Statements on career intentions as predictors of career choices

In the study reported here, the author examined the relevance of students' statements on career intentions to predictions of career choices. Similar career intentions questionnaires were administered to the members of the 1973 University of Toronto Faculty of Medicine graduating class at the end of their first undergraduate year and three years later at graduation. Ten years after graduation, the professional activities and geographic locations of the class members were determined using available directories and registers. The study provided evidence of considerable congruence between the early statements on career intentions and the actual career dispositions 10 years after graduation.     

Timing and motivation in pediatric career choices

A total of 257 third-year residents in pediatrics, internal medicine, and family practice were asked about their career goals for the year following their residency and in five years, and information was obtained from them about their motives for career choices. The authors specifically examined the following: humanitarian interests; intellectual motivation; service motives; and practical, personal, and financial considerations. The characteristics of the residency training program which may have influenced their career choices were also examined. A majority of the 214 pediatric residents said they had not considered going into pediatrics on entry to medical school. Of these residents, 109 planned academic pursuits for the following year, while only 81 of the 109 anticipated an academic career within five years. Intellectual stimulation, geographic location, and an "opportunity to clarify goals" were the three most frequently mentioned factors in choosing positions for the following year.     

Primary care career choices and medical student learning styles.

The study reported here focused on the influence of medical students' learning styles (that is, how they prefer to receive and use information in learning and problem-solving situations) on (a) their choice of a medical career type and (b) their sources of information and influence in making that choice. The results suggest that those students with learning styles that are associated with primary care careers are also those who are dissatisfied with a traditional basic science curriculum and are influenced more than the average student by concrete work experiences, as well as identification with role models, in making a career decision. Among the implications of these results for medical school admissions, curricula, and faculty is the possibility that more students might consider primary care careers if more primary care experiences and role models were available in medical school.     

Factors associated with medical students' career choices regarding internal medicine

Karen E. Hauer, MD; Steven J. Durning, MD; Walter N. Kernan, MD; Mark J. Fagan, MD; Matthew Mintz, MD; Patricia S. O’Sullivan, EdD; Michael Battistone, MD; Thomas DeFer, MD; Michael Elnicki, MD; Heather Harrell, MD; Shalini Reddy, MD; Christy K. Boscardin, PhD; Mark D. Schwartz, MD

JAMA. 2008;300(10):1154-1164.

Context  Shortfalls in the US physician workforce are anticipated as the population ages and medical students' interest in careers in internal medicine (IM) has declined (particularly general IM, the primary specialty serving older adults). The factors influencing current students' career choices regarding IM are unclear.

Objectives  To describe medical students' career decision making regarding IM and to identify modifiable factors related to this decision making.

Design, Setting, and Participants  Web-based cross-sectional survey of 1177 fourth-year medical students (82% response rate) at 11 US medical schools in spring 2007.

Main Outcome Measures  Demographics, debt, educational experiences, and number who chose or considered IM careers were measured. Factor analysis was performed to assess influences on career chosen. Logistic regression analysis was conducted to assess independent association of variables with IM career choice.

Results  Of 1177 respondents, 274 (23.2%) planned careers in IM, including 24 (2.0%) in general IM. Only 228 (19.4%) responded that their core IM clerkship made a career in general IM seem more attractive, whereas 574 (48.8%) responded that it made a career in subspecialty IM more attractive. Three factors influenced career choice regarding IM: educational experiences in IM, the nature of patient care in IM, and lifestyle. Students were more likely to pursue careers in IM if they were male (odds ratio [OR] 1.75; 95% confidence interval [CI], 1.20-2.56), were attending a private school (OR, 1.88; 95% CI, 1.26-2.83), were favorably impressed with their educational experience in IM (OR, 4.57; 95% CI, 3.01-6.93), reported favorable feelings about caring for IM patients (OR, 8.72; 95% CI, 6.03-12.62), or reported a favorable impression of internists' lifestyle (OR, 2.00; 95% CI, 1.39-2.87).

Conclusions  Medical students valued the teaching during IM clerkships but expressed serious reservations about IM as a career. Students who reported more favorable impressions of the patients cared for by internists, the IM practice environment, and internists' lifestyle were more likely to pursue a career in IM.