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written by Prof Omar Hasan Kasule Sr
Personal
interest:
- Many factors, some unknown and unrecognized, play a role in the career choice decision. A study with disturbing findings showed that student career choice was not guided by previous experience or knowledge of the area meaning that trust of expressed choices should be taken with caution[1].
- On entry into medical school the students are idealists wanting to study medicine for intellectual and personal fulfillment, getting community respect, financial security as well as admiration for the doctor as a committed, smart, decisive leader with interpersonal skills[2].
- As they progress through their studies to eventually choose their careers, their choices are driven by more pragmatic considerations. Lifestyle and earning potential were rated higher than research opportunities in career selection[3].
- 'Personal interest' was rated by 80% of students as important in influencing their choice, followed by stability (58%), reputation of the specialty (56%) and lifestyle (55%)[4].
- Career choices change and evolve with time. A UK prospective study showed that one quarter of post graduates were working in specialties other than what they chose at the start of their training[5].
Public
interest:
- Career choices do not always match the needs of the country they tend to reflect student priorities.
- Graduates of a medical college in 1982 Bombay either went abroad (one quarter) and 90 percent of those who stayed in India went into private practice where they were satisfied with their career[6].
- Career intentions of medical students in Sub Saharan Africa were not aligned to local health priorities[7].
- A Canadian study showed a mismatch between student career preferences on entry into medical school and the needs of the different specialties[8].
- US medical schools offered more research tenured tracks than educational or clinical tracks[9]. The proportion of US students planning full time clinical practice careers is decreasing[10]. Mistreatment in medical school turned students off academic careers[11].
- Factors influencing choosing an academic career in hematology were presenting and publishing research, mentorship, intellect, and practice type. Those choosing a non-academic career were more concerned with lifestyle.[12].
Effect
of prior exposure to the discipline:
- Dutch medical students who attended periods of training in a US academic center had a high chance of developing academic careers[13].
- The nature of clerkship influenced specialty choice[14].
- A sub-medicine internship did not affect students’ application to join internal medicine[15]. Clinical exposure was an important factor in choosing family medicine[16].
- Preceptors have an impact on student career choices the impact being larger the longer the duration of contact[17].
- Students from small colleges had more hands on experience and felt more confident at internship[18].
Professional
success:
- Selection of an appropriate career, based on existing student attributes, ensures professional success and career satisfaction.
- A 10-year longitudinal study identified academic achievement as a predictor of professional competence, copying styles predicted career satisfaction, and levels of anxiety and depression predicted future quality of life. Professional stress was not predictable[19].
Career
guidance:
- Career choice is neither easy nor straightforward and a lot if career guidance/counseling is needed. Medical students experience anxiety and depression due to external pressures to succeed in a medical career[20].
- This anxiety may be positive when it spurs them to work and succeed and may be negative when it paralyzes their effort out of fear of failing.
- College based career advisory programs were more effective than one-to-one faculty advising about careers[21].
- Fourth year medical students were satisfied with career advisory services at the college[22].
- A UK study showed that students delayed career choices especially general practice however those from poorer areas has early career intentions[23].
Other
factors:
- A US study showed that postgraduate experience was more important than undergraduate clinical attachments in determining career choices[24].
- New Zealand data showed no relation between career choice and size if the secondary school or town of origin[25].
REFERENCES
Available upon request