Future medical student practice intentions: the South Africa experience

Abstract

Background Primary care is a broad spectrum specialty that can serve both urban and rural populations. It is important to examine the specialties students are selecting to enter, future community size they intend to practice in as well as whether they intend to remain in the communities in which they trained. Aim The goals of this study were to characterize the background and career aspirations of medical students. Objectives were to (1) explore whether there are points in time during training that may affect career goals and (2) assess how students’ background and stated motivations for choosing medicine as a career related to intended professional practice. Setting The setting for this study was the Nelson R. Mandela School of Medicine, located in Durban, South Africa. Methods We conducted a cross-sectional survey of 597 NRMSM medical students in their first, fourth, or sixth-year studies during the 2017 academic year. Results Our findings show a noticeable lack of interest in primary care, and in particular, family medicine amongst graduating students. Altruism is not as motivating a factor for practicing medicine as it was among students beginning their education. Conclusion Selection of students into medical school should consider personal characteristics such as background and career motivation. Once students are selected, local context matters for training to sustain motivation. Selection of students most likely to practice primary care, then emphasizing family medicine and community immersion with underserved populations, can assist in building health workforce capacity. There are institutional, legislative, and market pressures influencing career choice either toward or away from primary care. In this paper, we will discuss only the institutional aspects.

Career aspirations of specialty among medical students in sub-Saharan Africa: a systematic review and meta-analysis of data from two decades, 2000–2021

“…The proposed interventions include consideration of personal characteristics of students at the time of selection as a prerequisite for entry into medical school, having career motivation and measures to sustain student motivation. 33 Our results on motivators of career aspirations support these interventions.…”

“…Building a health workforce capacity, therefore, necessitates effective control over influences from several sources namely, individual, institutional and market forces since they push or pull students’ career aspirations to or away from primary healthcare or a given medical discipline. 33 There is also a need to provide career counselling 34 with focus on influencing student attention towards equitable distribution of specialised human resources. 35 Governments will also need to put in place policies for distribution of resources for training to ensure that the required career aspirations are supported.…”

Students’ intentions to practice primary care are associated with their motives to become doctors: a longitudinal study

“…In Switzerland, PCPs work predominantly in private practice, explaining the importance of this motive, which has also been found in other countries with a similar practice context [ 15 ]. Altruistic motives have already been related to primary care career choices in previous studies [ 14 , 22 , 44 ], even in the context of an educational culture encouraging specialization [ 45 ]. Our findings expand on this knowledge by adding the longitudinal perspective showing that the motive of altruism was consistently associated with primary care career intentions over the four study years.…”

Specialties preference by gender among medical students at Sefako Makgatho Health Sciences University, South Africa

“…The questionnaire was developed by the researchers using relevant literature. 18 , 19 , 28 , 29 The tool collected information on socio-demographic characteristics such as age, gender, previous qualification, intention to pursue postgraduate medical training and their speciality of choice. To determine the participants choice of specialty, the following question was asked ‘What is your planned future speciality?’ The tool was given to the panel of experts in research to evaluate its face and content validity (i.e.…”

“…14 , 18 , 20 , 22 , 25 , 26 Few studies on career preferences within the South African context have been conducted in medical schools among students in various academic levels. 18 , 19 , 28 , 29 Most of these studies have been conducted for long period, and such research is needed again for an update. 18 , 19 , 29 In our institution, no studies investigated career preferences and which specialities are mostly preferred.…”