A thematic network for factors affecting the choice of specialty education by medical students: a scoping study in low-and middle-income countries

Abstract

Background Medical specialty selection is a complex phenomenon that can affect the performance of health systems, community health, and physicians’ lives. It is essential to identify the key factors influencing the choice of specialty for evidence-based policymaking. This scoping review aimed to provide a comprehensive map of evidence regarding the factors influencing the choice of specialty by medical students (MS) in low-and middle-income countries (LMICs) and also to determine knowledge gaps. Methods We carried out a systematic search on six online databases from January 2000 to May 2020. We used a five-step scoping review method proposed by Arksey and O’Malley. We synthesized the data using a quantitative content analysis approach. Then, we developed a thematic network as a conceptual map for a better understanding of the concept. Results The analysis led to the development of five main themes, including personal determinants, life fulfillment aspects, influential career aspects, educational determinants, and interpersonal effects. Moreover, the most frequent sub-themes were specific personal factors, controllable lifestyle, quality of working life, and future working conditions. Conclusion This review provided evidence on the factors influencing the choice of specialties. In order to support physician workforce policy with more precise evidence, it is necessary to explore the weight and ranking of these factors based on the socioeconomic contexts of the countries. This study also indicated that factors such as ethical values, various aspects of medical philosophy, and immigration tendencies are areas for further investigations.

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

“…The number and type of specialists required is also based on the existing number of specialists in each discipline and their spatial distribution [ 2 , 4 ]. This has resulted in an ever-growing body of literature on medical specialist career choices among medical students and medical graduates [ 5 , 6 ]. Yet, to date, to the best of our knowledge only two other studies have reported psychometric properties of questionnaires used to study the motivators for selected medical specialist career choices [ 14 ].…”

“…The items to be included as probes were discussed among the authors (AN and CTS) until a consensus was reached. Additional items to be included as probes were also derived from published systematic reviews and individual studies reported from Malaysia [ 5 – 7 ].…”

“…Cross-sectional questionnaire survey studies among medical students and interns/house officers have reported that the choice of medical specialist career is influenced by several factors. These factors are the prestige of the specialty, income from the specialty, a preference for hospital-based practice in urban locations, experience during clinical postings, academic role models, career progression prospects, the flexibility of work arrangements, and work-life balance [ 5 , 6 ]. Advice from family, friends, physicians, personal life events, and an interest in working in community-based settings may also influence their choice [ 7 ] .…”

“…Qualitative studies have provided deeper insights into the factors that influence medical specialist career choices of medical students or graduates [ 11 – 13 ]. According to systematic reviews, most published studies employed non-validated ad hoc questionnaires to explore reasons or motivations for medical specialist career choices [ 5 , 6 ]. Considering this, the Career Preference Factors Scale (CPFS) was developed to assess the motivators that drive the decision process of medical graduates about their specialist career choice [ 14 ] .…”

What do Iranian physicians value most when choosing a specialty? Evidence from a discrete choice experiment

“…The main themes that emerged from the scoping review were used to develop a topic guide for the qualitative study. The findings of the review study are published in a separate report [ 36 ]. In the second stage, 41 in-depth interviews were conducted with medical students (N: 12), junior doctors (N: 11), and medical residents (N: 18) to identify the most important determinants of specialty selection in Iran.…”