Objectives
To gain insight into
factors affecting career preference and career choice during the final phase of
medical school, above and beyond a model that was presented by Bland and
colleagues in 1995 (the "Bland model").
Methods
A qualitative study was
conducted. One-hour semi-structured interviews were conducted with final-year
medical students about career preference and the factors influencing preference
and choice. The interviews were transcribed and a thematic analysis was
applied, to identify patterns and interrelationships in the data and to compare
and contrast these with the Bland model.
Results
Twenty-four students
participated. Three critical sets of factors, not present in the Bland model,
emerged from the interviews: (a) factors arising from student-initiated
information collection, (b) patient population characteristics of a specialty
domain, and (c) the characteristics of teams and colleagues within a specialty.
Conclusions
Students appear to actively match and calibrate
perceptions of different specialty characteristics with their current personal
needs and expected future needs, and to include cues from self-initiated
information collection about a speciality. This agency aligns with Billett's
workplace learning theory. Next, specialty patient population features appear
to be taken into account; this was not unexpected but not included in the Bland
model. Finally, the characteristics of teams and colleagues of a specialty were
stressed in the interviews. These three components broaden the applicability of
the Bland model--originally created for primary-care careers--to medical
specialties in general.