Ugandan Medical Student Career Choices Relate to Foreign Funding Priorities

Abstract

Introduction The surgical workforce in sub-Saharan Africa is insufficient to meet population needs. Therefore, medical students should be encouraged to pursue surgical careers and ''brain drain'' must be minimized. It is unknown to what extent foreign aid priorities influence medical student career choices in Uganda. Methods Medical students in Uganda completed an online survey examining their career choices and attitudes regarding career opportunities and funding priorities. Data were analyzed using descriptive statistics, and responses among men and women were compared using Fisher's exact tests. Results Ninety-eight students participated. Students were most influenced by inspiring role models, employment opportunities and specialty fit with personal skills. Filling an underserved specialty was near the bottom of the influence scale. Women placed higher importance on advice from mentors (p = 0.049) and specialties with lower stress burden (p = 0.027). Men placed importance on opportunities in non-governmental organizations (p = 0.033) and academia (p = 0.050). Students expressed that the most supported specialties were infectious disease (n = 65, 66%), obstetrics (n = 15, 15%) and pediatrics (n = 7, 7%). Most students (n = 91, 93%) were planning a career in infectious disease. Fifty-three students (70%) indicated plans to leave Africa for residency. Female students were more likely to have a plan to leave (p = 0.027). Conclusion Medical students in Uganda acknowledge the career opportunities for physicians in specialties prioritized by the Sustainable Development Goals. In order to avoid ''brain drain'' and encourage students to pursue careers in surgery, career opportunities including surgical residencies must be prioritized and supported in sub-Saharan Africa.

Career aspirations of specialty among medical students in sub-Saharan Africa: a systematic review and meta-analysis of data from two decades, 2000–2021

“…This may not only limit the choice but may also influence the medical graduates to seek training abroad, subsequently leading to brain drain. The disconnect between career aspirations and opportunities for training, and the incongruity between career aspirations and disease epidemiology has examined in the past by Kakembo et al who recommended opening up more career opportunities and surgical residencies in SSA to minimise brain drain 11…”

“…It is not clear whether the career aspirations held by medical students match these areas of need. It is also not clear what the drivers of the career aspirations are, but it appears that motivation from role models,10 funding priorities11 and financial remuneration12 13 play a significant role. Some medical students have expressed an intention to relocate or migrate from their home countries14 15 but the data across the continent are variable.…”

“…There are several studies scattered across the continent on career aspirations of medical students but the results show significant variation. Some studies show that general surgery is the most popular career aspiration for specialisation,16–21 Obstetrics and gynaecology in others,13 yet some show a career in infectious diseases as the most popular choice 11. Although results on career aspirations vary, no study has been done to aggregate this information.…”

Development of an Interactive Global Surgery Course for Interdisciplinary Learners

“…In this same survey, students perceived surgical care as cost-ineffective and only 3% of students believed that surgical care was a reliable indicator of a robust health care system [ 5 ]. Students in LMICs have expressed disinterest in choosing surgery as a career [ 26 ], and a recent survey of Ugandan medical students showed specialty choice was highly influenced by funding priorities, making surgery a less desirable choice [ 27 ].…”