The Significance of Experiencing Clinical Responsibilities for Specialty Career Choice

Abstract

Aim Medical trainees make career choices in the final year of medical school or after graduation, if they do not continue with residency directly. Most Dutch medical students are trained in vertically integrated (VI) curricula, with early clinical experience and a gradual increase in clinical responsibilities. Students in such curricula have been reported to make career choices at an earlier stage than graduates from more traditionally designed curricula. Many Dutch graduates build further clinical experience after graduation as physicians-not-in-training (PNITs) before beginning residency. We explored how students make career choices and whether pre-residency clinical responsibilities influence this choice. Method A qualitative study with a phenomenology approach was used. The authors conducted a longitudinal interview study of medical students with two intervals over a 2-year period. The interview questions covered how trainees establish career preferences and which factors affect preference and choice over time. Results Experiencing clinical responsibility was a key factor for career preference during all interview rounds. Being a PNIT who makes diagnostic and therapeutic decisions, have their own patients and have significant patient care responsibilities creates opportunities to build an image of a future context of employment. Some participants mentioned that their experience of having full responsibility as a PNIT was pivotal in a career preference change. Conclusion Clinical responsibility as a student or a PNIT appears to be important for career preference and choice. The experience of responsibility as a medical doctor forces trainees to reflect on personal needs and to consider which career preference fits best.

Traveling by winding roads or highways: Stability of medical students’ specialty preferences over time

“…training appears to be important for career preference (Querido et al 2019). This forces trainees to reflect on personal needs and to consider which career fits best.…”

“…They could withdraw from the study at any time without giving a reason. The research proposal was approved by the Ethical Review Board of the Dutch Association for Medical Education (NERB #308) and included a larger study (Querido et al 2019) to explore students' considerations in making a career choice. The focus of the current study is merely on career stability over time, but the interview study provided the data to explore this stability.…”

“…Most graduates do not directly continue residency after medical school. This period contributes in making the career choice (Querido et al 2019).…”

Offsetting Burnout Among Medical Cadets During Internship Year: The Role of Empowerment, Continuous Appraisal, Psychological and Career Counseling. An 18-Months Successful Experience in a Tertiary Medical Center.

“…In the qualitative study conducted by Sophie Querido and Co. Experiencing clinical responsibility was found to be a key factor for career preference (14). Their conclusion was that by receiving clinical responsibility the students are forced to re ect on their personal needs and to think in depth about the best career choice for them.…”

Building a continuum Competence development from student to medical specialist

“…The 'intercurricular' period between undergraduate and postgraduate education, in which recent graduates work as a physician-not-in-training, has importance for professional identity formation and career orientation [97]. Currently, a follow-up study of ACTY graduates is conducted to illuminate their specialty choices and career paths toward the attainment of postgraduate training posts, as enhanced preparedness and competence in the ACTY could shorten the 'intercurricular' period.…”