of factors affect these students differently, including demographics, the medical school experience, student interests, perceived specialty characteristics, lifestyle and financial considerations, the health care environment, identity development, and the choice process. CONCLUSIONS This theoretical model is a guide to targeting interventions toward cultivation of more primary care physicians and clarifies areas needing further research.
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Levine RB, Cayea D, Shochet RB, Wright SM. Case study: a midclerkship crisis-lessons learned from advising a medical student with career indecision. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:654-659. [PMID: 20354382 DOI: 10.1097/acm.0b013e3181d299b7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Advising medical students is a challenging task. Faculty who serve as advisors for students require specific skills and knowledge to do their jobs effectively. Career choice is one of the many complex issues about which medical students often seek assistance from a faculty advisor. The authors present a case of a third-year medical student with career indecision, with a focus on the various factors that may be influencing her thinking about career choice. Key advising principles are provided as a framework for the discussion of the case and include reflection, self-disclosure, active listening, support and advocacy, confidentiality, and problem solving. These principles were developed as part of the Advising Case Conference series of the Johns Hopkins University School of Medicine Colleges Advisory Program. Emergent themes from the case included a student's evolving professional identity, a student's distress and burnout, lifestyle considerations, and advisor bias and self-awareness. The authors propose reflective questions to enhance meaningful discussions between the advisor and student and assist in problem solving. Many of these questions, together with the key advising principles, are generalizable to a variety of advising scenarios between advisors and learners at all levels of training.
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Affiliation(s)
- Rachel B Levine
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21214, USA.
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Abstract
OBJECTIVE Medical students are expected to make residency and career decisions early in their undergraduate medical education. In medical school curricula, there is limited exposure to emergency medicine (EM) in the preclerkship years. The purpose of this study was to evaluate a structured EM observership program for preclerks by surveying the students' perceptions and attitudes about the program following their participation. METHODS A structured observership program was developed and implemented at the University of Toronto Medical School in February 2007. All first- and second-year students were eligible to participate on a voluntary basis. Nine emergency department (ED) teaching sites were enlisted, with each site recruiting interested preceptors. The observership consisted of two 4-hour shifts with 1 preceptor at 1 site. Specific expectations were provided to the students at the start of the observership. A convenience sample was used for the period between Feb. 26 and Nov. 4, 2007, to conduct an anonymous online survey about the students' experience after the observership. RESULTS During the study period, 82 students completed 99 observerships at 9 sites with 54 different preceptors. Of the 82 students who completed the observerships, 70 students completed the survey. Overall, all the students (70/70) found the experience to be worthwhile. Most students (68/70) viewed the preceptors as good role models. As a result of the observership, 47 of 70 students reported that their attitudes about and interest in EM had changed and most (59/70) planned on exploring other opportunities in EM (e.g., electives). CONCLUSION Structured EM observerships are viewed by medical students to be worthwhile. These observerships can change attitudes about and interest in EM and allow students to make more informed career choices.
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Hayashi J, DeCherrie L, Ratner E, Boling PA. Workforce development in geriatric home care. Clin Geriatr Med 2009; 25:109-20, vii. [PMID: 19217496 DOI: 10.1016/j.cger.2008.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
With the rapidly aging population, it is anticipated that within two decades several million more individuals in the United States with functional impairment and serious ill health will need home health care. This article discusses workforce development, which is a critical issue for future planning, as recently highlighted by the Institute of Medicine (IOM). Key aspects of recruitment, training, and retention of home care workers are discussed, including those who provide basic support for activities of daily living as well as a variety of skilled professionals: therapists, nurses, pharmacists, and physicians. Although the geriatric workforce shortage affects all care settings, it is especially critical in home health care, in part because we are starting with far too few clinicians to meet the medical needs of homebound elderly. A combination of actions is needed, including educational programs, such as those developed by the American Academy of Home Care Physicians (AAHCP), changes in financial incentives, and changes in the culture and practice of health care, to make the home the primary focus of care for these vulnerable, underserved individuals rather than an afterthought.
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Affiliation(s)
- Jennifer Hayashi
- Johns Hopkins University School of Medicine, 5505 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
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Glavin KW, Richard GV, Porfeli EJ. Predictive validity of the medical specialty preference inventory. JOURNAL OF VOCATIONAL BEHAVIOR 2009. [DOI: 10.1016/j.jvb.2008.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rogers ME, Creed PA, Searle J. The Development and Initial Validation of Social Cognitive Career Theory Instruments to Measure Choice of Medical Specialty and Practice Location. JOURNAL OF CAREER ASSESSMENT 2009. [DOI: 10.1177/1069072708330676] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social cognitive career theory served as the basis for the instrument development for scales assessing self-efficacy, outcome expectations, and goals to predict medical career choice. Lent and Brown's conceptualization of social cognitive constructs guided the development of items to measure choice of medical specialty and practice location. Study 1 involved four stages: identification of attitudes and beliefs, generation of scale items, evaluation of scale items by experts, and a pilot study. The pilot study tested the item pool with 293 medical students and allowed item and exploratory factor analyses. Study 2 administered the scales to a second sample of 499 medical students. Confirmatory factor analysis assessed consistency and validity, and identified six psychometrically sound instruments. Initial validity for the scales was found encouraging, with further testing of these measures expected to support their use. Implications for use in research are discussed.
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Mihalynuk T, Leung G, Fraser J, Bates J, Snadden D. Free choice and career choice: Clerkship electives in medical education. MEDICAL EDUCATION 2006; 40:1065-71. [PMID: 17054615 DOI: 10.1111/j.1365-2929.2006.02614.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Medical education experiences, particularly in clinical years, are reported determinants of career choice. Less is known about features of clinical education experiences including length, discipline, setting and choice, which may serve as landmarks in career choice decisions. This study's purpose was to explore the benefits of a free choice clerkship elective, and more specifically, its role in clarifying career choice. METHODS Using framework and content analysis methodology, we analysed University of British Columbia, third-year medical student anonymised assignments regarding free choice and 2-week clerkship elective experiences. This clerkship was designed to provide students with clerkship experiences outside the conventional curricular model, while encouraging student choice of ambulatory and community settings. Assignment questions included: reasons for choosing elective; whether learning objectives were met; influence of elective on career choice; and unique elective experiences. Iterative review, coding, analysis and indexing of assignments were carried out to identify themes and corroborate findings. RESULTS Emergent themes included: positive views of experience; transferable knowledge and skills; and influencer of future education and career choices. Although students were encouraged to choose clerkship experiences outside the conventional curricular model, most students chose the elective to clarify future career decisions. DISCUSSION This qualitative descriptive study highlights the influence of highly regarded, free choice clerkship elective experiences in the career decision making process in medical education. Further examination of the details of clerkship elective experiences which influence career choice is recommended.
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Affiliation(s)
- Tanis Mihalynuk
- Faculty of Medicine, Undergraduate Education, University of British Columbia, Vancouver, Canada.
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Nieuwhof MGH, Rademakers JJDJM, Kuyvenhoven MM, Soethout MBM, ten Cate TJ. Students' conceptions of the medical profession; an interview study. MEDICAL TEACHER 2005; 27:709-14. [PMID: 16451892 DOI: 10.1080/01421590500271159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Students' beliefs and attitudes towards the medical profession have been studied in relation to career choices, but most research has been restricted to either predetermined aspects or to a limited number of specialties. This study aimed at getting unprompted insight in the students' perceptions of their future profession in dimensions that may be determinants of study success and career choice. Undergraduate and graduated medical students were interviewed and asked to characterize the medical profession in general and four contrasting specialties in particular. Grounded Theory methodology was used to analyse the data. Participants were medical students at the start of their training (n = 16), during clerkships (n = 10) and after graduation (n = 37). Beginning students perceive the medical profession in limited dimensions: the activities of a physician, their relationship to patients and the physician's knowledge, skills and personality. They do not see many differences between specialties, in contrast with students with clinical experience and graduate students. Undergraduate students' perception is focussed more on social aspects of the profession compared to graduates.
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Affiliation(s)
- M G H Nieuwhof
- University Medical Center Utrecht, School of Medical Sciences, Utrecht, The Netherlands
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Reed VA, Jernstedt GC, McCormick TR. A Longitudinal Study of Determinants of Career Satisfaction in Medical Students. MEDICAL EDUCATION ONLINE 2004; 9:4351. [PMID: 28253131 DOI: 10.3402/meo.v9i.4351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
CONTEXT There is evidence of significant career dissatisfaction among practicing physicians and those considering medicine as a profession. Most research on career satisfaction has examined practicing physicians. This study was undertaken to look at determinants of satisfaction in those at the earliest stage of their medical careers - medical students. METHODS As part of a larger study, students comprising one class at the University of Washington School of Medicine were surveyed three times over the course of their medical education. For the present study we examined measures specifically related to determinants of career satisfaction. FINDINGS Over time, students' sense of the importance of most measured determinants of satisfaction showed significant change, the majority of which were in the direction of decreased importance. However, most of the change was relative. That is, factors that students considered to be most important at the start of medical school continued to be most important throughout the educational experience and those factors students considered to be least important at Year 1 continued to be least important at Years 2 and 4. DISCUSSION These findings have implications for medical education, a time when students are forming expectations that will impact their career satisfaction. In addition to information on career satisfaction, students should understand the professional values of medicine, their own values and expectations, current practice patterns, economics, and the role of advocacy.
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Affiliation(s)
- Virginia A Reed
- a The Center for Educational Outcomes at Dartmouth, The Department of Psychological & Brain Sciences , Dartmouth College, and the The Department of Community & Family Medicine Dartmouth Medical School
| | - G Christian Jernstedt
- a The Center for Educational Outcomes at Dartmouth, The Department of Psychological & Brain Sciences , Dartmouth College, and the The Department of Community & Family Medicine Dartmouth Medical School
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Nierenberg DW, Carney PA. Nurturing educational research at Dartmouth Medical School: the synergy among innovative ideas, support faculty, and administrative structures. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2004; 79:969-974. [PMID: 15383357 DOI: 10.1097/00001888-200410000-00016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In recent years, Dartmouth Medical School has increased its commitment to educational research within the school, and in collaboration with other schools across the country. Passionate faculty members with ideas and expertise in particular curricular areas are one critical component needed for a successful educational research program. Other components include an atmosphere that fosters research collaborations and mentoring, and various types of institutional support structures. This same model has effectively supported basic science and clinical research for decades. Because of the complexities involved in studying medical education, Dartmouth Medical School has invested in support structures for educational grant and manuscript development, financial support for pilot projects and partial salary support for investigators and key staff members, and other support targeted toward specific research projects. Ultimately, the goal is to use the results of the school's educational research projects to improve the curriculum through cycles of hypothesis development and testing, providing evidence for subsequent curricular change. When some research findings are relevant and applicable for use in other medical schools, that is an additional benefit of the educational research process. In this report, the authors describe the development of Dartmouth Medical School's infrastructure for supporting educational research, which has helped to accelerate the educational research productivity teaching faculty now enjoy. The authors also address some of the challenges that they anticipate in the near future.
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Affiliation(s)
- David W Nierenberg
- Office of Medical Education, Hinman Box 7005, Dartmouth Medical School, Hanover, NH 03755, USA.
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Zun LS, Downey L. Is a third year clerkship in emergency medicine correlated with a career choice in emergency medicine? TEACHING AND LEARNING IN MEDICINE 2004; 16:14-17. [PMID: 14987168 DOI: 10.1207/s15328015tlm1601_4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND The factors medical students use to choose emergency medicine (EM) as a career path have not been well studied. The role of a 3rd year clerkship in EM in a student's choice of EM residency is not known. PURPOSE The purpose of this survey was to determine whether a 3rd year clerkship in EM is correlated with a student's choosing EM as a career choice, as evidenced by the number of students who apply for or matching in EM in medical schools in the United States. METHODS The deans of American medical schools were surveyed by mail, using a seven-part questionnaire inquiring as to type of exposure, number of students, length of the exposure, number of students applying for and matching in EM in the past 3 years. The data was analyzed using SPSS software. RESULTS The survey was returned by 71 of the 125 medical schools (56.8 percent) in the country. The average class size was 129.9 students. Over one half of the medical schools (58.8 percent) provided EM exposure in the 3rd year; in 38.7 percent it was a required clerkship. The number of students applying for or matching in EM was not correlated with a required or elective rotation in EM, departmental status, percentage of board certified emergency physicians, emergency department volume, or a residency training program in EM (p >.05). CONCLUSIONS This study did not demonstrate a correlation of a 3rd year rotation in EM with the number of students applying or matching in EM.
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Affiliation(s)
- Leslie S Zun
- Department of Emergency Medicine, Finch University/Chicago Medical School, Mount Sinai Hospital, Illinois 60608, USA.
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Malloy MH, Stroup-Benham CA. Impact of Generalist Physician Initiatives on Residency Selection. MEDICAL EDUCATION ONLINE 2001; 6:4524. [PMID: 28253743 DOI: 10.3402/meo.v6i.4524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare the residency selection choices of students who experienced courses resulting from generalist physician initiatives to choices made by students prior to the implementation of those courses and to describe the characteristics of students selecting primary care residencies. BACKGROUND In the fall of 1994 a first year Community Continuity Experience course was initiated and in the summer of 1995 a third year Multidisciplinary Ambulatory Clerkship was begun at the University of Texas Medical Branch in Galveston. These courses were inserted into the curriculum to enhance and promote primary care education. DESIGN/METHODS We examined the residency selections of cohorts of graduating medical students before (1992-1996) and after (1997-1999) the implementation of the primary care courses. Survey information on career preferences at matriculation and in the fourth year of medical school were available for students graduating after the programs began. We compared the career preferences and characteristics of those students who selected a primary care residency to those who did not. RESULTS Prior to the implementation of the programs, 45%(425/950) of students graduating selected primary care residencies compared to 45% (210/465) of students participating in the programs (p=0.88). At matriculation, 45% of students had listed a primary care discipline as their first career choice. Among the students who had indicated this degree of primary care interest 61% ended up matching in a primary care discipline. At year 4, 31% of students indicated a primary care discipline as their first career choice and 92% of these students matched to a primary care residency. By univariate analysis, minority students (53%) were more likely to select a primary care residency than non-minority students (40%); students in the two lowest grade point average quartiles (55% and 50%) selected primary care residencies compared to 37% and 38% of students in the top 2 quartiles; and students who stated that income potential had little or no impact on their choice were more likely to select a primary care residency (48%) than those who said income potential was important (37%). CONCLUSIONS We observed no significant trend towards higher proportions of graduating students selecting primary care discipline residencies as a result of implementing courses that emphasized primary care. Those students expressing an interest in a primary care discipline at their entrance into medical school were more likely to select a primary care residency. A more significant impact on graduating students interested in primary care may be made through the medical student selection process than by altering the curriculum.
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