Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland

Abstract

Background: Specialty career choice is a critical decision for medical students, and research has examined factors influencing particular specialties or assessed it from a demographic perspective. The purpose of this study was to explore and describe influential factors in students' decision-making, irrespective of their particular specialty in a Canadian medical school.Methods: Study participants were recruited from fourth-year medical classes at the Memorial University of Newfoundland in 2003, 2006, 2007 and 2008. Sixteen focus groups (n = 70) were led by a nonfaculty facilitator to uncover factors affecting medical student career choice. The analysis was guided by principles of grounded theory methodology. The focus group transcripts were sequentially coded based on recurring topics and themes that arose in the students' discussions. A set of key themes emerged and representative quotations for each theme were tracked.Results: Twenty themes were identified from the focus group discussions: 7 major, 3 intermediate and 10 minor themes. The major themes were undergraduate experience, exposure, public perception and recruitment, teacher influence, family/outside influences, residency issues and personal philosophy. Intermediate themes included lifestyle, bad-mouthing/negative perceptions and context. Minor themes included critical incidents/experiences, information gaps, uncertainty, nature of the work, extracurricular programs, timing of decision-making, financial issues, prestige, fit with colleagues and gender issues.Interpretation: Exposure to specialties and the timing of this exposure appears to be crucial to career choice, as does the context (who, what, when, where) of any particular rotation. Given the influence of personal philosophy, future research examining students' level of self-assessment and self-reflection in their decision-making processes and level of certainty about their selected specialty would be useful. Abstract Research CMAJ OPEN E148CMAJ OPEN, 4(2) Methods SettingThis is a qualitative study using focus groups to determine what factors influence medical students' career choice. Medical students at the Memorial University of Newfoundland in the graduating classes of 2003, 2006, 2007 and 2008 were invited to participate in focus groups. Memorial University's medical school program is 4 years long, where the first 2 years are mostly classroom-based and the final 2 years are clinically based. The preclerkship curriculum included exposure to rural practice for 10 days each year. The mandatory clinical rotations are completed in the third year of study, whereas there are elective opportunities from September to November in fourth year. The students have surgical selective opportunities after the Canadian Resident Matching Service (CaRMS) ranking deadline in fourth year. Study participants were recruited from fourth-year classes in 2003, 2006, 2007 and 2008. Classes were approached as a whole to describe the focus group and identify it as part of the longitudinal survey in which they had part...

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