Motivational factors influencing student intentions to practise in underserved areas

Abstract

Context Exploring student intentions to practise in underserved areas (UAs) is necessary to inform the planning and training of the future medical workforce in order to increase effectiveness and fulfil societal needs. However, little is known about the motivational factors influencing these intentions. This paper explores medical students’ intentions to practise in UAs and the motivational factors predicting these intentions. Methods Eligible participants included graduating medical students from four of the five Swiss medical schools, who self‐reported specialty choice, intentions to practise in UAs, and motives that explained their career choices. Chi‐squared analysis was used to compare site, gender, specialty choice and UA practice intention. Motives were aggregated to obtain motivational factors using a principal component analysis with varimax rotation. Logistic regression was used to predict the effects of these motivational factors and of gender on UA practice intention. Results Of 1749 students included in the study, 240 (13.7%) expressed an intention to practise in UAs (62.1% of whom intended to practise in rural areas) and 719 (41.1%) were undecided. In those who wished to practise in UAs, general practice (21.6%) was the most preferred specialty. Motivational factors influencing specialty choice were intellectual challenge, work variety, work conditions and enthusiasm (Kaiser‐Meyer‐Olkin index 0.79, P < .001, 49.0% of variance explained). Students motivated by work variety (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2‐1.7) and by work conditions (OR 1.3, 95% CI 1.1‐1.6) were more likely to choose UAs and those motivated by intellectual challenge (OR 0.4, 95% CI 0.3‐0.5) were less likely. Undecided students’ motivations were very similar to those of students interested in working in UAs. Conclusions The actual number of Swiss students interested in working in UAs is low and is probably insufficient to meet current societal needs. Work variety and work conditions appear to be factors that might attract interested and undecided students towards working in UAs.

Motivational factors influencing student intentions to practise in underserved areas: Authors' reply

“…In both analyses, we found a similar aggregation of motivational factors. 1,3 This supports our epistemological assumption that medical career choice is part of a addressing negative medical student perceptions during these experiences may increase practise in underserved areas. 5 As in other European countries, Swiss students tend to study in their region of origin as a result of cultural and language differences despite the fact that physical proximity to urban areas is not a hindrance.…”

Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study

“…Identification with another discipline [ 12 ]; personal connections to another region [ 7 , 15 , 16 ]; unwilling to work in the countryside [ 31 ]; parents/partner are/is settled in another region [ 7 , 15 ]; financial support is insufficient [ 15 , 31 ].…”

“…Identification with another discipline [12]; personal connections to another region [7,15,16]; unwilling to work in the countryside [31]; parents/partner are/is settled in another region [7,15]; financial support is insufficient [15,31]. This list is supplemented by reasons given by students in communication with the project staff: "not willing to commit long-term" and "planned to take over the practice from parents/acquaintances in another region".…”

“…This problem is not new -in the 1960s, too few medical students were interested in a career as a general practitioner as well [11]. Another problem in many countries is that not enough students are motivated to work in rural areas [2,[12][13][14]. Research shows that the reasons for this are both personal and professional.…”

Exploring Medical Career Choice to Better Inform Swiss Physician Workforce Planning: Protocol for a National Cohort Study

“…In our previous research, we explored the areas of intention to practice (urban and rural) of graduating students at 4 Swiss medical schools [ 30 ]. We found that 13.7% expressed an intention to practice in underserved areas (62.1% of whom intended to practice in rural areas) and 41.1% were undecided.…”