Specialty choice determinants among Mexican medical students: a cross-sectional study

Abstract

BackgroundThe choice of medical specialty is related to multiple factors, students’ values, and specialty perceptions. Research in this area is needed in low- and middle-income countries, where the alignment of specialty training with national healthcare needs has a complex local interdependency. The study aimed to identify factors that influence specialty choice among medical students.MethodsSenior students at the National Autonomous University of Mexico (UNAM) Faculty of Medicine answered a questionnaire covering demographics, personal experiences, vocational features, and other factors related to specialty choice. Chi-square tests and factor analyses were performed.ResultsThe questionnaire was applied to 714 fifth-year students, and 697 provided complete responses (response rate 81%). The instrument Cronbach’s alpha was 0.8. The mean age was 24 ± 1 years; 65% were women. Eighty percent of the students wanted to specialize, and 60% had participated in congresses related to the specialty of interest. Only 5% wanted to remain as general practitioners. The majority (80%) wanted to enter a core specialty: internal medicine (29%), general surgery (24%), pediatrics (11%), gynecology and obstetrics (11%) and family medicine (4%). The relevant variables for specialty choice were grouped in three dimensions: personal values that develop and change during undergraduate training, career needs to be satisfied, and perception of specialty characteristics.ConclusionsSpecialty choice of medical students in a middle-income country public university is influenced by the undergraduate experience, the desire to study a subspecialty and other factors (including having skills related to the specialty and type of patients).

Factors influencing medical students’ choice of specialization: A gender based systematic review

“…2009 [39] New Zealand (O) QT 87 First to fifth year 0.25% 37.0% NA 11 Average Enoch L. 2013 [40] USA (O) QT 145 Forth year 88.0% 54.0% 26.2 (1.6) 12 Average Fehlmann A. 2019 [41] Switzerland (O) QT 1749 Final year 56.0% 37.0% NA 15 Good Grasreiner D. 2018 [42] Germany (O) QT 720 First to sixth year 13.1% 24.9% 24 11 Average Gutierrez-Cirlos C. 2019 [43] Mexico (NO) QT 697 Final year 81.0% 35.0% 24 (1) 13 Good Hamid S. 2019 [44] Pakistan (NO) QT 314 Fourth and final year 54.5% NA 22.63 (1.473) 12 Average Ibrahim M. 2014 [45] UK (O) QT 641 Final year and graduate 12.0% 44.0% NA 12 Average Ie K. 2018 [46] Japan (NO) QT 1408 Final year students' 74.0% 66.3% 24 14 Good Kawamoto R. 2016 [47] Japan (NO) …”

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

“…A-2-Economic concerns: economic and financial concerns are among the highly discussed factors (N: 20, 69%) regarding the choice of specialty. This sub-theme has three categories including future income [31,41,56], other financial incentives (such as some financial rewards, and less investment) [41,44,54], and status of financial dependency [42].…”

“…Working conditions reflect the characteristics of a specialty as a career. These conditions include working schedules [46,51], workfamily compatibility [42,49], autonomy [23,32], future practice location [35,39], concern about malpractice consequences [47], and prospects for further development [31,45].…”

“…This factor explains the particular features of a specialty as a career. These features include diversity of patients [36,42], extent of interaction with patients [43,50], existence and amount of on-call or emergency schedule [17,46], as well as Intellectual challenging field [33,47].…”

“…C-1-Specific personal factors: this review revealed that the most frequent determinants of specialty selection (N: 23, 79.3%) were personal factors. These factors include personal interest [17,39,48], personal competencies [34,50], personality type [37,51], personal or relatives experience of a specific disease [38,42], and personal awareness of the specialty [44,51].…”