Traveling by winding roads or highways: Stability of medical students’ specialty preferences over time

Querido, Sophie; Wigersma, L; Cate, Olle ten

doi:10.1080/0142159x.2020.1804056

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…We identified the moments when career intentions changed, thus expanding on previous evidence that career intentions change between matriculation and graduation [ 37 ]. These findings are in line with those from a recently published study of specialty preferences in a small student cohort in the Netherlands [ 38 ], which observed that career preference paths were unstable in subgroups of students. In our cohort, most changes occurred during the clinical years, suggesting that clinical experiences might have influenced career intentions [ 39 , 40 ].…”

Section: Discussionsupporting

confidence: 92%

Students’ intentions to practice primary care are associated with their motives to become doctors: a longitudinal study

et al. 2022

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Background Medical schools can contribute to the insufficient primary care physician workforce by influencing students’ career preferences. Primary care career choice evolves between matriculation and graduation and is influenced by several individual and contextual factors. This study explored the longitudinal dynamics of primary care career intentions and the association of students’ motives for becoming doctors with these intentions in a cohort of undergraduate medical students followed over a four-year period. Methods The sample consisted of medical students from two classes recruited into a cohort study during their first academic year, and who completed a yearly survey over a four-year period from their third (end of pre-clinical curriculum) to their sixth (before graduation) academic year. Main outcome measures were students’ motives for becoming doctors (ten motives rated on a 6-point scale) and career intentions (categorized into primary care, non-primary care, and undecided). Population-level flows of career intentions were investigated descriptively. Changes in the rating of motives over time were analyzed using Wilcoxon tests. Two generalized linear mixed models were used to estimate which motives were associated with primary care career intentions. Results The sample included 217 students (60% females). Career intentions mainly evolved during clinical training, with smaller changes at the end of pre-clinical training. The proportion of students intending to practice primary care increased over time from 12.8% (year 3) to 24% (year 6). Caring for patients was the most highly rated motive for becoming a doctor. The importance of the motives cure diseases, saving lives, and vocation decreased over time. Primary care career intentions were positively associated with the motives altruism and private practice, and negatively associated with the motives prestige, academic interest and cure diseases. Conclusion Our study indicates that career intentions are not fixed and change mainly during clinical training, supporting the influence of clinical experiences on career-related choices. The impact of students’ motives on primary care career choice suggests strategies to increase the attractivity of this career, such as reinforcing students’ altruistic values and increasing the academic recognition of primary care.

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Section: Discussionsupporting

confidence: 92%

Students’ intentions to practice primary care are associated with their motives to become doctors: a longitudinal study

et al. 2022

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“…Recent qualitative evidence from studies about early career doctors reveals that early career doctors go through a complex and dynamic process in determining their chosen specialty [17]; however, quantitative evidence about this process could be complementary for informing policy. Most evidence about specialty decisions and their timing is largely centred on medical students, demonstrating how specialty choice intention can vary yearto-year over the course of medical school training [18][19][20][21][22]. An Australian study found that 76% of medical students changed their first preference specialty from commencement to exit from medical school [23].…”

Section: Introductionmentioning

confidence: 99%

Exploring Doctors’ Emerging Commitment to Rural and General Practice Roles over Their Early Career

McGrail

O’Sullivan

Gurney

et al. 2021

IJERPH

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Producing enough doctors working in general practice or rural locations, or both, remains a key global policy focus. However, there is a lack of evidence about doctors’ emerging commitment to these decisions. This study aimed to explore changes in the level of certainty about career interest in working in general practice and working rurally, as doctors pass through various early career stages. The participants were 775 eligible respondents to a 2019 survey of medical graduates of The University of Queensland from 2002–2018. Certainty levels of specialty choice were similar between GPs and specialists up until the beginning of registrar training. At that point, 65% of GPs compared with 80% of other specialists had strong certainty of their specialty field. Consistently (and significantly) less of those working rurally had strong certainty of the location where they wanted to practice medicine at each career time point. At the start of registrar training, a similar gap remained (strong certainty: 51% rural versus 63% metropolitan). This study provides new evidence that career intent certainty is more delayed for the cohort choosing general practice and rural practice than the other options. The low level of certainty in early career highlights the importance of regular positive experiences that help to promote the uptake of general practice and rural practice.

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“…Our study is based on a theoretical framework of medical student career choice [ 6 ] and draws inspiration from and expands on a previously published study quantifying career intention stability [ 11 ]. To our knowledge, this is the first study using a large cohort to describe career intention dynamics using more than two time points, to quantify career intention indecision, and to test associations with other variables.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these motives remained stable over a four-year period, suggesting that they might be related to students’ intrinsic characteristics and thus be important factors to consider when studying the development of career choices. Other authors explored career intentions in a cohort of 24 students, developing a score quantifying career intention stability [ 11 ]. Their findings suggested three trajectories: students with stable career intentions; students considering two or three options; and students with unstable preferences.…”

Section: Introductionmentioning

confidence: 99%

Dynamics of career intentions in a medical student cohort: a four-year longitudinal study

et al. 2023

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Background Medical students’ career intentions often change between matriculation and graduation, yet little is known about the precise timing and dynamics of individual students’ career decisions. This study expands on previous research by exploring the stability of individual students’ career intentions over four years and by analyzing associations between unstable career intentions and students’ characteristics. Methods Medical students from two classes were recruited into a cohort during their first academic year and completed a yearly survey over a four-year period (end of pre-clinical curriculum to graduation). Measures included career intention (specialty and practice type), personality, coping strategies, empathy, and motives for becoming a physician. The authors developed a score ranging from 0 to 10 quantifying instability of career intentions (0 = stable; 10 = unstable). The distribution of the score was analyzed descriptively, and the association between the score and other variables was quantified using a stepwise beta regression model. Results The sample included 262 students (61% females). The mean score was 3.07 with a median of 3. 18% of students (N = 46) did not change their specialty intention over the four years, whereas 10% (N = 26) changed every year. No further subgroups were identified between these extremes. An intention to work in private practice in year 3 and the motive care for patients were significantly associated with more stable career intentions. Conclusion Most students are situated on a continuum between the two extremes of being firmly committed and undecided. Extrinsic factors may be more important drivers of these fluctuations than personal characteristics and should be explored in future research. This study’s findings also provide avenues for supporting students in their career decision-making.

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Traveling by winding roads or highways: Stability of medical students’ specialty preferences over time

Cited by 8 publications

References 8 publications

Students’ intentions to practice primary care are associated with their motives to become doctors: a longitudinal study

Students’ intentions to practice primary care are associated with their motives to become doctors: a longitudinal study

Exploring Doctors’ Emerging Commitment to Rural and General Practice Roles over Their Early Career

Dynamics of career intentions in a medical student cohort: a four-year longitudinal study

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