Background Medical students experience difficulties in the process of making decisions about their careers, which is referred to as career indecision. This study aimed to examine the difficulties in the career decision-making processes of medical students and to explore the association of coping strategies and psychological health with career indecision. The findings may provide a reference for designing interventions to advance satisfying career decisions for medical students. Methods A cross-sectional survey of 359 medical students was conducted in 5 Chinese medical schools. Students completed an anonymous self-administered questionnaire measuring their career indecision, coping strategies, and psychological health. Independent t-test, F-test, bivariate Pearson’s correlation analysis, and linear regression analysis were applied to test the relation between career indecision and the associated factors. Data were analyzed using SPSS V.22 for Windows. A p-value < 0.05 was considered to be statistically significant. Results Difficulties regarding lack of readiness frequently occurred in medical students when making career decisions, with the highest score of 2.48 ± 0.58. Among all the associated factors in this study, career indecision was positively associated with psychological distress problem (β = 0.20, p < 0.05). This study also proved that being at a higher level of career indecision is negatively associated with using problem-focused coping strategies (β = − 0.14, p < 0.05). For the maladaptive coping strategies, applying dysfunctional coping strategies showed a significantly positive association with career indecision among medical students (β = 0.25, p < 0.05). Conclusions Medical students experienced difficulties regarding lack of readiness frequently when making career decisions. Both coping strategies and psychological health were associated with career indecision among medical students. To prevent career indecision, it is necessary to promote earlier career awareness to medical students. Specifically, psychological health should be addressed in career intervention programs for medical students. Additionally, when helping medical students to cope with career indecision, cognitive techniques that reduce the use of maladaptive coping strategies and enhance the use of adaptive coping strategies should be adopted.

BackgroundSince the global standards for postgraduate medical education (PGME) were published in January 2003, they have gained worldwide attention. The current state of residency training programs in medical-school-affiliated hospitals throughout China was assessed in this study.MethodsBased on the internationally recognized global standards for PGME, residents undergoing residency training at that time and the relevant residency training instructors and management personnel from 15 medical-school-affiliated hospitals throughout China were recruited and surveyed regarding the current state of residency training programs. A total of 938 questionnaire surveys were distributed between June 30, 2006 and July 30, 2006; of 892 surveys collected, 841 were valid.ResultsFor six items, the total proportions of “basically meets standards” and “completely meets standards” were <70% for the basic standards. These items were identified in the fields of “training settings and educational resources”, “evaluation of training process”, and “trainees”. In all fields other than “continuous updates”, the average scores of the western regions were significantly lower than those of the eastern regions for both the basic and target standards. Specifically, the average scores for the basic standards on as many as 25 of the 38 items in the nine fields were significantly lower in the western regions. There were significant differences in the basic standards scores on 13 of the 38 items among trainees, instructors, and managers.ConclusionsThe residency training programs have achieved satisfactory outcomes in the hospitals affiliated with various medical schools in China. However, overall, the programs remain inadequate in certain areas. For the governments, organizations, and institutions responsible for PGME, such global standards for PGME are a very useful self-assessment tool and can help identify problems, promote reform, and ultimately standardize PGME.

BACKGROUND Clinical reasoning (CR) is a fundamental skill medical students need to learn. Challenge still remained in our current education using conventional methods. New technology is needed for enhancing our CR teaching, especially when we are facing new generations of health trainees. China Medical University (CMU) has developed computer-based CR training system (CMU-CBCRT). OBJECTIVE We performed a construct validity test of CMU-CBCRT in this study. METHODS We recruited 385 students from 5th year undergraduates to PGY 3 to complete the test on CMU-CBCRT. Testing scores were compared over four training level (5th year MD, PGY-1, PGY-2, PGY-3) using an one-way analysis of variance. RESULTS We found that testing scores increased as the years of training growth. Significant differences were found on the testing score of information collection, diagnosis, and treatment, as well as total scores among different training years of medical students, but not of treatment errors. CONCLUSIONS We provided evidence of construct validity of CMU-CBCRT. It was able to distinguish CR skills over different levels of medical students on their early stage of medical career.