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Brügge S, Günther V, Cascorbi I, Maass N, Ruchay Z, Fischer MR, Huber J, Alkatout I. Encouraging medical students to become surgeons? Impact of psychological and surgical factors on career choice at medical school. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc21. [PMID: 38779696 PMCID: PMC11106567 DOI: 10.3205/zma001676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 01/10/2024] [Accepted: 02/12/2024] [Indexed: 05/25/2024]
Abstract
Aim Training decisions are viewed as a problem by the majority of medical students.In the present study we compared sociodemographic and psychological characteristics of students who are interested in surgical training to those who preferred a non-surgical specialty. Furthermore, we examined whether students who wish to be trained as surgeons performed better than their non-surgical counterparts in a course designed to acquire skills in minimally invasive surgery. Method From October 2020 to January 2021 we performed a cross-sectional survey among 116 medical students prior to their year of practical training at Christian-Albrechts University in Kiel. Based on their intended field of specialization, the students were divided into a non-surgical and a surgical group. Sociodemographic and psychological characteristics such as self-efficacy expectations, resilience and stress perception were evaluated and compared between groups. Simultaneously, we compared their surgical performance in two laparoscopic exercises and their self-assessment as surgeons. Statistical differences between the training groups were determined by the Mann-Whitney U test or Pearson's Chi square test. Results Ninety-two students participated in the study, of whom 64.1% intended to train in a non-surgical specialty and 35.9% in a surgical specialty. Students who wished to be trained as surgeons had higher general self-efficacy expectations (p<0.001) and greater resilience (p=0.009). However, on comparison they had a lower stress level (p=0.047). The inter-group comparison of training results and self-assessment as surgeons revealed no unequivocal differences in surgical performance. Conclusion Interest in surgical specialties is correlated, among other factors, with the strength of psychological skills such as general self-efficacy expectations, resilience and stress perception. Early attention to these psychological resources in academic training might assist medical students in future career choices.
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Affiliation(s)
- Sandra Brügge
- University Hospitals Schleswig-Holstein, Campus Kiel, Clinic for Obstetrics and Gynecology, Kiel, Germany
| | - Veronika Günther
- University Hospitals Schleswig-Holstein, Campus Kiel, Clinic for Obstetrics and Gynecology, Kiel, Germany
| | - Ingolf Cascorbi
- University Hospitals Schleswig-Holstein, Campus Kiel, Institute for Experimental and Clinical Pharmacology, Kiel, Germany
| | - Nicolai Maass
- University Hospitals Schleswig-Holstein, Campus Kiel, Clinic for Obstetrics and Gynecology, Kiel, Germany
| | - Zino Ruchay
- University Hospitals Schleswig-Holstein, Campus Kiel, Clinic for Obstetrics and Gynecology, Kiel, Germany
| | - Martin R. Fischer
- Ludwig-Maximilians University Munich, Institute for Didactics and Training Research in Medicine, Munich, Germany
| | - Johanna Huber
- Ludwig-Maximilians University Munich, Institute for Didactics and Training Research in Medicine, Munich, Germany
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, Clinic for Obstetrics and Gynecology, Kiel, Germany
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Koh EYH, Koh KK, Renganathan Y, Krishna L. Role modelling in professional identity formation: a systematic scoping review. BMC MEDICAL EDUCATION 2023; 23:194. [PMID: 36991373 PMCID: PMC10052869 DOI: 10.1186/s12909-023-04144-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Role modelling's pivotal part in the nurturing of a physician's professional identity remains poorly understood. To overcome these gaps, this review posits that as part of the mentoring spectrum, role modelling should be considered in tandem with mentoring, supervision, coaching, tutoring and advising. This provides a clinically relevant notion of role modelling whilst its effects upon a physician's thinking, practice and conduct may be visualised using the Ring Theory of Personhood (RToP). METHODS A Systematic Evidence Based Approach guided systematic scoping review was conducted on articles published between 1 January 2000 to 31 December 2021 in the PubMed, Scopus, Cochrane, and ERIC databases. This review focused on the experiences of medical students and physicians in training (learners) given their similar exposure to training environments and practices. RESULTS 12,201 articles were identified, 271 articles were evaluated, and 145 articles were included. Concurrent independent thematic and content analysis revealed five domains: existing theories, definitions, indications, characteristics, and the impact of role modelling upon the four rings of the RToP. This highlights dissonance between the introduced and regnant beliefs and spotlights the influence of the learner's narratives, cognitive base, clinical insight, contextual considerations and belief system on their ability to detect, address and adapt to role modelling experiences. CONCLUSION Role modelling's ability to introduce and integrate beliefs, values and principles into a physician's belief system underscores its effects upon professional identity formation. Yet, these effects depend on contextual, structural, cultural and organisational influences as well as tutor and learner characteristics and the nature of their learner-tutor relationship. The RToP allows appreciation of these variations on the efficacy of role modelling and may help direct personalised and longitudinal support for learners.
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Affiliation(s)
- Eugene Yong Hian Koh
- Singapore Armed Forces, 303 Gombak Drive, Singapore, 669645, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Kai Kee Koh
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Yaazhini Renganathan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore
| | - Lalit Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK.
- Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- Duke-NUS Medical School, National University of Singapore, College Rd, Singapore, 169857, Singapore.
- Centre of Biomedical Ethics, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore.
- The Palliative Care Centre for Excellence in Research and Education, PalC, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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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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O’Sullivan B, McGrail M, Gurney T, Martin P. A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228566. [PMID: 33218189 PMCID: PMC7699208 DOI: 10.3390/ijerph17228566] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/09/2020] [Accepted: 11/17/2020] [Indexed: 01/29/2023]
Abstract
There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when and in what contexts, to yield doctors’ choice to be a generalist or specialist. We interviewed 32 Australian doctors (graduates of a large university medical school) who had decided on a generalist (GP/public health) or specialist (all other specialties) career. They reflected on their personal responses to experiences at different times to stimulate their choice. Theory was refined and confirmed by testing it with 17 additional doctors of various specialties/career stages and by referring to wider literature. Our final theory showed the decision involved multi-level contextual factors intersecting with eight triggers to produce either a specialist or generalist choice. Both clinical and place-based exposures, as well as attributes, skills, norms and status of different fields affected choice. This occurred relative to the interests and expectations of different doctors, including their values for professional, socio-economic and lifestyle rewards, often intersecting with issues like gender and life stage. Applying this theory, it is possible to tailor selection and ongoing exposures to yield more generalists.
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Affiliation(s)
- Belinda O’Sullivan
- Faculty of Medicine, The University of Queensland, Rural Clinical School, Locked Bag 9009, Toowoomba 4350, DC Queensland, Australia; (T.G.); (P.M.)
- Correspondence: ; Tel.: +61-4-2740-5030
| | - Matthew McGrail
- Faculty of Medicine, The University of Queensland Rural Clinical School, 78 on Canning St, Rockhampton 4700, Queensland, Australia;
| | - Tiana Gurney
- Faculty of Medicine, The University of Queensland, Rural Clinical School, Locked Bag 9009, Toowoomba 4350, DC Queensland, Australia; (T.G.); (P.M.)
| | - Priya Martin
- Faculty of Medicine, The University of Queensland, Rural Clinical School, Locked Bag 9009, Toowoomba 4350, DC Queensland, Australia; (T.G.); (P.M.)
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Radha Krishna LK, Renganathan Y, Tay KT, Tan BJX, Chong JY, Ching AH, Prakash K, Quek NWS, Peh RH, Chin AMC, Taylor DCM, Mason S, Kanesvaran R, Toh YP. Educational roles as a continuum of mentoring's role in medicine - a systematic review and thematic analysis of educational studies from 2000 to 2018. BMC MEDICAL EDUCATION 2019; 19:439. [PMID: 31775732 PMCID: PMC6882248 DOI: 10.1186/s12909-019-1872-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/13/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Recent studies have gone to great lengths to differentiate mentoring from teaching, tutoring, role modelling, coaching and supervision in efforts to better understand mentoring processes. This review seeks to evaluate the notion that teaching, tutoring, role modelling, coaching and supervision may in fact all be part of the mentoring process. To evaluate this theory, this review scrutinizes current literature on teaching, tutoring, role modelling, coaching and supervision to evaluate their commonalities with prevailing concepts of novice mentoring. METHODS A three staged approach is adopted to evaluate this premise. Stage one involves four systematic reviews on one-to-one learning interactions in teaching, tutoring, role modelling, coaching and supervision within Internal Medicine, published between 1st January 2000 and 31st December 2018. Braun and Clarke's (2006) approach to thematic analysis was used to identify key elements within these approaches and facilitate comparisons between them. Stage two provides an updated view of one-to-one mentoring between a senior physician and a medical student or junior doctor to contextualise the discussion. Stage three infuses mentoring into the findings delineated in stage one. RESULTS Seventeen thousand four hundred ninety-nine citations were reviewed, 235 full-text articles were reviewed, and 104 articles were thematically analysed. Four themes were identified - characteristics, processes, nature of relationship, and problems faced in each of the four educational roles. CONCLUSIONS Role modelling, teaching and tutoring, coaching and supervision lie within a mentoring spectrum of increasingly structured interactions, assisted by assessments, feedback and personalised support that culminate with a mentoring approach. Still requiring validation, these findings necessitate a reconceptualization of mentoring and changes to mentor training programs and how mentoring is assessed and supported.
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Affiliation(s)
- Lalit Kumar Radha Krishna
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, North West Cancer Research Centre, Liverpool, UK.
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
- Duke-NUS Graduate Medical School, Singapore, Singapore.
| | - Yaazhini Renganathan
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kuang Teck Tay
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Jia Yan Chong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ann Hui Ching
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kishore Prakash
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicholas Wei Sheng Quek
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Rachel Huidi Peh
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore, Singapore
| | | | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, North West Cancer Research Centre, Liverpool, UK
| | - Ravindran Kanesvaran
- Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ying Pin Toh
- Department of Family Medicine, National University Health System, Singapore, Singapore
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Gebhard A, Müller-Hilke B. Criteria of medical students for the selection of their future clinical specialisation: a cross-sectional survey at the Medical Faculty of Rostock. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc76. [PMID: 31844648 PMCID: PMC6905363 DOI: 10.3205/zma001284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 08/24/2019] [Accepted: 09/04/2019] [Indexed: 06/10/2023]
Abstract
Objective: Despite the increase in the number of graduates in Human Medicine, it has been predicted that there will not only be a shortage of doctors, but also a shortage of specialists in Germany for the years to come. At the same time there are only a few studies on the factors that influence medical students in their decision to select a specialty. Against this background, a study was conducted at the Medical Faculty in Rostock, to investigate the criteria for deciding on a later field of specialty. Methods: Conducting focus groups of four to seven participants of each year of study, criteria were determined which seemed relevant to the students during their selection of their specialty field. The interviews were transcribed and the answers of the participants classified in super categories. With the data obtained a questionnaire was prepared and sent electronically to all students of Human Medicine. Via exploratory factor analysis important criteria and their correlations were determined. Results: A total of 421 students took part in the questionnaire (31.4% return) and indicated their own clinical experience, but also patient contact and work-life-balance as important criteria for a future selection of specialty field. 44.8% of the participants had already made their choice of specialty at the time of the query, and this for the most part took place in the clinical study phase and most often for the subjects Internal Medicine (15.3%), General Medicine (14.2%), Pediatrics (12.0%) and Surgery (11.5%). For those students who already had made a decision, the size and complexity of the field as well as the opportunity to be able to build relationships with patients, were decisive for selection. Those still undecided indicated that for their choice of specialty family friendliness of the field, leisure time and esteem from others were important. Conclusions: Our results show that the personal clinical experience can be a decisive influential factor for future specialty selection. Early contact with the different disciplines could therefore be structured as an aid to help in the decision making, in order to break down any apprehensions and to stop a pending deficiency in specialists.
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Affiliation(s)
- Anke Gebhard
- University of Medicine of Rostock, Institute for Immunology, Rostock, Germany
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Keis O, Schneider A, Heindl F, Huber-Lang M, Öchsner W, Grab-Kroll C. How do German medical students perceive role models during clinical placements ("Famulatur")? An empirical study. BMC MEDICAL EDUCATION 2019; 19:184. [PMID: 31159794 PMCID: PMC6547468 DOI: 10.1186/s12909-019-1624-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 05/22/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND Studies have demonstrated the importance of role models in medical education. Medical students in Germany participate in clinical placements ("Famulatur") that last 4 months in total and represent the first real-world setting where students encounter possible role models in their clinical education. These placements are an extracurricular activity, however, and regarded as the "black box" of medical education. This study aimed to evaluate whether and how students experience role models during clinical placements, the qualities associated with potential role models and whether role model-related learning gains are relevant. METHODS We recruited 96 students (mean age: 23.83 years; 75% female) in their 5th to 9th semesters at the Faculty of Medicine at the University of Ulm, Germany, who were participating in a clinical placement between July and October 2015. Participants completed a questionnaire at the beginning of a 5-day working week to record sociodemographic and other information and another one at the end of the week to assess various aspects of their experiences. On each of the 5 days, they completed a structured questionnaire to record their perceived role models and self-assessed learning gains. RESULTS Role models and role modelling play an important role in clinical placements. The positive function of medical staff as role models predominated (88.4%) across all specialties. Junior doctors were the most frequently perceived role models (28.5%), followed by consultants (25.1%) and nursing staff (22.4%). The most commonly perceived positive quality was the interaction with students (16.5%), followed by team behaviour (13.6%), interaction with patients (13.6%) and professional expertise (13.4%). Students also had various kinds of learning gains such as knowledge or skills. CONCLUSIONS Although these clinical placements are extracurricular activities in Germany and their content is not regulated, they are home to a relevant amount of role modelling. Students experience the various medical professions in different roles and in a range of tasks and interactions. Defining basic learning objectives could help to increase the relevance of these placements for the medical curriculum in Germany and transfer the associated learning gains from the hidden to the open curriculum.
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Affiliation(s)
- Oliver Keis
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
| | - Achim Schneider
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
| | - Felix Heindl
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
| | - Markus Huber-Lang
- Institute for Clinical and Experimental Trauma Immunology, Ulm University Medical Center, Helmholtzstr. 8/2, 89081 Ulm, Germany
| | - Wolfgang Öchsner
- Center for Surgery / Department for Cardiac Anesthesiology, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Claudia Grab-Kroll
- Medical Faculty, Office of the Dean of Studies, University of Ulm, Albert Einstein Allee 7, 89081 Ulm, Germany
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Bien A, Ravens-Taeuber G, Stefanescu MC, Gerlach FM, Güthlin C. What influence do courses at medical school and personal experience have on interest in practicing family medicine? - Results of a student survey in Hessia. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc9. [PMID: 30828609 DOI: 10.5061/dryad.74tk6cr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/25/2018] [Accepted: 12/05/2018] [Indexed: 05/28/2023]
Abstract
Aim: Against the background of an impending shortage of family practitioners, it is important to investigate the factors influencing the choice to become one. The aim of this study was to identify factors that encourage medical students to choose to practice family medicine. Method: Using a questionnaire, students in the fourth and fifth years of their studies in the Federal State of Hesse were asked about the factors that had influenced their choice of medical specialty and their experience of courses in family medicine. Predictors of an interest in practicing family medicine were calculated using multiple logistic regression. Results: 361 questionnaires were returned, representing a response rate of 70.9%. Confirmation of personal strengths, an interest in the field, and practical experience of the subject generally turned out to be important factors influencing the choice of medical specialty. 49.3% of students expressed an interest in practicing family medicine. A link existed between an interest in working as a family doctor and the opportunity to take over an existing practice, experience of medicine in rural areas, and an appreciation of the conditions of work. With regard to education at medical school, positive experiences during a clinical traineeship in family medicine and positive role models among teachers of general practice were identified as predictors. Conclusion: Almost half the medical students were open to the idea of practicing family medicine. Experience of medicine in rural areas and positive experiences of courses in general practice were linked to an increased interest in working as a family doctor. To promote this interest, it may be a promising approach to increase opportunities to collect experience of medicine in rural areas, and to encourage highly motivated teaching practices.
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Affiliation(s)
- Antonia Bien
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
| | - Gisela Ravens-Taeuber
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
| | - Maria-Christina Stefanescu
- Frankfurt University Hospital, Clinic of Pediatric Surgery and Pediatric Urology, Frankfurt/Main, Germany
| | - Ferdinand M Gerlach
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
| | - Corina Güthlin
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
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9
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Bien A, Ravens-Taeuber G, Stefanescu MC, Gerlach FM, Güthlin C. What influence do courses at medical school and personal experience have on interest in practicing family medicine? - Results of a student survey in Hessia. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc9. [PMID: 30828609 PMCID: PMC6390086 DOI: 10.3205/zma001217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/25/2018] [Accepted: 12/05/2018] [Indexed: 05/15/2023]
Abstract
Aim: Against the background of an impending shortage of family practitioners, it is important to investigate the factors influencing the choice to become one. The aim of this study was to identify factors that encourage medical students to choose to practice family medicine. Method: Using a questionnaire, students in the fourth and fifth years of their studies in the Federal State of Hesse were asked about the factors that had influenced their choice of medical specialty and their experience of courses in family medicine. Predictors of an interest in practicing family medicine were calculated using multiple logistic regression. Results: 361 questionnaires were returned, representing a response rate of 70.9%. Confirmation of personal strengths, an interest in the field, and practical experience of the subject generally turned out to be important factors influencing the choice of medical specialty. 49.3% of students expressed an interest in practicing family medicine. A link existed between an interest in working as a family doctor and the opportunity to take over an existing practice, experience of medicine in rural areas, and an appreciation of the conditions of work. With regard to education at medical school, positive experiences during a clinical traineeship in family medicine and positive role models among teachers of general practice were identified as predictors. Conclusion: Almost half the medical students were open to the idea of practicing family medicine. Experience of medicine in rural areas and positive experiences of courses in general practice were linked to an increased interest in working as a family doctor. To promote this interest, it may be a promising approach to increase opportunities to collect experience of medicine in rural areas, and to encourage highly motivated teaching practices.
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Affiliation(s)
- Antonia Bien
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
- *To whom correspondence should be addressed: Antonia Bien, Goethe University Frankfurt am Main, Institute of General Practice, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany, E-mail:
| | - Gisela Ravens-Taeuber
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
| | - Maria-Christina Stefanescu
- Frankfurt University Hospital, Clinic of Pediatric Surgery and Pediatric Urology, Frankfurt/Main, Germany
| | - Ferdinand M. Gerlach
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
| | - Corina Güthlin
- Goethe University Frankfurt am Main, Institute of General Practice, Frankfurt/Main, Germany
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Grasreiner D, Dahmen U, Settmacher U. Specialty preferences and influencing factors: a repeated cross-sectional survey of first- to sixth-year medical students in Jena, Germany. BMC MEDICAL EDUCATION 2018; 18:103. [PMID: 29743057 PMCID: PMC5944057 DOI: 10.1186/s12909-018-1200-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/20/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Given the expected increase in those entering retirement, the number of practising physicians is predicted to decrease. Conversely, the number of physicians needed is set to increase, due to higher demands resulting from the increasing average age of the German population. This may cause a deficit in the availability and accessibility of medical care for the population in Germany, as well as in other countries. As such, there needs to be a specific focus on the next generation of physicians. Will they fill the gap in those medical specialties where it is most needed? This study aims to investigate (a) preferences for medical specialties over time and (b) the reasoning behind these preferences among students. METHODS Over three subsequent years, all medical students from the Jena Faculty of Medicine were repeatedly invited to participate in an online survey. The questionnaire consisted of three parts to explore the students' (1) preferred postgraduate specialty, (2) the reasons for their decision and (3) socio-demographic data. Data analysis was performed using Fisher's exact tests and logistic regression analysis. RESULTS The number of students completing the questionnaire in a given year ranged from 180 to 320, resulting in a total number of 720 completed questionnaires. Between 40 and 50% of the students preferred internal medicine as postgraduate specialty. About 25% of the students were interested in a surgical specialty. Diagnostics and psychiatric medical fields were preferred by about 10% of all students for each field in each year of the survey. A large percentage (about 18%) of the students remained undecided. The factors influencing the students' specialty preferences were most frequently reconciliation of work and family life, career goals as well as predicted workload. The factors depended on the preferred medical specialty. CONCLUSION The influencing factors should be taken into account for recruiting prospective residents. Doing so could increase the chance to attract the number of physicians needed to ensure adequate medical care in the field of interest, according to the growing health needs of the population.
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Affiliation(s)
- Diana Grasreiner
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Experimentelle Transplantationschirurgie, Universitätsklinikum Jena, Drackendorfer Str. 1, 07747 Jena, Germany
| | - Uta Dahmen
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Experimentelle Transplantationschirurgie, Universitätsklinikum Jena, Drackendorfer Str. 1, 07747 Jena, Germany
| | - Utz Settmacher
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany
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11
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Harendza S, Pyra M. Just fun or a prejudice? - physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students. BMC MEDICAL EDUCATION 2017; 17:128. [PMID: 28747204 PMCID: PMC5530564 DOI: 10.1186/s12909-017-0964-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/13/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Many jokes exist about stereotypical attributes of physicians in various specialties, which could lead to prejudices against physicians from a specific specialty. It is unknown whether and when medical students are aware of stereotypes about different specialties. The goal of this study was to analyze the degree of stereotypes that exist about medical specialties amongst undergraduate medical students at different stages of their education. METHODS One hundred fifty-two jokes with different content about attributes of physicians from different specialties were found by an internet search. In total, 36 characteristics of the five specialties of anesthesia, general surgery, internal medicine, orthopedics, and psychiatry were extracted from the jokes and they constituted the basis for the development of an online questionnaire. The questionnaire allowed each characteristic to be assigned to one of the five specialties and was sent to 999 undergraduate medical students from semester 1, 7, and 12 at the Medical Faculty of Hamburg University. RESULTS Three hundred eight (30.8%) of the invited students completed the survey. The characteristics of general surgeons and psychiatrists were assigned congruently most frequently (>50%). For internists and orthopedics, there was a significantly more congruent assignment of the characteristics by final year students versus students in their first semester. Male students assigned the characteristics of anesthetists and internists significantly more congruently than female students. The three characteristics "…are a bit slow on the uptake", "…consider income to be relatively unimportant", and "...apologize a lot" were not assigned to any of the five specialties by more than 50% of the students. CONCLUSIONS While stereotypes about physicians from certain specialties seem to exist commonly, medical educators need to be aware that stereotypes about specialties might develop during undergraduate medical training. In order to support students in their professional identity formation without developing stereotypes, medical educators should receive training. Performing a similar study with physicians in postgraduate training would shed some light on stereotypes and prejudices that might develop at a later stage in medical education.
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Affiliation(s)
- Sigrid Harendza
- III. Medizinische Klinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Martin Pyra
- III. Medizinische Klinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
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12
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Heikkilä TJ, Hyppölä H, Vänskä J, Halila H, Kujala S, Virjo I, Sumanen M, Kosunen E, Mattila K. What predicts doctors' satisfaction with their chosen medical specialty? A Finnish national study. BMC MEDICAL EDUCATION 2016; 16:125. [PMID: 27114239 PMCID: PMC4845435 DOI: 10.1186/s12909-016-0643-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/19/2016] [Indexed: 06/01/2023]
Abstract
BACKGROUND In Finland the number of medical specialists varies between specialties and regions. More regulation of the post-graduate medical training is planned. Therefore, it is important to clarify what predicts doctors' satisfaction with their chosen specialty. METHODS A random sample contained 50% of all Finnish doctors under 70 years of age. The respose rate was 50.5%. Working-age specialists were asked to value their motives when choosing a specialty. They were also asked if they would choose the same specialty again. The odds ratios for not choosing the same specialty again were tested. RESULTS Diversity of work was the most important motive (74% of respondents). Seventeen percent of GPs would not choose the same specialty again, compared to 2% of ophthalmologists and 4% of pediatricians. A major role of Diversity of work and Prestigious field correlated with satisfaction whereas Chance with dissatisfaction with the specialty. DISCUSSION Motives and issues related to the work and training best correlate with satisfaction with the specialty. CONCLUSIONS When the numbers of Finnish postgraduate medical training posts become regulated, a renewed focus should be given to finding the most suitable speciality for each doctor. Information about employment and career advice should play an important role in this.
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Affiliation(s)
- Teppo J Heikkilä
- Unit of Primary Health Care, Hospital District of Northern Savo, P.O. Box 1777, FI 70211, Kuopio, Finland.
| | - Harri Hyppölä
- Emergency Department, Kuopio University Hospital, P.O. Box 1777, FI 70211, Kuopio, Finland
| | - Jukka Vänskä
- Finnish Medical Association, P.O. Box 49, FI 00501, Helsinki, Finland
| | - Hannu Halila
- Finnish Medical Association, P.O. Box 49, FI 00501, Helsinki, Finland
| | - Santero Kujala
- Finnish Medical Association, P.O. Box 49, FI 00501, Helsinki, Finland
| | - Irma Virjo
- Department of General Practice, School of Medicine, University of Tampere, Kalevantie 4, FI 33014, Tampere, Finland
| | - Markku Sumanen
- Department of General Practice, School of Medicine, University of Tampere, Kalevantie 4, FI 33014, Tampere, Finland
| | - Elise Kosunen
- Department of General Practice, School of Medicine, University of Tampere, Kalevantie 4, FI 33014, Tampere, Finland
| | - Kari Mattila
- Centre of General Practice, Pirkanmaa Hospital District, P.O. Box 2000, FI 33521, Tampere, Finland
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