Attitudes of the 1984 medical graduates of Sri Lanka to anaesthesia

A total of 196 intern medical officers who had graduated from the four medical schools in Sri Lanka in 1984 indicated their attitudes towards anaesthesia as a medical specialty in response to a postal questionnaire. Eighty per cent of the graduates considered anaesthesia to be an established specialty in Sri Lanka, while 17% felt that the specialty had limited clinical application. A total of 62% of the graduates were not aware, prior to their entry to medical school, that anaesthesia was related to medical practice. All the graduates indicated that the intra-operative role of the anaesthetist was on a par with that of the surgeon, but 40% felt that the pre- and post-operative roles were of a secondary nature. Overall, 42% considered that an anaesthetist acts as an assistant to the surgeon. The graduates were of the opinion that only 35% of the patients undergoing surgery were appreciative of the services rendered by an anaesthetist. Fifty per cent of the graduates considered exposure to the specialty in the undergraduate curriculum as inadequate. Anaesthesia was chosen as the first career preference by 1.5%. The dominant reasons for not selecting anaesthesia as a career specialty were: minimal patient contact and patient recognition (62%), and lack of recognition of the specialty by society (54%). Anaesthetists in Sri Lanka are challenged to alter the perceptions associated with the specialty, which are probably a result of chronic staff shortages restricting practice to the confines of operating theatres.     

Early medical career choices and eventual careers

The revised structure of hospital specialist training being introduced in the United Kingdom means that a doctor wanting a career in a hospital specialty will need to be confident that his or her early career choice, made within 3 years of qualification, is realistic. Using data from a longitudinal study of the 1983 cohort of UK medical graduates, the early career choices made by over 2000 doctors were compared with their employment 11 years after qualification. At year 11 65% of the doctors were working within the first choice they had expressed towards the end of their pre-registration year, and 79% were employed in their year 3 first choice. There was, however, important variation within this general picture: lower predictive value was associated with choices made by women; choices for hospital mainstreams rather than for general practice; and choices that were less than definite. The recent drop in popularity of general practice as a career choice of new graduates in the UK, and the steady increase in the proportion of women graduates, mean that the predictive value of the career choices of recent graduates may prove to be lower than that of the 1983 cohort.     

Relationship between US medical school admission policy and graduates entering family practice

Rural areas in the United States continue to lack an adequate supply of primary care doctors, particularly family physicians, despite the oversupply of physicians nationally. Previous studies have provided strong evidence that students from rural backgrounds, as well as those who expressed an interest at the time of medical school admission for a career in family medicine, are significantly more likely to eventually practise family medicine in rural areas than their peers. US medical schools were classified into three groups based on their written selection factors for preferentially admitting students into the graduating class of 1982. Of those schools with selection factors for students from both a rural background and an interest in a future career in family medicine, 23.7% of their graduates entered family medicine training programmes. This compares with 14.5% of graduates from schools with a preference for students from a rural background, and 12.4% from all other schools (P less than 0.001). Coupled with previous data which shows that family physicians from rural areas are more likely to eventually practise in rural areas than their peers, preferentially admitting students from rural backgrounds interested in a career in family medicine could help to solve the problem of the shortage of primary care physicians in rural areas in the US.     

UK consensus statement on the content of communication curricula in undergraduate medical education

Context The teaching and assessment of clinical communication have become central components of undergraduate medical education in the UK. This paper recommends the key content for an undergraduate communication curriculum. Designed by UK educationalists with UK schools in mind, the recommendations are equally applicable to communication curricula throughout the world. Objectives This paper is intended to assist curriculum planners in the design, implementation and review of medical communication curricula. The document will also be useful in the education of other health care professionals. Designed for undergraduate education, the consensus statement also provides a baseline for further professional development. Methods The consensus statement, based on strong theoretical and research evidence, was developed by an iterative process of discussion between communication skills leads from all 33 UK medical schools conducted under the auspices of the UK Council of Clinical Communication Skills Teaching in Undergraduate Medical Education. Discussion How this framework is used will inevitably be at the discretion of each medical school and its implementation will be determined by different course designs. Although we believe students should be exposed to all the areas described, it would be impractical to set inflexible competency levels as these may be attained at different stages which are highly school‐dependent. However, the framework will enable all schools to consider where different elements are addressed, where gaps exist and how to generate novel combinations of domains within the communication curriculum. It is hoped that this consensus statement will support the development and integration of teaching, learning and assessment of clinical communication.     

Variation by medical school in career choices of UK graduates of 1999 and 2000

OBJECTIVE: To report on how newly qualified doctors' specialty choices, and factors that influenced them, varied by medical school. DESIGN: Postal questionnaires. SETTING: United Kingdom. SUBJECTS: All doctors who graduated in the UK in 1999 and 2000. MAIN OUTCOME MEASURES: Choices of eventual career expressed 1 year after graduating, and factors influencing their choices. RESULTS: There were some significant differences between medical schools in the career choices made by their graduates. For example, the percentage of respondents who expressed the choice of general practice was significantly low among graduates of Oxford and Cambridge and high among graduates of Birmingham and Leicester. There was also significant variation between medical schools in choices for hospital medical and surgical specialties. There were significant differences, too, between medical schools in the extent to which career choices had been strongly influenced by graduates' inclinations before starting medical school and by their experience of their chosen specialty, particular teachers and departments at medical school. As well as the differences, however, there were also many similarities between the schools in graduates' career choices. DISCUSSION: Medical schools currently provide students with a broad training suited to any subsequent choice of specialty. We suggest that the similarities between schools in the career choices made by graduates are generally more striking than the differences. We raise the question of whether there should be any specialisation by individual schools to train students for careers in particular branches of medical practice.     

Career preferences of the 1984 medical graduates of Sri Lanka

A total of 196 graduates from the four medical schools in Sri Lanka responded to a postal questionnaire on their career preferences and factors influencing the choice of specialty. Medicine (38%), surgery (21%), paediatrics (15%) and obstetrics (12%) were the most popular choices. 'Service' specialties such as anaesthesia (1.5%), pathology (1.5%) and radiology (1%) were strikingly less attractive. Community medicine (2%) and general practice (2%) were similarly unattractive; medical administration (0.5%) was the least popular choice. In the choice of a career, opportunity for direct contact with patients (59%) was the most important determinant when compared to financial reward (12%), social prestige (10%) and fixed hours of work (12%). Research prospects (6%) and teaching opportunity (5%) were relatively unimportant considerations. The graduates preferred employment in the state health service (65%) to teaching in the clinical departments of medical schools (26%) and full-time private practice (7%). Pre- and paraclinical departments of medical schools attracted only 2% of the graduates. A total of 80% of the graduates wished to practise in the capital city or a major provincial city, while 10% chose to seek employment overseas. These results will be useful in planning undergraduate and postgraduate education, and in designing policies to attract manpower to the scarcity and high priority disciplines, so that the imbalances encountered would be minimal in the future.     

Curriculum change: the importance of team role

This paper describes a study examining aspects of team role in the management of curriculum change. The Belbin Team Role Self-Perception Inventory was completed by 25 members (83%) of a faculty curriculum development team. Overall the group showed a preference for the implementer and shaper roles, whilst the completer-finisher role was relatively weakly represented, ranking fifth out of eight possible roles. Older and more senior team members favoured the co-ordinator role, whilst younger and more junior members favoured the team-worker and completer-finisher roles. Some implications of these findings are discussed in the light of the current trend for widespread change in undergraduate medical curricula and the challenges faced by medical schools in a resource constrained environment.     

Are differences between graduates and undergraduates in a medical course due to age or prior degree?

BACKGROUND: The number of medical programmes targeted at graduates is increasing and there are reports of beneficial outcomes. However, many new graduate medical schools have simultaneously changed their admission criteria and curricula. This study aimed to determine whether there were differences between graduates and undergraduates on the same medical course and to establish which differences might be due to having a prior degree, the course itself or age at entry to medical school. METHODS: A questionnaire-based survey was administered to all students in Years 2-5. It included the Study Process Questionnaire, the Achievement Motivation Profile and Likert scale questions on career. RESULTS: Questionnaires were completed by 587 students (response rate 80.3%), of whom 143 had a prior degree. Whilst having a prior degree was associated with many outcomes, for most this disappeared, and the overall predictive ability of the model improved when age was included. Age at entry to medical school brought certainty and motivation about career choice, a prior degree had some effect on approaches to studying and co-operativeness, while the course itself had effects on most outcomes, some of which were positive and some negative. CONCLUSION: Graduates bring a distinct quality to a course but many of these relate to a student's age. Older age at entry may be more important than having a prior degree.     

Career preferences of graduate and non-graduate entrants to medical schools in the UK

OBJECTIVE: Recent UK policy has been to increase substantially the number of graduate entrants to medical schools. Our aim was to study whether graduate and non-graduate entrants have different long-term career preferences. METHODS: We conducted postal questionnaire surveys of medical qualifiers from all UK medical schools in 1999, 2000 and 2002, surveyed 1 year after qualification, and qualifiers of 1999 and 2000, surveyed 3 years after qualification. RESULTS: By Year 3 after qualification, general practice was the choice of 33% of men graduate entrants and 21% of men non-graduates ( = 12.5, P < 0.001) and of 43% of women graduates and 38% of women non-graduates ( = 1.6, P = 0.2). Surgery was a much less popular choice for men graduate entrants than for men non-graduates; but similar percentages of women graduate and non-graduate entrants chose surgery. A lower percentage of graduate entrants than of non-graduates favoured paediatrics. Other differences between graduates and non-graduates were generally small. General practice was the preferred career for a much lower percentage of those who took an intercalated degree while at medical school, than of those who did not. CONCLUSIONS: Increasing graduate entry to medical school is likely to increase the percentage of doctors who want to become general practitioners, but only modestly so. It may also lead to a decline in the percentages choosing surgery and paediatrics. Otherwise, at least on the current criteria used for selecting students, increasing graduate entry will probably not make much difference to the percentage of newly qualified doctors seeking careers in different branches of practice.     

Career choices for paediatrics: national surveys of graduates of 1974-2002 from UK medical schools

BACKGROUND: Knowledge of UK doctors' career intentions and pathways is essential for understanding future workforce requirements. The aim of this study was to report career choices for and career progression in paediatrics in the UK. METHODS: Postal questionnaire surveys of qualifiers from all UK medical schools in nine qualification years since 1974. RESULTS: In total, 74% (24 621/33 412) and 73% (20 720/28 459) of doctors responded at 1 and 3 years after graduation. Choices for paediatrics 1 year after qualifying fell from 7.8% of 1974 graduates to 5.0% of 1983 graduates, increased to 7.2% of 1993 graduates, and since the level has remained fairly constant. Approximately twice the percentage of women graduates than men graduates indicated a long-term career choice for paediatrics. A total of 44% of those who chose paediatrics 1 year after graduation were working in it 10 years after qualifying. Experience of the subject as a student, and enthusiasm/commitment: what I really want to do, affected long-term career choices more for paediatrics than for other medical careers. CONCLUSIONS: The proportion of junior doctors wishing to become paediatricians has not changed much during the last 30 years. The planned increase in the number of medical school graduates is necessary to increase the number of UK-trained consultant paediatricians. Medical students who experience enthusiastic and stimulating training in paediatrics may be more likely to become paediatricians.     

Some notes on the admission of graduate applicants to the medical schools

A survey of the admissions policy adopted by the medical schools towards older applicants, and in particular graduate applicants, has been carried out. Some 1000 graduates applied for places in 1976, of whom about one in six was successful (compared with one in four for all applicants). The academic requirements for this category of student are normally at least an upper second class degree, age maxima vary from 25 to around 30 years and, increasingly, schools require a financial guarantee from students not in receipt of a Local Education Authority grant. A minority of medical schools reserve a proportion of places for older applicants, but only a very small minority of schools will consider reducing the length of their course for graduate entrants.
These factors are tabulated for each of thirty-one of the medical schools in the United Kingdom and the Irish Republic.     

MHA admission criteria and program performance: do they predict career performance?

The purpose of this study was to determine to what extent admission criteria predict graduate school and career performance. The study also analyzed which objective and subjective criteria served as the best predictors. MHA graduates of the University of Minnesota from 1974 to 1977 were surveyed to assess career performance. Student files served as the data base on admission criteria and program performance. Career performance was measured by four variables: total compensation, satisfaction, fiscal responsibility, and level of authority. High levels of MHA program performance were associated with women who had high undergraduate GPAs from highly selective undergraduate colleges, were undergraduate business majors, and participated in extracurricular activities. High levels of compensation were associated with relatively low undergraduate GPAs, high levels of participation in undergraduate extracurricular activities, and being single at admission to graduate school. Admission to MHA programs should be based upon both objective and subjective criteria. Emphasis should be placed upon the selection process for MHA students since admission criteria are shown to explain 30 percent of the variability in graduate program performance, and as much as 65 percent of the variance in level of position authority.     

Examination performance and the future careers of Aberdeen medical graduates

School certificate attainment, performance at medical school, and early postgraduate career, were linked in a study of five cohorts of Aberdeen medical graduates. The results show a measure of correlation but it is argued that the time has come for long-term prospective research into the validity of selection of entrants to medical schools.     

The early career progress of baccalaureate healthcare management students

Programs in healthcare management are increasingly asked to demonstrate program outcomes by identifying graduates working in the profession of healthcare management. In particular, standards under AUPHA's certification process for undergraduate programs require that programs identify programmatic and educational outcomes. However, little is known about the career track of undergraduate healthcare management graduates. This paper describes management roles and settings for the graduates of a baccalaureate program in healthcare management, and presents salary and career progression information obtained from a recent alumni survey. Findings and implications are important to highlight the success of program graduates, and support the value of undergraduate programs in healthcare management.     

Development of an interest in a career in public health during medical school

OBJECTIVES: In The Netherlands, approximately 12% of medical graduates spend their professional life in public health, but it is the authors' belief that few of them become interested in such a career during medical school. The aim of this study was to investigate students' development of interest in a career in a public health specialty during medical school. METHODS: A written questionnaire was completed by students of all years at a Dutch medical school in 2002 (n=1371) and 2003 (n=1293). Students indicated their interest in a career in 37 Dutch medical specialties. Three public health specialties were distinguished and compared with the least popular specialty, the most popular specialty and with the average interest over all specialties. RESULTS: Interest in a career in occupational health and social insurance health was low throughout medical school. However, almost 15% of students indicated a high level of interest in youth health care in the first year of medical school, which is over twice as many as for the average specialty. This percentage decreased dramatically during medical school. At graduation, all three public health specialties had interest figures well below the average. CONCLUSIONS: Students have little interest in careers in public health. However, given that approximately 12% of medical graduates spend their professional life in public health, the factors that influence career preferences should be investigated. Targeted measures may yield more primary career preference in this direction. Reasons for the loss of interest in youth health care need to be investigated.     

Choice of general practice for postgraduate training among medical graduates and undergraduates in Nigeria

A questionnaire survey of career choices was carried out among 112 medical graduates, after one year's internship (group I), during their National Youth Corps programme in Kaduna, Lagos, Cross River and Oyo states of Nigeria, and 365 final-year medical undergraduates (group 2) in the colleges of medicine in the corresponding states. A total of 13% in group I and 40% in group 2 were undecided as regards their first choice. Obstetrics and gynaecology was the most popular first choice in both groups. General practice ranked fifth among group I, but displaced surgery to rank second among group 2. The differences were statistically significant. A total of 41% of group I and 46% of group 2 preferred to work in a teaching hospital, reflecting the high preference for surgical specialties. Twenty-six per cent and 33.7% of respondents in groups 1 and 2 respectively wished to own their own practice or work in the private sector. General practice is a new specialty and its growth is supported by a national postgraduate training programme. A shift towards general practice is seen compared with previous studies of career preference among Nigerian medical graduates and students. This may be due to a changing balance of supply and demand in the medical work-force, or a better assessment of the nation's health problems and manpower needs.     

The careers of men graduates from the Royal Free Hospital School of Medicine, London

The survey records the data supplied by the 290 respondents to a questionnaire sent out to the first 390 male graduates of the Royal Free Hospital School of Medicine who qualified during the 20 year period after the school became co-educational in 1948. As might have been expected, there was a preponderance of students from homes in Greater London and South East England. Whilst an equal entry of male and female students was felt desirable the achievement of this objective was slow, since selection was based on merit and the male applicants in the first few years seemed less well qualified for the medical training. During the period of the survey half of the entry was at the premedical stage and the average age for starting preclinical studies was 20.0 years—a little higher than that (18.9) recorded in the ASME survey for the 1966 entry to medical schools. A slightly higher number of Royal Free men took higher degrees and diplomas than did the women. On the number available it appeared that a higher percentage of Royal Free men took MRCP as compared with women or Birmingham graduates. The DA and DCH qualifications were more favoured by women than men. Three times as many men worked in, and twice as many lived in London as in South East England, a situation that was the reverse of that for Royal Free women. There was no evidence to show that the men preferred to do career training in London and then move out. A greater number of Royal Free men and women were doing hospital work rather than general practice, in contrast with Birmingham graduates, although it would seem likely from the expressed career preferences that a considerable number of the Royal Free men would eventually take up general practice. A much greater number of Royal Free men than Birmingham graduates were practising surgery. Medicine and obstetrics were more favoured by Royal Free men than women or Birmingham doctors. The Royal Free women favoured anaesthetics, paediatrics, pathology and physical medicine as specialities as compared with the men. Of the respondents 5.4% were practising psychiatry as compared with 5.1% of Royal Free women and 4.4% and 4.3% of Birmingham graduates and those in the ASME survey, respectively. The survey showed that the respondents considered themselves to require training until about 6 years after qualification, 43.7% thought this was best done in a hospital post. In the majority of cases a definite career decision was made by Royal Free men within 3–5 years after qualification. About equal numbers chose hospital work with continuing patient responsibility and general practice as first choice for their career, though the numbers of Royal Free men with the preference for general practice was not in agreement with the number actually doing this type of work. For the location of the work there was a marked aversion to large provincial communities, London, South and South West England being favoured. Of the respondents, 14.5% had taken permanent appointments abroad and 13% had made arrangements to do so. The view quoted by Kilgour (1971) that financial benefit was not the strongest motivation for emigration was confirmed in the survey.     

Influence of training changes on the stability of specialty choices of UK medical graduates: surveys of the graduates of 2002 and 2008

ObjectivesTo explore the impact of Modernising Medical Careers (MMC) training on the stability of medical career choices in the UK.SettingUKParticipantsGraduates of 2002 and 2008 from all UK medical schools, 1 and 3 years postgraduation.DesignQuestionnaire surveys were conducted of 2002 and 2008 graduates from all UK medical schools 1 and 3 years post graduation.Results2008 graduates were a little more likely than graduates of 2002 to retain their year 1 choice in year 3 (77.3% vs. 73.3%; p = 0.002). Among 2008 graduates, the percentage retaining their year 1 choice varied between 42% (clinical oncology) and 79% (general practice). Enthusiasm for a specialty, student experience and inclinations before medical school were associated with choice retention; consideration of domestic circumstances and hours/working conditions were associated with changes of choice. 2008 graduates were more likely than 2002s to be influenced by enthusiasm for a specialty, self-appraisal of their skills, working hours and their domestic circumstances; and less likely to be influenced by their experience of jobs, a particular teacher/department or eventual financial prospects.ConclusionsPost-MMC, graduates were less likely to change their career choice and more likely to be motivated by personal factors and self-assessment of their suitability to a particular area of work.     

Associations between medical school and career preferences in Year 1 medical students in Scotland

Medical Education 2012: 46 : 473–484 Objectives Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students’ medical training. Methods Year 1 (2009–2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors. Results The response rate was 87.9% (883/1005). No significant differences were found among medical schools with regard to first‐choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work–life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job‐related factors by most respondents. Few differences were found among schools in terms of the impact of job‐related factors on future career preferences. Students for whom the work–life balance was extremely important (odds ratio [OR] = 0.6) were less likely to prefer surgery. Students for whom the work–life balance (OR = 2.2) and continuity of care (OR = 2.1) were extremely important were more likely to prefer general practice. Conclusions Students’ early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work–life balance is very important to tomorrow’s doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students’ career preferences change as they progress through medical school and training.     

Careers in medicine: appointment to specialist training posts in Queensland in 1988

Appointments to accredited specialist training positions in the State of Queensland, Australia in 1988 were analysed to show the success rates of applicants. Women were less likely to apply for training, but gained proportionately more appointments than men. Other factors in success were application from a major teaching hospital, graduation from the State medical school and, for new applicants, an honours degree. The success rates in various specialties differed significantly as did their appeal to women and to honours graduates. It is concluded that new graduates need better information and advice on career choice and that individual disciplines need to look carefully at the image and organization of their training programmes.