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Specialty choice determinants among Mexican medical students: a cross-sectional study.

ABSTRACT: BACKGROUND:The choice of medical specialty is related to multiple factors, students' values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students. METHODS:Senior students at the National Autonomous University of Mexico (UNAM) Faculty of Medicine answered a questionnaire covering demographics, personal experiences, vocational features, and other factors related to specialty choice. Chi-square tests and factor analyses were performed. RESULTS:The questionnaire was applied to 714 fifth-year students, and 697 provided complete responses (response rate 81%). The instrument Cronbach's alpha was 0.8. The mean age was 24?±?1?years; 65% were women. Eighty percent of the students wanted to specialize, and 60% had participated in congresses related to the specialty of interest. Only 5% wanted to remain as general practitioners. The majority (80%) wanted to enter a core specialty: internal medicine (29%), general surgery (24%), pediatrics (11%), gynecology and obstetrics (11%) and family medicine (4%). The relevant variables for specialty choice were grouped in three dimensions: personal values that develop and change during undergraduate training, career needs to be satisfied, and perception of specialty characteristics. CONCLUSIONS:Specialty choice of medical students in a middle-income country public university is influenced by the undergraduate experience, the desire to study a subspecialty and other factors (including having skills related to the specialty and type of patients).

SUBMITTER: Gutierrez-Cirlos C

PROVIDER: S-EPMC6854711 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Specialty choice determinants among Mexican medical students: a cross-sectional study.

Gutiérrez-Cirlos Carlos C Naveja J Jesús JJ García-Minjares Manuel M Martínez-González Adrián A Sánchez-Mendiola Melchor M

BMC medical education 20191114 1

<h4>Background</h4>The choice of medical specialty is related to multiple factors, students' values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students.<h4>Methods</h4>Senior students at the National Autonomous University of Mexico (UNAM) Faculty of Medi ...[more]

PMID: 31727026

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Project description:BackgroundChoosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.Methodology and findingsA cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ(2) = 107.2). The choice mainly occurred during the internship period in medical school (n = 466; 38.7%). An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%), which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3) and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2). With regard to influential factors in controllable lifestyle specialties, "financial reason" (mean score ± standard deviation: 2.8 ± 1.0; median = 3) and "personal time" (3.1 ± 1.3; median = 4) were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both), and higher scores were observed for "curricular internship" (3.2 ± 1.1, median = 4) and "social commitment" (2.6 ± 1.3, median = 3).ConclusionThe present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the Brazilian healthcare system.

Project description:Background: Despite being a vital part of medical workforce planning and development, how medical students and graduates choose their career specialty is still not well understood. This study aimed to identify the factors medical graduates consider important influences in their choice of specialty after their first year of practice, and to test the validity of relying on respondent recall to measure changes in specialty choice.Methods: The baseline survey was administered online to all final year students in Ireland's six medical schools. Those who consented to follow-up (n =?483) were surveyed 18?months later (June 2018), during the final month of first year of practice.Results: The baseline survey had a 67% (n =?483) response rate. At the follow-up survey, (n =?232, 48% response rate) the top specialty choices were: Medicine, n =?54 (26%); Surgery, n =?34 (16%); General Practice, n =?28 (13%); Anaesthesia, n =?16 (8%) and Paediatrics, n =?14 (7%). Of the 49 respondents (28%) reporting a change of specialty since baseline, 13 (27%) selected the same specialty in both surveys; of the 121 (69%) reporting no change, 22 (18%) selected a different specialty at follow-up. Over 90% of respondents rated as 'important or 'very important': 'Own aptitude', 'Work-life balance' and 'What I really want to do'. Over 75% rated as 'not at all', or 'not very important' 'Current financial debt' and 'Inclinations before medical school'. When adjusted for sex and age, compared with Medicine, General Practice rated as more important: continuity of patient care (RRR 3.20 CI(1.59-6.41), p =?0.001); working hours/conditions (RRR 4.61 CI(1.03-20.60), p =?0.045) and a career that fit their domestic circumstances (RRR 3.19 CI(1.27-8.02), p =?0.014). Those choosing Surgery rated as less important: patient contact (RRR 0.56 CI(0.33-0.95), p =?0.033) and working hours/conditions (RRR 0.55 CI(0.31-0.96), p =?0.035).Conclusions: The different demographic and motivational profiles by specialty choice are consistent with other studies suggesting a distinct profile for doctors intending to enter General Practice. In addition, our results suggest longitudinal study designs guard against recall bias and so provide more robust medical workforce models to inform and direct recruitment drives and interventions in future medical workforce planning.

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Specialty choice determinants among Mexican medical students: a cross-sectional study.

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Specialty choice determinants among Mexican medical students: a cross-sectional study.

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