How do medical schools influence their students' career choices? A realist evaluation

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.

Perceptions of community care among nursing students: A cross-sectional study with implications to nursing workforce

BACKGROUND

A shift of health care services towards community care has driven the need to develop the community care nursing workforce. However, challenges exist in attracting nursing graduates to a career in community care.

AIM

To examine perceptions of community care and placement preference among undergraduate nursing students across different years of study in a Singapore university.

METHODS

This study examined perceptions of community care and placement preference among undergraduate nursing students across different years of study. A cross-sectional study was conducted using the 'Scale on COmmunity care Perceptions' (SCOPE).

RESULTS

Only 31.3 % of the 501 nursing students who completed the survey preferred community care placement. They rated opportunities for advancement, work status and enthusiastic colleagues in community care with relatively lower scores in the SCOPE. Students' placement preferences and year of study were predictive factors of their perceptions of community care nursing. Students who indicated their placement preference in home-based care (p < 0.001) and intermediate long-term care (p < 0.05) reported significantly positive perceptions towards community nursing as compared to students who indicated acute care as their preferred placement. Despite pre-perceived ideas among the year 1 cohort, the community care placement within their course curriculum had an impact on year 2 to 4 students' perceptions of community care.

CONCLUSIONS

These findings identified key strategies to increase the community care nursing workforce which include promoting a better understanding of the role of a community nurse, providing quality community placement opportunities supported by preceptors who are good role models and fostering an optimistic career outlook and advancement in community nursing.

Impact of medical school experiences on the career choice of neurosurgery: a cross- sectional study from Pakistan

BACKGROUND

Pakistan grapples with the issue of an inadequate neurosurgery workforce but the reasons for such a disparity remain uncertain. Previous studies have highlighted how various factors including medical school experiences have an impact on career choice, but no study has delved into the impact of medical school exposure among Pakistani medical students, especially for the field of neurosurgery. This study aims to evaluate the impact of neurosurgery exposure, mentorship, and interest groups on medical students' decision to pursue neurosurgery.

METHODS

A national cross-sectional survey was conducted in Pakistan, collecting data from medical students, interns, and medical officers over a one-month period. Ethical approval was obtained from the Ethical Review Committee at Aga Khan University, Pakistan. The data was analyzed using SPSS version 26.

RESULTS

Out of 2618 participants, 38.0% were male and 62.0% were female, with an average age of 21.82 years (± 2.65). Among them, only 358 (13.6%) were interested in pursuing neurosurgery as a career, while the remaining 2,260 (86.3%) were not. More females (58.9%) than males (41.1%) expressed interest in pursuing neurosurgery as their intended career. Most medical students interested in pursuing neurosurgery were in the early years of their medical school (1st Year: 19.6%, 2nd Year: 26.0%, 3rd Year: 20.9%). In our study, students from public sector institutions (52.2%) showed more interest in neurosurgery as a career choice compared to those from private sector institutions (44.1%). The main deterrents for choosing neurosurgery were intense training (42.2%), work-life balance (39.9%), limited residency slots (56.7%), medical knowledge (34.1%), and surgical skills (36.6%).

CONCLUSION

This study highlights the need for increased student engagement to inculcate the decision to pursue neurosurgery among medical students in Pakistan. A significant gap is highlighted, with the majority of interested students in early years. Public sector students show higher interest than their private sector counterparts. However, barriers like intense training, limited residency slots, and work-life balance concerns influence career choice. Targeted interventions like mentorship programs are crucial for fostering future neurosurgeons and advancing patient care and research. By addressing the identified disparities in experiences and promoting a supportive educational environment, it is possible to cultivate a future generation of skilled and dedicated neurosurgeons who can contribute to advancements in patient care and research in the field.

Minority Student Perceptions of the Impact of Financial Cost of Pharmacy School and Career Choice at a Historically Black College and University (HBCU)

OBJECTIVE

One of the barriers that might prevent an underrepresented minority (URM) individual from pursuing a professional career in the United States is finances. The high disproportionate burden of student debt among URM students further perpetuates the racial wealth gap. Therefore, this study sought to evaluate the extent to which URM students' personal finance perceptions, and current and projected student loan indebtedness affect postgraduation career intentions.

METHODS

A cross-sectional analysis was conducted using data from four cohorts of pharmacy students using a survey from November 2, 2022, to February 1, 2023. The financial perception survey included subscales namely personal finance self-efficacy, debt influence and pressure, and risk mitigation and retirement. Descriptive statistics, simple logistic regression, and multivariate logistic regression analyses were conducted.

RESULTS

In total, 93 students completed the survey and had a mean age of 28.1 ± 5.3 years. Seventy-one percent of the respondents were female, and 67.7 % had completed a 4-year bachelor's degree. There was a significant association between age and the intention to pursue postgraduate training as well as a significant association between risk mitigation and retirement perceptions and intention to pursue postgraduate training after adjusting for other factors.

CONCLUSION

Among students from largely minority backgrounds, age, and confidence in their ability to make wise investment decisions for retirement are associated with a greater likelihood of pursuing postgraduate training opportunities.

[The concept of the Excellence Academy of the Convention of University Professorships for Orthopaedics and Trauma Surgery]

BACKGROUND

The departure of young habilitated colleagues from their university careers reflects, on the one hand, a move away from university medicine per se and, on the other, an unwillingness to take on university management positions. In addition to the question of "How do I qualify for these positions?", the question of "Why should I aspire to such a position?" is increasingly taking centre stage when less expensive alternatives are available. In addition, there is uncertainty about the extent to which one's own achievements and qualities are sufficient to distinguish oneself clinically and scientifically in the course of one's career and thereby recommend oneself for management positions.

AIMS

This is where the KUOU's Excellence Academy comes in, with the aim of identifying young colleagues with high potential for university leadership positions at an early stage, encouraging them to get to know each other, and focusing the attention and visibility of the university locations and the associated appreciation on the members of the Academy. The focus here is on ensuring that excellent colleagues benefit from the many years of experience of the members of the KUOU, receive feedback on their clinical and scientific achievements and are supported in their university career in the form of mentoring.

CONCLUSION

The large number of 22 very good applications, of which 12 candidates were accepted, confirms our belief that there are excellently qualified colleagues at our sites, who are ready to take on responsibility in the future in the triad of research, teaching and patient care.

Attitudes towards career choice and general practice: a cross-sectional survey of medical students and residents in Tyrol, Austria

BACKGROUND

The global primary healthcare workforce is declining, leading to a shortage of general practitioners. Although various educational models aim to increase interest in general practice, effective interventions are limited. The reasons for this low appeal among medical graduates remain unclear.

METHODS

This cross-sectional study surveyed medical students' and residents' attitudes towards general practice in Tyrol, Austria. The online questionnaire addressed professional values, general practice-related issues, personal professional intentions, and demographics. Data analysis employed chi-square tests and multivariate logistic regression to explore predictors of interest in general practice.

RESULTS

The study included 528 students and 103 residents. Key values identified were stable positions, assured income, and work-family reconciliation. General practice was recognised for long-term patient relationships and patient contact, with students attributing more positive work-environmental characteristics and higher reputation to it than residents. Few participants (students: 3.2%, residents: 11.7%) had opted for general practice; about half were considering it as career option. Reasons not to choose general practice were preferences for other specialties, intrinsic characteristics of general practice, workload, insufficient time for the patients, financial pressures, low reputation, and perceived mediocre training quality. Predictors of interest in general practice included perception of independent decision-making, importance of work-family balance (students), better practical experiences in general practice during medical school (students and residents), younger age, and perceiving general practice as offering a promising future (residents). Both groups felt underprepared by medical school and/or general practice training for general practice roles. The attractiveness of specialist medicine over general practice was related to clearer content boundaries, better career opportunities, and higher incomes.

CONCLUSIONS

According to these results, measures to improve attractiveness of general practice should focus on (i) high-quality undergraduate education including practical experiences, and (ii) on ensuring professional autonomy, work-family reconciliation, and job stability. Efforts to encourage more graduates to pursue this essential healthcare sector are crucial for strengthening primary healthcare and public health services.

TRIAL REGISTRATION

The study has not been registered as it did not include a direct medical intervention on human participants.

Effect of morality or capitalist ideology in choosing dentistry as a career in Türkiye: a cross sectional study

BACKGROUND

Previous studies have provided important findings on the profession of dentistry and the motivators for choosing dentistry. This study has attempted to contribute to this accumulation by using a sociocultural perspective and interpreting the relationships among motivators from this perspective in a large Turkish sample. The aim of this study was to investigate what motivates dental students to choose dentistry as a career in Türkiye.

METHODS

First-year dental students from different dental schools were included in a descriptive cross-sectional study. The questionnaire included sections covering demographics, motivators and career satisfaction. A total of 919 students from 29 different state dental schools and four private dental schools participated. Descriptive statistics such as percentages, means and standard deviations were used to summarize the sociodemographic information and the distribution of the motivators. Factorial analysis was carried out for the structural status of the questionnaire items. The relationships between the motivators were analyzed using Pearson's correlation.

RESULTS

Among the 919 students, 64.2% were female, and 35.8% were male. Half of them chose dentistry after seeing their higher education institution's examination results, while the other half had already considered it a career during their preuniversity years. Communicating with people, artistic skills, and helping others were the main motivators for students to choose dentistry as a career in Türkiye, and students' overall career satisfaction was moderately high. The strongest correlations were between communication with people and benefits (r =.74), between communication with people and helping others (r =.71), between communication with people and artistic skills (r =.66), between artistic skills and benefits (r =.69), between artistic skills and helping others (r =.65), between dental experience and benefits (r =.51), between dental experience and helping others (r =.50), and between benefits and helping others (r =.71).

CONCLUSION

Helping others, artistic skills, communicating with people, and benefits were the most important factors motivating dental students to choose a career, and positive relationships were detected between these four factors. This information may help to develop more effective career guidance and mentorship strategies for dental students.

Developing a broad perspective of future work and career in medical students through field trips to a disaster area: a qualitative study

OBJECTIVE

Field trips to disaster-affected areas (FTDAs) without a specific purpose, such as medical cooperation, are widely used in medical education. However, what medical students gain from FTDAs remains unclear. The present study aimed to clarify what medical students gain from FTDAs. Five medical students who had visited the Fukushima nuclear power plant in Japan participated in a semi-structured group interview to ask what they gained from such a visit. The narratives were analysed using open coding.

RESULTS

The following four themes emerged: "Spirit of scientific inquiry", "Foundation for lifelong education and personal growth", "Broadened understanding of the medical profession", and "Importance of practicing medicine in the community setting". The ambiguity of medical students' specific roles in the field trip compared to the fieldwork may have encouraged them to make sense of the experience from their perspective. As a result, students may have gained a broader perspective of their future work and career through the FTDA. If medical educators can gain consensus from the residents of a disaster site, different disaster-affected areas can be potential sites for medical education using FTDAs.

Medical trainees' speciality considerations at their transition from under- to postgraduate education: a descriptive, cross-sectional study

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.

The impact of final-year clinical placements on nursing students' career planning for the graduate year and beyond

AIMS

This study had three objectives: 1) to determine final-year nursing students' career preferences and long-term career plans; 2) to investigate factors influencing nursing students' specialty choices following their final-year clinical placement(s); and 3) to understand how final-year clinical placements can be used to develop the career interests of nursing students to different nursing specialties.

BACKGROUND

Clinical placement provides an insightful experience that may influence students to feel inclined to work in certain specialties. Therefore, each clinical placement should promote students' learning and enhance positive experiences that could develop their career interests and encourage them to seek employment in the specialty on graduation.

DESIGN

A cross-sectional online survey.

METHODS

The survey was structured using the Career Decision Self-Efficacy Scale - Short Form. The questionnaire was distributed to final-year nursing students (N = 222) at two public universities in Western Australia. This study specifically reports on the Goal selection and Planning domains of the Career Decision Self-Efficacy Scale - Short Form, which were explored through additional questions prompting participants to explain their career preferences and reasons for their nursing specialty choices.

RESULTS

Most participants, fifty-three percent, had low confidence in making career decisions. The Goal Selection and Planning questions measured the students' confidence in choosing a suitable practice destination and preparing for their professional careers. Overall, participants prefer employment in hospital settings both in the short- and long-term aspects of their nursing career. The factors influencing the students' career decisions were classified into three main categories: the clinical environment, educational factors and individual factors.

CONCLUSIONS

The nursing curriculum may encourage nursing students to work in some specialties over others. This study provides insight into factors that may promote or inhibit students' career choices and how students may be motivated to pursue the less preferred nursing specialties.

Psychometric evaluation of the Chinese version of the attitudes, subjective norms, perceived behavioural control and intention to pursue a career in mental health nursing scale

AIM

To adapt culturally and assess the reliability and validity of the Attitudes, Subjective Norms, Perceived Behavioural Control and Intention to Pursue a Career in Mental Health Nursing (ASPIRE) scale among Chinese nursing students.

BACKGROUND

Mental health nurses make up a substantial proportion of the mental health workforce and are pivotal for improving access to professional mental health care. However, a shortage of mental health nurses persists across various countries. Although new nursing graduates have the potential to alleviate the labor shortages, there is currently no standardized tool specifically designed to measure nursing students' intentions to pursue a career in mental health nursing in China.

DESIGN

A quantitative and cross-sectional design.

METHODS

Following email authorization from the author, the Chinese version of the ASPIRE scale was translated following the cross-cultural adaptation process guidelines established by the American Association of Orthopedic Surgeons (AAOS). A questionnaire survey was conducted among 540 nursing students from three universities in Hunan Province from April 2023 to October 2023. Nine experts were invited to evaluate the content equivalence of each item. Item analysis, exploratory factor analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability were used to test reliability and validity.

RESULTS

The Chinese version of the ASPIRE scale retained 14 items and it has high content validity. Pearson correlation analysis revealed a statistically significant difference in the correlation between the total scores of the items (P < 0.001). Exploratory factor analysis indicated that the one-factor solution explained 65.82% of the total variance and confirmatory factor analysis results indicated a good fit (CMIN/DF = 2.64, RMSEA = 0.079, GFI = 0.908, IFI = 0.964, SRMR = 0.0326). The Cronbach's alpha coefficient for the scale was 0.958 and the test-retest coefficient was 0.783.

CONCLUSION

The Chinese version of the ASPIRE scale has great reliability and validity and can be used for assessing Chinese nursing students' intention to pursue a career in mental health nursing.

Influence of the COVID-19 Pandemic on Health-Care Career Interests Among High School Students

PURPOSE

This study investigates the influence of the COVID-19 pandemic on high school students' interest in health-care careers.

METHODS

A voluntary web-based survey, approved by the Medical College of Wisconsin's Institutional Review Board, was administered across eight high schools in Milwaukee and its suburbs in Wisconsin. The survey collected students' demographic details, opinions on the health-care system's pandemic response, and their interest in health-care careers before and after the pandemic.

RESULTS

Out of 2,949 respondents, 29.9% were already contemplating a health-care career before the pandemic, with 27.7% indicating increased interest thereafter. Students not previously interested in health-care careers registered an 11.5% increase in interest due to the pandemic. Notably, the pandemic significantly boosted health-care career interest among females and freshmen.

DISCUSSION

The COVID-19 pandemic has distinctly influenced high school students' interest in health-care careers, notably among females and freshmen. This finding has implications for addressing projected health-care professional shortages.

Would you like to be a general practitioner? Baseline findings of a longitudinal survey among Danish medical trainees

BACKGROUND

Recruiting and securing primary care physician workforce has been the center of international attention for decades. In Denmark, the number of general practitioners has decreased by 8.5% since 2013. However, a rising population age and increasing prevalence of chronic diseases and multimorbidity place an even greater future need for general practitioners in Denmark. The choice of general practice as specialty has been associated with a range of both intrinsic and extrinsic factors, however, few studies have examined the recruitment potential that lies within medical trainees' who are undecided about general practice specialization. The aim of this study was, therefore, to explore how medical trainees who are undecided about general practice specialization (GP-positive/undecided) differ from medical trainees who are either committed (GP-committed) or not committed to a general practice career (GP-non-committed) regarding factors related to future work life.

METHODS

The present study concerns baseline findings from a longitudinal survey study. An online questionnaire was e-mailed to a national cohort of medical trainees during their transition from under- to postgraduate education. The associations between orientations towards general practice specialization and work-related factors and potential influencing factors, respectively, were analyzed using uni- and multivariable modified Poisson regression models.

RESULTS

Of 1,188 invited participants, 461 filled out key study variables concerning specialty preferences and rejections, corresponding to a response rate of 38.8%. We found significant positive associations between GP-positive/undecided orientation and valuing a good work/life balance and the opportunity to organize own working hours when compared to GP-non-committed respondents. Compared to the GP-committed orientations, the GP-positive/undecided orientation was associated with a positive attitude towards technology, working shift hours, and an openness towards several career paths. Across all orientations, undergraduate exposure to the specialties was found to be highly influential on the specialty preferences.

CONCLUSION

GP-positive/undecided medical trainees value autonomy over their working hours more than the GP-non-committed, but less than the GP-committed. However, the GP-positive/undecided respondents present more openness to different career opportunities and the use of technology in daily work. We suggest using this knowledge in the planning of recruitment strategies aiming to increase interest in general practice specialization.

Five Recommendations to Foster a Love of Teaching

How can educators foster a passion for teaching in a health sciences student who has never considered education as a career? The author recounts 5 experiences that were instrumental in shaping his own career as an educator. These experiences illustrate principles which may be used to encourage students to consider careers in education. Principles discussed include exposure to teaching opportunities while students are still studying the health sciences, recognition of students showing promise as teachers, role models, mentorship, and appropriate compensation for those in education careers.

Rural family medicine as a career option among Hungarian medical students

BACKGROUND

The shortage of family physicians is a considerable challenge in Hungary. The number of vacant practices is increasing and the rural and deprived areas are more affected.

OBJECTIVES

This study aimed to investigate medical students' attitudes towards rural family medicine.

METHODS

The current study used a cross-sectional design with a self-administered questionnaire. Each of the four Hungarian medical universities was represented by their medical students from December 2019 to April 2020.

RESULTS

The response rate was 67.3% (n = 465/691). Only 5% of the participants plan to be a family doctor, 5% of the students plan to work in rural areas. On a 5-point Likert scale (1 = 'surely not', 5 = 'surely yes'), half of the participants answered 1 or 2 to choose rural medical work, while 17.5% answered 4 or 5. There was a significant relationship between rural working plans and rural origin (OR = 1.97; p = 0.024), and the plan to work in family practice (OR = 4.90; p < 0.001).

CONCLUSION

Family medicine is not a popular career option among Hungarian medical students and rural medical work is even less attractive. Medical students with a rural origin and an interest in family medicine are more likely to plan to work in rural areas. More objective information and experience need to be given to medical students about rural family medicine to increase the attractiveness of the speciality.

Dental hygiene and dental students' motivations for future work: a cross-sectional study of first-year students at a dental hygiene school and a dental school in Japan

BACKGROUND

It is important to understand the career motivations and perceptions of students who intend to become dental health professionals. Both dental and dental hygiene students may have different opinions about the profession and future work prospects. To our knowledge, no study has compared the career motivations and career perceptions of Japanese dental and dental hygiene students after admission to dental or dental hygiene school. This cross-sectional study examined the motivations of dental and dental hygiene students for their future career perceptions.  METHODS: First-year students of dental and dental hygiene schools in the academic years 2021 and 2022 participated in the study. Group 1 comprised 104 female dental hygiene students, Group 2-1 comprised 55 female dental students, and Group 2-2 comprised 61 male dental students. A self-administered questionnaire survey was conducted on opinions of the work and prospects of future work with four-point Likert scales ranging from "strongly agree" to "strongly disagree," according to the items.

RESULTS

Dental hygiene students consider that they would like to work as professionals and would also like to earn efficiently. Specifically, female dental students prioritized contributing to society by working long-term in a fulfilling environment rather than earning an income, whereas male dental students would like to work as a professional while also effectively earning income.

CONCLUSIONS

Small but significant differences were found in opinions of the dental hygienist/dentist profession in terms of attractiveness and credibility. Small but significant differences were found for income and working hours when considering future job prospects. The results of this study revealed differences in the first year students between dental and dental hygiene school in their attitudes toward career motivation and prospects for future work.

Life satisfaction and peace of mind among dentists: a cross-sectional study

OBJECTIVES

This study sought to identify the factors associated with the life satisfaction and peace of mind (PoM) of dentists not in full-time clinical training.

MATERIALS AND METHODS

Cross-sectional questionnaires were distributed to dentists in Taiwan to collect their life satisfaction, PoM, sociodemographic data, and dental career-related characteristics. Life satisfaction was measured using a 5-item Satisfaction with Life Scale. PoM was measured using a 7-item Peace of Mind Scale. Descriptive statistics and multiple linear regression models were estimated to explore potential associations between the two scales and the examined factors.

RESULTS

A total of 1196 dentists (45.6% female; mean age = 44.12) completed the questionnaires. The response rate of completed questionnaires from email invitations was 32.9%. On multivariable analysis, life satisfaction and PoM were associated with age (b = 0.008 in both), better perceived health (b = 0.262 and 0.308, respectively), family interaction (b = 0.264 and 0.207, respectively), and friend relationships (b = 0.076 and 0.091, respectively). Being married (b = 0.191), being specialized (b = 0.127), working in private practice, and spending 10 to 39 h per week with patients (b = 0.101 to 0.162) were associated with a higher level of life satisfaction but not PoM.

CONCLUSIONS

Specialists working in private practice without working overtime were associated with better life satisfaction. However, the dentists' health and relationships with family were more related to their subjective well-being than their professional achievements.

CLINICAL RELEVANCE

Our findings can help policymakers increase awareness of the well-being of general dentists and those in academia or hospitals to promote their mental health.

Impact of clinical rotational posting on attitude toward psychiatry of undergraduate medical students in Malaysia

Background

Almost all over the world, psychiatry training of undergraduate medical students has been criticized to be deficient in imparting required knowledge and improving the perception of students towards psychiatry and psychiatric treatment. Considering the large mental health need gap in the community, it is essential to improve undergraduate students' attitude toward psychiatry.

Aim

Hence, this study was planned to study the impact of psychiatry clinical posting on attitude toward psychiatry of undergraduate medical students.

Materials and Methods

Undergraduate medical students undergoing psychiatry posting were assessed on the first and last day of clinical posting with the help of semi-structured proforma consisting of sociodemographic information, favored future career choice, the relevance of psychiatry to their future careers, the usefulness of particular knowledge and skills, the value of knowledge of psychiatric specialties and the utility of different settings for learning psychiatry.

Results

After their clinical posting, students had a more positive attitude towards the usefulness of psychiatry knowledge in future general practice and the usefulness of psychiatry knowledge from undergraduate training in the future. Knowledge of alcohol withdrawal management, detection and management of delirium, and Mental Health Acts were perceived more essential in the future. Also, specialties such as deaddiction and child and adolescent psychiatry were felt more useful in future practice. After posting, students perceived that psychiatry can also be learned at medical and surgical wards as well as during home visits. However, despite some positive changes in attitude toward psychiatry, there was no significant change in choosing psychiatry as a career by the students after posting.

Conclusion

Undergraduate psychiatry training during clinical posting was able to make some positive changes in the knowledge and attitude of students. However, still, there were lacunae in some areas of concern. Preference of psychiatry as a branch of specialization was not increased after posting. This indicates the need for better reforms in psychiatry education at the undergraduate level to improve the perception of undergraduate students about psychiatry.

What motivates young Arab Muslim women to choose nursing as a profession: A cross-sectional study

AIM

This study examines the impact of nurse uniforms, the coronavirus pandemic, and the image of nurses and the nursing profession on the career choice of young Muslim Arab women in nursing, with a focus on policy implications.

BACKGROUND

The global nursing shortage poses significant challenges, including in Israel. Attracting young Muslim Arab women to nursing careers is vital. Understanding how nurse uniforms, the pandemic, and perceptions of nurses and the nursing profession shape their career decisions can inform policy interventions.

METHODS

A cross-sectional study utilized digital questionnaires administered to 200 Muslim Arab women aged 20-30 in Israel. The study adhered to the EQUATOR checklist for cross-sectional studies.

RESULTS

Only 29.2% of participants expressed interest in studying nursing. Findings revealed a positive correlation between the pandemic's impact and intention to pursue nursing. A linear regression analysis shows the impact of the white uniform, the image of nurses, and the image of the profession on the choice of a career in nursing.

DISCUSSION

The study emphasizes the significance of nurse uniforms, the image of nurses, and the image of the nursing profession in shaping young Muslim Arab women's career choices in nursing. Policy interventions should raise awareness about nursing roles, expand responsibilities, and highlight nurses' contributions to society.

CONCLUSION

Strategies to attract young Muslim Arab women to nursing careers should address nurse uniforms, the image of nurses, and the image of the nursing profession.

IMPLICATIONS FOR POLICY

Policy interventions should prioritize diversity, promote positive images of nurses and the nursing profession, and raise awareness of nursing roles and contributions among young Muslim Arab women.

Women in trauma and orthopaedics: are we losing them at the first hurdle?

INTRODUCTION

Diversity in the healthcare workforce is associated with improved performance and patient-reported outcomes. Gender disparity in Trauma and Orthopaedics (T&O) is well recognised. The aim of this study was to compare factors that influence career choice in T&O between male and female final-year students. Furthermore, the trend of representation of women in T&O over the last decade was also compared with other surgical specialities.

METHODS

An online survey of final-year students who attended nationally advertised T&O courses over a 2-year period was conducted. Data from NHS digital was obtained to assess gender diversity in T&O compared with other surgical specialities.

RESULTS

A total of 414 students from 13 UK medical schools completed the questionnaire. Compared with male students (34.2%), a significantly higher proportion of women (65.8%) decided against a career in T&O, p<0.001. Factors that dissuaded a significantly higher percentage of women included gender bias, technical aspects of surgery, unsociable hours, on-call commitments, inadequate undergraduate training and interest in another specialty (p<0.05). Motivating factors for choosing a career in T&O were similar between both sexes. T&O was the surgical specialty with the lowest proportion of women at both consultant and trainee level over the last decade.

CONCLUSION

T&O remains an unpopular career choice among women. To enhance recruitment of women in T&O, future strategies should be directed toward medical students. Universities, orthopaedic departments and societies must work collaboratively to embed culture change, improve the delivery of the undergraduate curriculum, and facilitate students' exposure to operating theatres and female role models.

Survey on brachytherapy training among radiation oncology residents in the German-speaking regions of Europe

PURPOSE

This survey aimed to determine the perception of brachytherapy training among residents in the DACH region, consisting of Austria, Germany and Switzerland.

MATERIAL & METHODS

An online questionnaire containing 22 questions related to trainee demographics (n = 5) and to brachytherapy training (n = 17) was sent in two iterations in 11/2019 and 02/2020. The following topics were evaluated: institutional support, barriers to training, extent of training, site-specific training (prostate, gynaecology, breast, gastrointestinal and skin), preferences for further training and outlook on overall development of brachytherapy. The responses were mostly based on a Likert scale of 1 to 5, thereby reflecting strength of opinion. Descriptive statistics were used to describe frequencies.

RESULTS

Among the 108 respondents, approximately 69% of residents considered the ability to perform brachytherapy independently to be important or somewhat important. However, only 31% of respondents reported to have a dedicated brachytherapy training during residency. The major limitation to achieve independence in performing brachytherapy was seen in a low case load in Austria, in the lack of training in Switzerland and in both of them in Germany.

CONCLUSION

The interest in brachytherapy training among residents in German-speaking countries was generally high, but there is a perceived lack of sufficient case volumes and partially also in formal training opportunities. Fellowships at departments with a high case load as part of a formalised curriculum and dedicated hands-on workshops at national or international conferences might help to overcome these issues.

[The completion of trial apprenticeships is followed by the choice of an apprenticeship profession: Predicting the decision to pursue a trial apprenticeship profession in the career choice process]

This article investigated the factors that lead adolescents to pursue a trial apprenticeship profession in their career choice process. Gottfredson's Theory of Circumscription, Compromise, and Self-Creation (TCCSC) served as the theoretical basis for the analyses. A longitudinal sample of 128 female and 202 male adolescents who completed standardized questionnaires in seventh and ninth grades and who indicated that they would begin vocational education and training after compulsory schooling was analyzed separately by gender. Regression models showed that the number of apprenticeship positions has the strongest effect for both female and male adolescents (significant positive effect). Only for female adolescents, the extent of enterprising requirements of the trial apprenticeship profession was shown to have a negative effect on the decision to pursue a trial apprenticeship profession, controlling for the number of apprenticeship positions. The results support the accessibility hypothesis postulated in the TCCSC, according to which individuals are more likely to pursue professions they perceive as more accessible, i.e., with a large number of apprenticeship positions. In light of the compatibility idea contained in the TCCSC, a possible explanation for the negative effect of enterprising requirements of trial apprenticeship professions among female adolescents is that they may assess their enterprising skills as too low. As a result, they perceive professions with high enterprising requirements as incompatible and turn away from these professions. This study was able to address a gap in career choice research by examining the role of trial apprenticeship professions and offers important reference points for future research.

Career paths and workforce diversity in hematology: A cross-sectional study of a 35-year alumni cohort from an academic residency program in Brazil

INTRODUCTION

Although not mandatory, medical residency has become a sine qua non condition for practicing in most medical specialties in Brazil. Residency programs are hosted mainly by university accredited academic centers and hospitals in the national public healthcare system, under guidance and accreditation by a national commission. Despite the importance of these programs for the development of the hematology workforce, few studies have addressed their characteristics and impact on society.

METHODS

We performed a comprehensive cross-sectional survey of a 35-year alumni cohort from a hematology academic residency program in Brazil.

RESULTS

In total, 86/98 (87.8%) responded to the survey. The mean age at residency completion was 28.5 years, 60.5% of the alumni were women and sixty-four (74.4%) self-declared their skin color as white. Higher rates of parental education attainment and low rates of trainee financial dependence were observed and these patterns were stable over time. While the proportion of trainees from other states increased steadily, the number of hematologists practicing in other states remained stable. Approximately half of the alumni worked both in the private and public sectors, mainly in malignant hematology and in outpatient clinics. Twenty-five percent of the alumni reported prior leadership and teaching positions, mainly as directors of transfusion services.

CONCLUSION

Our results provide data that can be potentially useful for policymakers and curricular development in the planning of strategies concerning the future workforce of hematologists.

A nationwide survey of Turkish medical students' upon interest and decision for cardiovascular surgery as a future career: A cross-sectional survey

Background

In this study, we aimed to investigate the current interest of Turkish medical students to pursue a career in cardiovascular surgery and to identify possible factors which positively or negatively affected their decisions.

Methods

Between January 2022 and August 2022, a cross-sectional survey of 34 questions was created using the Google Forms online survey platform. Questions were directed to participants to evaluate demographic features, interest level in cardiovascular surgery, interest in other specialty programs, and interest in residency abroad using fivepoint Likert scales.

Results

A total of 5338 Medical Students were reached who were balanced to 7 geographical regions across Türkiye and 1233 (23%) medical students participated in the questionnaire. Of the respondents, 544 were males and 689 were females with a mean age of 21.2±0.5 (range, 17 to 28) years. More than half of the students (56.2%) considered residency training programs in Türkiye. Cardiology had the highest preference rate for residency training (8.3%), followed by cardiovascular surgery (7.5%). More than one-third of students (36.5%) who were interested in pursuing a career in cardiovascular surgery decided to be trained abroad. Achieving a prestigious job, motivation for life saving, prioritizing innovations, and high academic studies were the main factors that positively affected the perspective of students on cardiovascular surgery, while stressful surgeries, intense and tiring night shifts, and a relatively poor social life/work balance were the main deterrent factors. Attendance to cardiovascular surgeries positively affected the decisions of students (p=0.008).

Conclusion

Although it is thought that the interest in pursuing a career in cardiovascular surgery has reduced in recent years all over the world, our study shows that cardiovascular surgery still continues to be a popular specialty among Turkish medical students. Therefore, we believe that guiding medical students by using their current potential and encouraging the students to attend cardiovascular surgeries more frequently throughout their education life are essential in choosing cardiovascular surgery as a future career option.

Reasons for choosing and completing nursing studies among incoming and outgoing students: A qualitative study

BACKGROUND

The shortage of nurses is causing instability and crisis in health systems and will continue. The WHO reinforced the importance of recruiting and retaining new students. Authors of various studies recommend the need to identify and understand the reasons for pursuing a nursing degree.

OBJECTIVES

To determine students' preference for nursing studies and to identify the reasons for choosing, continuing, and completing a bachelor's degree in nursing.

DESIGN

Qualitative, descriptive study.

PARTICIPANTS

106 nursing students at the University of Huelva (Spain) participated during their first year (2017) and final year (2021) of the nursing degree.

METHODS

This study was conducted with the same group of students in two phases. Data were collected in writing in a document with open-ended questions and no maximum wordcount. The responses were analysed using content analysis.

RESULTS

A total of 76.4 % of participants stated that nursing had been their first choice. The main reasons for choosing a nursing degree were associated with fulfilment, and a desire to help others and interact with them. The reasons for completing their studies were primarily related to an interest in providing professional care, showing a deeper and more concrete knowledge of nursing care work.

CONCLUSION

For most participants, nursing was their first choice due to a strong intrinsic motivation related to self-satisfaction in helping others. The reasons for completing this degree had extrinsic motivations linked to nursing activity in hospital. Areas such as management, teaching, or research were not interesting to our students. Knowing the causes of this lack of interest could help us attract them to these areas.

Effect of the Management in Nursing course on students' time management and career planning attitudes: A single-group pre-test post-test study

AIM

This study aimed to determine the effect of the Management in Nursing course on the time management and career planning attitudes of nursing students.

BACKGROUND

University education is important for young people to develop their time management skills, plan their careers, and implement these plans.

DESIGN

This is a semi-experimental study used single-group pre-test post-test design.

METHODS

This study sample included 133 fourth-year nursing students who enrolled for the Management in Nursing course in the 2019-2020 academic year. Introductory Information Form, Career Futures Inventory (CFI), and Time Management Questionnaire (TMQ) were used for data collection.

RESULTS

A statistically significant difference was found between the pre- and post-test time planning and TMQ scores. Moreover, a significant difference was found between the pre- and post-test career adaptability, career optimism and CFI scores. No significant difference was found between the pre- and post-test scores for the TMQ's time attitudes and time wasters subdimensions; similarly, the CFI's perceived knowledge of the job market subdimension indicated no significant difference between the pre- and post-test scores.

CONCLUSIONS

The results of this study indicated that the Management in Nursing course improved the time management skills of fourth-year nursing students as well as increased adaptability and optimism in their career planning attitudes.

Understanding STEM career choices: A systematic mapping

STEM disciplines are considered essential for human development, and they are associated with low unemployment rates and good economic prospects. However, many countries are faced with the problem of too few STEM graduates, which raises the question of why more students do not choose STEM majors. This study presents a systematic mapping of studies published prior to 2021 in Web of Science or Scopus in order to examine the research trends on the factors that cause students to choose a career in Computer Science, or more generically, in the STEM fields. These factors have been identified and classified in 3 categories: Environmental factors, Social influencers and Personal factors. The categories are made up of 4 levels of subcategories. We analyzed (1) the countries in which the study was conducted, (2) the characteristics of the study and (3) the frameworks used. The results show that the bulk of the studies were conducted in developed countries, mainly in North America and Europe. The frameworks most commonly used in the studies are Expectancy-Value Theory and Social Cognitive Career Theory, and consequently, the most commonly studied factors for STEM degrees are those related to personal psychological factors. For Computer Science degrees, the most frequently studied factor is career prospects. On the other hand, a small number of studies on the impact of social media on the choice of studies in the technology field were detected. Among the studies analyzed, there is great interest in determining the factors that specifically affect women and the differences between men and women, especially in studies dealing with the Computer Sciences. Furthermore, there are few studies that analyze the effect of informal educational experiences among women. Given that this kind of experiences has become very popular in recent years among women, future research should analyze their impact on the choice of STEM studies. Taking into account the current relevance of the social media, additional research on their impact on the choice of studies should be conducted. It would also be necessary to analyze the situation in underdeveloped countries, especially among women, given that this field is currently a driver of economic development.

Impacts of COVID-19 on career choices in health professionals and medical students

BACKGROUNDS

The COVID-19 pandemic has resulted in not only significant mortalities in Vietnam but has had an impact on its economy. Previous studies have highlighted how the pandemic has had a marginal impact on Vietnamese healthcare workers working at the frontlines. To date, there have been several other studies examining the impact of COVID-19 on intentions to transition between jobs among healthcare professionals, but this has yet to be explored amongst Vietnamese healthcare workers.

METHODS

To achieve the study's objectives an online cross-sectional study was conducted between September to November 2021. Snowball sampling methodology was adopted for the recruitment of participants. The questionnaire that was used for this study comprised of the following sections: (a) socio-demographic information; (b) impact of COVID-19 on work; (c) risk of exposure to COVID-19; (d) career choices/intentions to change job, and (e) motivation at work.

RESULTS

There were 5727 completed the entire survey. 17.2% of the respondents have had increased job satisfaction, 26.4% reported increased motivation to work, and 40.9% reported decreased motivation to work. Whilst there were changes in the daily work intensity and the level of work-related stress, more than 60% of respondents we sampled did not intend to switch careers. Demographic variables like gender, whether one was a student or an existing healthcare worker, and income related to work motivation. The community's stigma was a negative factor that declined intrinsic motivation as well as decreased work retention.

CONCLUSIONS

Our study is instrumental in identifying the impact of COVID-19 on career choices amongst Vietnamese healthcare workers. The factors identified have clear implications for policymaking.

Career choice for ICT among Liberian students: A multi-criteria decision-making study using analytical hierarchy process

Information and communication technology graduates are among the highly skilled, paid, and perceived as capable and credible professionals worldwide. This has resonated in significant growth in the number of students pursuing careers in ICT at various African institutions. These developments illustrate the importance of conducting research that will provide insights into specific influencing factors that may be associated with students' choices of careers in ICT. Such a study is particularly essential for Liberia, which is experiencing a boost in ICT-related investments. This study considers 182 Liberian students' career choices for ICT as a multi-criteria decision-making problem. The Analytical Hierarchy Process is employed to empirically study the relative significance of factors that affect students' choice of ICT. Three main themes and twelve sub-themes influencing students' career choices were identified. Pairwise comparisons revealed that even though family factors play crucial roles in influencing students' career choices, overall analysis shows that students attach great importance to extrinsic factors such as financial remuneration when making ICT career choices. Students were also reported as giving high priorities to job security and access to jobs while giving lesser importance to the prestige attached to ICT careers. The findings are highly significant to the career choice literature because they provide practical implications that may be used by organizations and entities offering IT employment and colleges enrolling IT students.

Nationwide survey of internal medicine hospitalists in Korea: motivation and sustainability of a hospitalist career

Background/Aims

Although a management fee for hospitalist service was established in Korea, the number of hospitalists required for the system to run remains outmatched.

Methods

In January 2020 and February 2022, before and after the establishment of the hospitalist fee system respectively, cross-sectional online surveys were conducted among internal medicine board-certified hospitalists.

Results

There were 59 and 64 respondents in the 2020 and 2022 surveys, respectively. The percentage of respondents who cited financial benefits as a motive for becoming a hospitalist was higher in the 2022 survey than in the 2020 survey (34.4% vs. 10.2%; p = 0.001). The annual salary of respondents was also higher in the 2022 survey than in the 2020 survey (mean, 182.9 vs. 163.0 million in South Korean Won; p = 0.006). A total of 81.3% of the respondents were willing to continue a hospitalist career in the 2022 survey. In multivariate regression analysis, the possibility of being appointed as a professor was found to be an independent predictive factor of continuing a hospitalist career (odds ratio, 4.00; 95% confidence interval, 1.09-14.75; p = 0.037).

Conclusions

Since the establishment of the hospitalist fee system, monetary compensation has improved for hospitalists. The possibility of being appointed as a professor could predict long-term work as hospitalists.

How influential are medical school curriculum and other medical school characteristics in students' selecting pathology as a specialty?

There has been a significant decline in the number of United States allopathic medical students matching to pathology residency programs. Data acquired from the American Association of Medical Colleges (AAMC) show sustained variation in the medical school production of students who go on to pathology residency. When divided into groups based on the medical school's historical volume of graduates entering pathology, the schools in groups labeled Group 1 and Group 2 produced significantly higher and lower proportions of pathology residents, respectively. This study aimed to identify what medical school curriculum elements and other medical school characteristics might explain the differences observed in the AAMC data. The Dean or another undergraduate medical education contact from the Group 1 and Group 2 schools was invited to participate in an interview. Pathology Program Directors and Pathology Department Chairs were also included in communications. Thirty interviews were completed with equal numbers from each group. Interview questions probed pathology experiences, existence, and structure of a pathology interest group, options for post-sophomore fellowships, recent curriculum changes, and the extent of mentoring programs. Surprisingly, the curriculum does not appear to be a predictor of a medical school's production of students who enter pathology residency. A significantly greater percentage of Group 1 schools are public institutions compared to Group 2 schools. Other factors that may increase the number of students who go into pathology include mentoring, active learning versus observation, and post-sophomore fellowships or other opportunities to work in the capacity of a new pathology resident.

Assessing awareness and attitude of Egyptian medical students towards emergency medicine as a specialty and career choice: A single-institutional study

Introduction

Emergency medicine (EM) was formally recognized as a specialty in Egypt in 2002. Many institutions of higher education do not yet have an operational academic department of emergency medicine. This study attempts to quantify the awareness and attitude of Ain Shams University medical students towards emergency medicine as both a specialty and a career.

Methods

A paper-based survey was delivered to undergraduate medical students at the Faculty of Medicine, Ain Shams University in Cairo, Egypt between December 2021 and April 2022. The survey was designed to assess awareness towards the scope of practice of emergency physicians as well as general attitude toward emergency medicine as a specialty and career choice.

Results

A total of 391 students and interns/house officers participated in this study. 53.2% of participants were females and the mean age was 21.65 ± 2.25 years. Only 30 participants (7.7%) were classified as having "Excellent knowledge" of emergency medicine, 92 (23.5%) as "Good knowledge", 158 "40.4%" as "Fair knowledge" and 111 (28.4%) as "Poor knowledge". The difference in scores between academic years was not statistically significant (p = 0.239). 91.8% of respondents favored the creation of student interest groups in EM and 40% of respondents found it difficult to reach information regarding EM.

Conclusion

Our study demonstrates a lack of awareness and knowledge towards emergency medicine as a specialty across all academic years at our institution. Formal recognition of EM as a specialty doesn't guarantee widespread knowledge among medical students, particularly at institutions without academic EM departments.

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

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.

Medical students' perception of general practice: a cross-sectional survey

BACKGROUND

An increase in the demand for general practitioners is expected in many countries, but only a minority of medical students consider a career in general practice. More detailed and up-to-date knowledge about medical student's perception of general practice would be helpful for efforts to encourage medical students to consider a career in general practice.

METHODS

We performed a cross-sectional single center survey among Dutch medical students to evaluate their perception of general practice at three different stages in their study: Ba1: first-year bachelor students; Ba3: third-year bachelor students; Ma3: third-year master students. The impact of different factors on their attitudes and perceptions was quantified. A multivariate logistic regression was performed with 'interest in general practice' as the outcome variable.

RESULTS

The median age for Ba1 was 18 (IQR: 18-19) and 71.5% were female, for Ba3 the median age was 20 (IQR: 20-21) and 70.6% were female and for Ma3 the median age was 25 years (IQR: 24-26) and 73.3% were female. On average, 31.2% of the respondents had a migration background. The mean response rate for this study was 77.1%. Of the participating Ba1 students (n = 340) only 22.4% considered working as a GP after medical school; for Ba3 students (n = 231) this percentage was 33.8%, and for Ma3 students (n = 210) it was significantly higher at 70.5%; in the final multivariate model this corresponded to an odds ratio (OR) of 4.3 (95%-CI:2.6-6.9) compared to Ba1 students. The strongest predictor in the final model was the opinion that general practice provides a pleasant working environment (OR 9.5; 95%-CI: 6.2-14.5).

CONCLUSION

This study showed that multiple factors are significantly related to medical students' interest in general practice. Although students believed that general practice does not have a high status within the medical profession, they acknowledged the social importance and the pleasant working environment of general practice. Knowledge obtained in this study can be used when designing a medical curriculum or a general practice course.

Evaluation and description of a healthcare academia elective for student pharmacists

BACKGROUND AND PURPOSE

Pharmacists, regardless of practice setting, will be called to provide education to patients, healthcare professionals, students, and the community. In an effort to increase students' exposure to the knowledge, skills, and responsibilities of a pharmacist in academia, an introductory healthcare academia elective was created. The purpose of this article is to describe the implementation and assessment of this elective course.

EDUCATIONAL ACTIVITY AND SETTING

The course was offered to students in spring 2021 and focused on exposing students to academia aspects, including curriculum design, pillars of academia, and roles of assessment and feedback. The largest project was a student created and delivered Accreditation Council for Pharmacy Education-accredited continuing education presentation.

FINDINGS

The twelve students completed pre- and post-surveys regarding their perceived knowledge and personal abilities in select areas. Overall, students' perceived knowledge and abilities increased in each area at the end of the course. Additionally, a total of four continuing education presentations were delivered to students, faculty, and practicing pharmacists.

SUMMARY

One semester of a unique healthcare academia elective increased students' perceived confidence in their knowledge and application of academia-related tasks.

Factors influencing future career interests of pharmacy interns in Saudi Arabia: a survey from 25 colleges of pharmacy

BACKGROUND

Hundreds of pharmacists graduate from pharmacy colleges in Saudi Arabia, and various factors influence their choice of career pathway. Very few single-institution studies assessed career choices of pharmacy students with or without evaluating the influencing factors. Therefore, this study aimed to evaluate career choices and the associating factors of pharmacy interns from multiple colleges in Saudi Arabia.

METHODS

This was a cross-sectional study that surveyed pharmacy interns from 25 pharmacy colleges in Saudi Arabia using an online questionnaire. The survey was sent during the last rotation month in the internship year (May-June 2022).

RESULTS

Of 454 participants, 411 (90.5%) were enrolled in Doctor of Pharmacy programs. While most participants were interested in becoming clinical pharmacists (n = 183; 40.3%), a considerable number were also interested in working in different sectors of pharmaceutical companies and industry (n = 127; 28%). Internship training significantly correlated with selecting clinical pharmacy specialist career (r = 0.19; P = 0.0001), whereas salary/financial incentives significantly influenced the choice of working as sales and marketing representatives and pharmacy product specialists in pharmaceutical companies (r = 0.29 and 0.24; P < 0.0001 for both). College courses correlated with choosing academia in pharmaceutical sciences (r = 0.20; P < 0.0001), whereas summer training correlated with the community pharmacy career (r = 0.11; P = 0.02).

CONCLUSION

Pharmacy colleges should utilize results from this study to enhance the exposure of pharmacy students during their academic years to different pharmacy career pathways by allowing the opportunity to shadow pharmacists from different sectors as part of college courses, inviting previous graduates, and activating the role of academic advisors in career orientation.

Why choose paediatrics? A scoping review of factors affecting the choice of paediatrics as a career

Despite being a popular speciality at the undergraduate level, paediatrics lags behind most other medical and surgical specialities for postgraduate recruitment. As many individuals decide on their future career choice while still in medical school, it is essential to identify the factors that attract individuals to a career in paediatrics. To determine the positive influencing factors determining paediatrics as a career choice. A scoping review of primary research articles was conducted using a comprehensive electronic search strategy and reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews recommendations. Studies exploring medical students, junior doctors, and current paediatricians' perceptions of paediatrics were included. Factors affecting career choice were identified. Thirty-six studies out of a possible 3106 met the inclusion criteria and were included in this review. Six key influencing themes were identified. These were early undergraduate and clinical exposure to paediatrics; an attractive work-life balance; the presence of role models and mentors; an enjoyable working atmosphere and varied clinical work; a personal commitment to paediatrics; and working with children.

CONCLUSION

 Medical students are drawn by the wide clinical variety in paediatrics, enjoyable working atmosphere, and enthusiastic colleagues. Given the importance of early clinical exposure in determining student motivation, paediatrics needs to do more to advertise the wide variety of clinical and research work available, starting early in medical school. In addition, medical students need to be offered more opportunities to experience the speciality through student selected components, summer schools, or workshops, requiring coordination between medical schools and regional paediatric departments.

WHAT IS KNOWN

• Research suggests that many medical students make choices on their future career based on medical school experiences. • Paediatrics is a popular subject among medical students, however applications for the specialilty are in decline.

WHAT IS NEW

• Six key factors influencing paediatrics as a career choice have been identified, the most common being early exposure to paediatrics at medical school and lifestyle factors. • Interventions aimed at increasing student involvement in paediatrics at the undergraduate level have been shown to be associated with an increase in the number of individuals applying for the speciality following graduation.

Medical students' career decision-making stress during clinical clerkships

OBJECTIVES

Many medical students experience career decision-making stress in the final phase of training. Yet, the factors that induce or reduce career decision-making stress and how progression in their clerkships relates to these factors are unknown. This knowledge gap limits the possibilities for medical schools to develop and implement interventions targeting students' career decision-making stress. This study explores content, process, and context factors that may affect career decision-making stress.

METHODS

Using cross-sectional survey data from medical master students (n = 507), we assessed content (future work self), process (choice irreversibility, time pressure, career decision-making self-efficacy), and context (supervisory support, medical school support, study load, competition) factors and their relationships with career decision-making stress. The hypothesized relationships were tested with structural equation modelling.

RESULTS

A clearer future work self and higher career decision self-efficacy were associated with lower career decision-making stress, while experienced time pressure, competition, and study load were associated with higher career decision-making stress. Choice-irreversibility beliefs, supervisory support, and medical school support were unrelated to career decision-making stress. As students' clerkships progressed, they gained a clearer future work self, but also experienced more time pressure.

DISCUSSION

Clinical clerkships help students to form a clearer future work self, which can diminish career decision-making stress. Yet, students also experience more time pressure as the period of clerkships lengthens, which can increase career decision-making stress. A school climate of high competition and study load seems to foster career decision-making stress, while school support hardly seems effective in diminishing this stress.

Prosocial modelling matters: the association between parent and faculty involvement in fighting COVID-19 with medical students' career commitment

BACKGROUND

Role models are essential in medical education, yet empirical research is relatively insufficient on the influence of prosocial modelling on medical students' career commitment. The prosocial behaviour of medical staff involved in the fight against the novel coronavirus disease 2019 (COVID-19) at the beginning of 2020 presents an opportunity to fill the research gap. We explored and compared the different associations of the two most important role models for medical students - parents and faculty- with medical students' career commitment.

METHODS

The cross-sectional study was conducted with 99,559 undergraduate students majoring in clinical medicine in mainland China. Questions were asked to collect information about participants in the battle against COVID-19, medical students' determination to practice medicine after graduation, as well as students' socio-demographic characteristics. Chi-square tests and hierarchical regressions were performed to examine the associations between parent and faculty involvement and students' career commitment.

RESULTS

The results showed statistically significant associations between prosocial modelling during the COVID-19 pandemic in China and students' intention to pursue medical careers. The association of faculty involvement (OR = 1.165, p < .001) with students' career commitment was greater than that of parents (OR = 0.970, p > .05). For faculty involvement, the association was stronger among male students (OR = 1.323, p < .001) and students who were already determined to be doctors (OR = 1.219, p < .001) before the pandemic.

CONCLUSIONS

Our study provides new evidence on the potential roles of parents and faculty in shaping medical students' career commitment. Encouraging faculty to act as positive role models could help medical students increase their intention to become doctors.KEY MESSAGESProsocial modelling could enhance students' intention to pursue medical careers.The association of prosocial behaviour of faculty is larger than that of parents on medical students.Those who have prior medical career commitment are much more likely to persist in the medical profession, and prosocial modelling of faculty is positively associated with their medical career commitment.

Factors affecting the choice of dermatology as a specialty by medical students: Data from 28 KSA medical schools

OBJECTIVES

Choosing a future career path is a very important decision for undergraduate medical students. Determining the factors that affect specialty choices is essential to attaining a balanced distribution. Dermatology is known to be one of the most appealing and highly competitive specialties. The aim of this study was to determine the factors influencing the choice of dermatology as a future career by medical students.

MATERIALS AND METHODS

A cross-sectional study was carried out in 28 medical schools throughout Saudi Arabia. The questionnaire was prepared following a literature search of relevant studies and was distributed electronically to medical students and interns. The self-administered questionnaire included sociodemographic data, interest in dermatology as a future career, and factors that may affect specialty choices.

RESULTS

The study included 1087 participants. Sixty percent were female, and 39% were male. Approximately half of the participants considered dermatology as their preferred specialty. We found that 53.6% of females were more interested in dermatology. Students who were exposed to dermatology in both pre-clinical and clinical years showed greater interest. Personal interest, lifestyle/flexible work schedule, and private sector opportunities were the most captivating factors. Personal interest and high competition in dermatology residency program matching were the main factors among students who did not consider dermatology as a future career choice.

CONCLUSIONS

Several factors are influencing medical students when choosing dermatology as their future specialty; the lifestyle/flexible work schedule and personal interest were the most attractive factors. Recognizing these factors could be a useful tool that may lead mentors and residency training program directors to reach a balanced distribution of doctors in the various specialties.

Influence of demographic and socio-economic factors in choosing hospitalist careers among US medical students

BACKGROUND

The subspecialty of Hospital Medicine (HM) has grown rapidly since the mid-1990s. Diversity and inclusion are often studied in the context of healthcare equity and leadership. However, little is known about the factors potentially associated with choosing this career path among US medical students.

METHODS

We analyzed the results of the Annual Association of American Medical Colleges Survey administered to Graduating medical students from US medical schools from 2018 to 2020.

RESULTS

We analyzed 46,614 questionnaires. 19.3% of respondents (N = 8,977) intended to work as a Hospital Medicine [HM] (unchanged from 2018 to 2020), mostly combined with specialties in Internal medicine (31.5%), Pediatrics (14.6%), and Surgery (9.1%). Students interested in HM were significantly more likely to identify as female, sexual orientation minorities (Lesbian/Gay or Bisexual), Asian or Black/African-American, or Hispanic. Role models and the ability to do a fellowship were strong factors in choosing HM, as was higher median total debt ($170,000 vs. $155,000). Interest in higher salary and work/life balance negatively impacted the likelihood of choosing HM. There were significant differences between students who chose IM/HM and Pediatrics/HM.

CONCLUSION

About one in five US medical students is interested in HM. The probability of choosing future HM careers is higher for students who identify as sexual or racial minorities, with a higher amount of debt, planning to enter a loan forgiveness program, or are interested in doing a fellowship.

Dental students' interest in orthodontic careers: do orthodontic-related experiences and faculty and practitioner role models matter?

OBJECTIVES

To assess the percentage of dental students interested in orthodontics and likely to apply to orthodontic residency programs, the role of orthodontic-related experiences, and of orthodontic faculty and practitioner role models for student career decision-making.

MATERIALS AND METHODS

This study had a cross-sectional design. A total of 335 students from seven U.S. dental schools responded to an anonymous web-based survey.

RESULTS

35% were much/very much interested in becoming orthodontists and 26% were likely to apply for this specialty training. A total of 80.1% had orthodontic treatment, 58.7% knew an orthodontist in their community, 44% had shadowed an orthodontist, and 10.8% had worked in an orthodontic practice before dental school. Respondents evaluated orthodontic practitioners more positively than orthodontic faculty. They considered practitioners as more compassionate providers than faculty members (5-point scale with 5 = agree strongly: mean = 4.25 vs 3.83; P < .001), making more of a difference in their patients' lives (4.44 vs 4.05; P < .001), and as better role models (4.21 vs 3.94; P < .001) who encouraged students more to pursue orthodontics (4.03 vs 3.65; P < .001). Their interest in becoming an orthodontist and in applying for an orthodontic residency program correlated with educational experiences (r = 0.35; P < .001 / r = 0.34; P < .001) and positive impressions of orthodontic faculty (r = 0.23; P < .001 / r = 0.22; P < .001) and practicing orthodontists (r = 0.29; P < .001 / r = 0.27; P < .001).

CONCLUSIONS

Better understanding of factors motivating dental students to pursue orthodontics is crucial. Orthodontic practitioners and faculty play an important role in this context.

Development and testing of the career decision-making self-efficacy scale for nursing students: a methodological study

BACKGROUND

The conventional Career Decision-Making Self-Efficacy Scale does not reflect the situation in Korea due to different sociocultural attributes and fails to account for the unique nursing profession and changes in healthcare. We aimed to develop and psychometrically test the Career Decision-Making Self-Efficacy Scale for Nursing Students.

METHODS

A methodological study using a newly developed questionnaire tool and investigation of the validity and reliability of the preliminary instrument. Data were collected from 400 nursing students through an online survey conducted in May 2021. We identified 56 preliminary items through a literature review and focus group interviews. Of them, 40 were completed with a content validity index > .80. Content, construct, and criterion-related validity; internal consistency reliability; and test-retest reliability were used in the analysis.

RESULTS

Exploratory factor analysis revealed three factors including 21 items: adapting to work (20.5%), understanding the major (20.2%), and goal setting (16.4%), explaining 57.1% of the total variance. As a result of confirmatory factor analysis, 17 items in the three-factor structure were validated. Reliability, as verified by the test-retest interclass correlation coefficient, was .86 and Cronbach's α was .92. The final Career Decision-Making Self-Efficacy Scale for Nursing Students consists of 17 items: adapting to work (7 items); understanding the major (4 items); and goal setting (6 items).

CONCLUSION

The scale developed to measure the career decision-making self-efficacy of nursing students showed sufficient validity and reliability.

Gender Discrimination, Career Aspirations, and Access to Mentorship Among Medical Students in Brazil

INTRODUCTION

Gender-based discrimination (GBD) creates a hostile environment that can affect medical students. Mentorship has been recognized as a mitigating factor for GBD. We aimed to investigate the impacts of GBD on career selection and well-being of medical students in Brazil and to explore access to mentorship among these students.

METHODS

A cross-sectional study was performed using an anonymous survey in Portuguese. The survey was distributed in June 2021 to students enrolled in Brazilian medical schools. It contained 24 questions, including demographics, episodes of GBD experienced by responders and their impact on professional and personal life, and mentorship access.

RESULTS

Of 953 respondents, 748 (78%) were cisgender women, 194 (20%) cisgender men, and 11 nonbinary (1%). Sixty-six percent (625/953) of students reported experiencing GBD, with cisgender women and nonbinary being more likely to experience it than cisgender men (P < 0.001). Responders who experiences GBD report moderate to severe impact on career satisfaction (40%, 250/624), safety (68%, 427/624), self-confidence (68%, 426/624), well-being (57%, 357/625), and burnout (62%, 389/625). Cisgender women were more likely to report these effects than men counterparts (P < 0.01). Only 21% of respondents (201/953) had mentors in their medical schools.

CONCLUSIONS

Our findings demonstrate that GBD is widespread among Brazilian medical students affecting their personal and professional lives, and most of them do not have access to a mentor. There is an urgent need to increase access to mentors who could mitigate the adverse effects of GBD and help develop a diverse and inclusive medical workforce.

[What explains the "gendered reputation" of residency subjects? : Reasons for gendered specialty selection and careers in spine-surgery residency programs-compared to a "female" specialty]

BACKGROUND

Currently, the proportion of women in academic education and residency is predominant, but specialty-specific distribution of leading positions is partly reciprocal (orthopedics/surgery). Are there any differences that indicate a gender-dependent redistribution in leadership positions already in the selection of postgraduate training?

METHODS

Online survey with orthopedics/trauma surgery (OUC) and neurosurgery (NCH) residents. Comparison with gynecology (GYN). Statistical analysis, mean in percent, statistical differences using t‑ or chi²-test (significance level α = 0,05).

RESULTS

Returned questionnaire = 277, complete participation = 250. Female residents: OUC:52%, NCH:57%, GYN:85%. A total of 49% were told in medical school that a subject was inappropriate for gender reasons (f57-76%, m10-33%). The most frequent reason for a subject: all = "operating activity". The second most frequent reason: OUC-f = "good working atmosphere", OUC-m = "establishment", NCH-f = "career" and "good working atmosphere", NCH-m = "good working atmosphere", GYN-f = "establishment", GYN-m = "career". The most frequent reason against: OUC/GYN = "hardly any possibility to become established", NCH = "negative leadership style by superiors". For female residents in OUC/NCH, work/family balance had the smallest influence on the choice of specialty. Their subjective evaluation of compatibility was significantly the worst, and overall OUC/NCH was significantly worse than GYN. Although female residents in NCH were more likely to justify the specialty choice based on career goals, male residents in OUC/NCH were more likely to aim for a higher hierarchical position.

DISCUSSION

The results of this study emphasize that disciplines receive a gender-specific conditioning already at the undergraduate level, which has a clear impact on the choice of specialty. The image in this regard needs to be reconsidered, as even surgical subjects will predictably have to rely on more female specialists.

Calling: Never seen before or heard of - A survey among Swiss physicians

BACKGROUND

Research is needed to gain a deeper understanding of what motivates physicians to do their work and what keeps them in the profession.

OBJECTIVES

To explore calling as an approach to work in a sample of physicians.

METHODS

We designed an online survey addressing career choice and career calling among physicians in French-speaking Switzerland, and measured associations between calling and categorical variables (participant characteristics, motivations for choosing medicine, career choice(s) and consistency, and definition of calling).

RESULTS

The majority of physicians (n = 229) reported that a calling was not a career motivator. The main reasons for becoming a physician were to be useful (n = 173), the scientific aspects of medicine (n = 168), and altruism (n = 153). Viewing medicine as a calling was significantly associated with having been attracted specifically and only to the medical career and stability of this career choice. Physicians defined a calling as internal summons (n = 140), passion (n = 126), and sense of purpose in life (n = 101). Being in the right place, internal summons, and passion were significantly more often considered as a definition for calling by physicians with a calling.

CONCLUSIONS

A sense of calling influences career choice and professional stability, and might play a protective role in exhaustion or dissatisfaction at work.

Development and validation of motivators for medical specialist career choice questionnaire (MMSCCQ) - a methodological study

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.

Motivations, sources of influence and barriers to being a podiatrist: a national questionnaire of student views

BACKGROUND

Podiatry is an allied health profession which has seen a substantial decline in numbers in recent years. Every effort is required to recruit more students to reverse this diminishing supply and meet national foot health needs. To increase the number of applications to podiatry courses and encourage individuals to choose podiatry careers, the aim of this study was to understand the key motivations, sources of influence and barriers to choosing a podiatry career among current podiatry students, and consider the influence of choosing podiatry before or after a first career.

METHODS

An online questionnaire, comprising mainly Likert-scale questions, was disseminated to podiatry students in England between February and March 2021. Respondents to the questionnaire were categorised as individuals who had either decided to engage in the profession 'before' or 'after' a first career. Mann-Whitney U non-parametric difference tests were performed to compare outcome questions relating to motivations, sources of influence and barriers between groups.

RESULTS

One hundred and fifteen students completed the questionnaire. Overall, the study demonstrated many similarities between the groups (before and after a first career). However, there were distinct differences when considering some of the motivations (i.e., intellectually stimulating, student bursaries), sources of influence (i.e., own patient experience) and barriers (i.e., financial, job availability) associated with engaging in the podiatry profession. Overall, altruistic reasons were the key motivations for choosing podiatry. Personal sources of influence such as conducting own research, was the most important source of influence. Similar to other studies, a lack of awareness of the podiatry profession and what it entails remains problematic.

CONCLUSIONS

This is the first national questionnaire investigating career choice decision-making for podiatry students in England or in any other country. The similarities suggest that marketing is applicable to both groups. However, an absolute must is a future national strategy that makes educational sources more impactful. Additionally, following the Covid-19 pandemic, the increased interest in health and care professions suggests now is the right time to market podiatry to individuals looking for a career change. Finally, the influence of personal encounters with podiatrists shows the transformational role podiatrists can have in recruiting to the profession.

Surgical career choices of medical students in China: does gender bias play a role?

BACKGROUND

Gender bias in career choices has always been a matter of great concern, including in the field of medicine. This study reports on the current situation in this regard in China, including the reasons for Chinese medical students' willingness to engage in surgical careers; investigates their accounts of gender bias; and analyzes the effect of gender bias on their surgical career choices.

METHODS

This study invited medical students from Harbin Medical University to fill out a non-mandatory questionnaire on whether they had witnessed gender bias, their surgical career intentions, and factors influencing their career intentions. A one-way analysis of variance was used to compare the differences between continuous variables. Pearson's chi-squared test was used to compare the differences between the categorical variables, the Kendall correlation coefficient (tau) was used to assess the correlation between the reasons rankings reported by gender, and a multiple regression analysis was conducted by logit model.

RESULTS

A total of 643 students responded to the questionnaire. Of them, 63.76% expressed a willingness for a surgical career, with "interest" being a key driving factor (73.41%). Almost all respondents (96.27%) answered that there were more male leaders in the surgical departments they had rotated through or had contacted. Only a few respondents reported gender barriers influencing recruitment (32.19%). However, witnessing gender bias (recruitment of male required) was correlated to choice of surgical career (P < 0.05). Females were less willing to pursue a career in surgery if they had witnessed gender barriers in surgical recruitment. Male dominance also correlated to the choice of a surgical career (P < 0.1). Of the respondents, 53.19% believed that surgery was not suitable for females; among female respondents, this number was 56.12%, higher than for male respondents. When females think that the surgical profession is not suitable for them, it reduces the possibility of their pursuing a career in surgery.

CONCLUSION

Most medical students were interested in surgical care. Witnessing gender bias decreases females' willingness to pursue a career in surgery. It is necessary to stimulate medical students' interest in surgery when formulating strategies to promote surgical career choices, as well as to reduce gender bias in surgery; in this way, females' surgical careers should be ensured.

Working intentions of medical students in response to healthcare workplace violence and descending resources reform in China

BACKGROUND

In order to curb healthcare workplace violence (WPV) and better allocate healthcare resources, China launched the descending resources reform in 2013 and tightened the anti-violence legal environment simultaneously. Medical students are expected to reconsider their working intentions of entering the medical market (inter-market effect) and choosing high- or low-level hospitals (intra-market effect) in response to the evolving WPV. The goal of this study was to explore the link between the perceived WPV incidence and medical students' willingness to practice medicine in the context of China's descending resources reform.

METHOD

Medical students were selected with cluster sampling from 8 medical colleges in Zhejiang Province, China, and 1497 valid questionnaires were collected by using a five-point unbalanced scale, to perform cross-sectional empirical research using the ordered logit model (OLM).

RESULTS

The perceived WPV incidence negatively correlate with the willingness of medical students to practice medicine but positively correlate with their willingness to practice in low-level hospitals, indicating the existence of inter- and intra-market effects. The anti-violence legal environment has no direct link with working intention but contributes to the perceived decline in the incidence of violence. Descending resources reform has simultaneous opposite effects on medical students, with the coexistence of prudent motives driven by reform costs and optimistic expectations of sharing external benefits.

CONCLUSIONS

Safety needs and risk aversion motive play an important role in medical students' career choice when facing severe WPV. Tightening of the anti-violence legal environment and the descending resources reform could drive medical students to low-level hospitals.