A Study of the Hesitation of Choosing a Clinical Speciality in Medical Students of the Medical Sciences Universities of the Country:2023

Subject Areas : Health Management Services

Atefeh Pourhossin ¹ , bagher pahlavanzadeh ² , Armin Khaleghjoo ³ , mohammad Mahboubi ⁴

1 - Medical student, Abadan University of Medical Sciences
2 - Assistance professorSchool of Health,Abadan University of Medical Sciences, Abadan, Iran
3 - Assistant Professor, Pediatrics Department of Clinical Sciences, Faculty of Medicine, Shahid Beheshti Hospital, Abadan University of Medical Sciences, Abadan, Iran
4 - Associate Professor, Health Services Management, Department of Public Health, Faculty of Health, Abadan University of Medical Sciences, Abadan, Iran

Received: 2024-01-15 Accepted : 2024-06-09 Published : 2024-10-22

Keywords: Clinical Expertise, Doubt, Medicine, Student.,

Abstract :

Introduction: Uncertainty in the choice of medical speciality is one of the challenges of medical students' decision-making throughout the country, so this study investigated the uncertainty in the preference of clinical speciality among medical students of medical universities in Iran in 2023.

Methods: This cross-sectional descriptive-analytical study was performed on 188 medical students aged 5th and above by available sampling method in 2023. Data were collected using a valid and reliable questionnaire of clinical hesitancy with 38 questions in 4 dimensions (general doubt, decision postponement, decision-making barriers and indecisiveness). A tree map diagram was used to describe the samples and to compare the uncertainty in selecting clinical expertise and its components in the demographic subgroups of students, Mann-Whitney and Kruskal-Wallis tests were used using SPSS version 27.

Results: Of the 188 participating students, 63.5% (115) were female and the rest were male. The most frequent age of participants (112 people) was 25-29 years old. 47.5% (86 students) had a history of education of 8 years or more. 33.1 (60 students) were willing to start specialisation immediately after completion of the project. Radiology, dermatology, cardiology and ENT specialities were the most popular and forensic medicine, paediatrics, general surgery and emergency medicine majors were the least interested in selecting the speciality.

Conclusion: The popularity of some specialized medical disciplines in the country is a wake-up call for the empty seats of most of the required specialities in the country, which has been sounded. The popularity of some specialized fields for specific reasons will result in the concentration of specialities in some well-to-do cities and deprive cities of some vital specialities. Careful strategic planning is emphasised by health policymakers.

References:

1- Shahabi M, Tofighi S and Maleki MR. The nurse and specialist physicians manpower distribution by population and its relationship with the number of beds at public hospitals in iran’s; 2001-2006. Journal of health administration, 2010; 13: 7-14.
2- Hongoro C, McPake B. How to bridge the gap in human resources for health. Lancet (London, England), 2004; 364: 1451-6.
3- Lehmann U, Dieleman M, Martineau T. Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention. BMC Health Services Research, 2008; 8.
4- Kaliyadan F, Amin TT, Qureshi H, Al Wadani F. Specialty preferences of 1(st) year medical students in a Saudi Medical School - Factors affecting these choices and the influence of gender. Avicenna J Med. 2015; 5: 134-9. doi: 10.4103/2231-0770.165120. PubMed PMID: 26629470; PubMed Central PMCID: PMCPMC4637952.
5- Querido S, van den Broek S, de Rond M, Wigersma L, Ten Cate O. Factors affecting senior medical students’ career choice. Int J Med Educ. 2018;9:332-9. doi: 10.5116/ ijme.5c14.de75. PubMed PMID: 30594907; PubMed Central PMCID: PMCPMC6387763
6- Cleland J, Johnston PW, French FH, Need ham G. Associations between medical school and career preferences in Year 1 medical stu dents in Scotland. Med Educ. 2012;46:473- 84. doi: 10.1111/j.1365-2923.2012.04218.x. PubMed PMID: 22515755
7- Pfarrwaller E, Sommer J, Chung C, Maison neuve H, Nendaz M, Junod Perron N, et al. Impact of Interventions to Increase the Proportion of Medical Students Choosing a Primary Care Career: A Systematic Review. J Gen Intern Med, 2015; 30: 1349-58. doi: 10.1007/s11606-015-3372-9. PubMed PMID: 26173529; PubMed Central PMCID: PMCPMC4539313.
8- Sivey P, Scott A, Witt J, Joyce C, Humphreys J. Junior doctors’ preferences for specialty choice. J Health Econ, 2012; 31: 813-23. doi: 10.1016/j.jhealeco.2012.07.001. PubMed PMID: 22940638.
9- Takeda Y, Morio K, Snell L, Otaki J, Takahashi M, Kai I. Characteristic profiles among stu dents and junior doctors with specific career preferences. BMC Med Educ, 2013; 13: 125. doi: 10.1186/1472-6920-13-125. PubMed PMID: 24028298; PubMed Central PMCID: PMCPMC3847686
10- Al-Shamsi M. Addressing the physicians’ shortage in developing countries by accel erating and reforming the medical education: Is it possible? J Adv Med Educ Prof, 2017; 5: 210-9. PubMed PMID: 28979916; PubMed Central PMCID: PMCPMC5611431.
11- Pagnin D, De Queiroz V, Oliveira Filho MAD, Gonzalez NVA, Salgado AET, Oliveira BCE, et al. Burnout and career choice motivation in medical students. Medical teacher, 2013; 35(5): 388-94.
12- Hamedi Rad F, Ghaffari T, Hoshyar E. Motivations for choosing field of study among medical and dental students of Tabriz University of Medical Sciences, Tabriz, Iran. Research and Development in Medical Education, 2014; 3(1): 25.
13- Gąsiorowski J, Rudowicz E, Safranow K. Motivation towards medical career choice and future career plans of Polish medical students. Advances in health sciences education, 2015; 20(3): 709-25.
14- Shakornia A, Khajeh Ali N, Bagheri A, Bijanzadeh M. Factors affecting medical major selection and the extent of changes in students’ motivation during their study in Ahvaz Jundishapur University of Medical Sciences. Iranian Journal of Medical Education, 2016; 16: 189-99
15- Puljak L, Kraljevic JB, Latas VB, Sapunar D. Demographics and motives of medical school applicants in Croatia. Medical Teacher, 2007; 29(8): e227-e34.
16- Iravani K, Amini M, Doostkam A. A survey of medical students’ attitude toward medicine and it’s future in Jahrom Medical University [basic and clinical stages]. Iranian Journal of Medical Education, 2002; 2: 28-9.
17- Ghaderi R, Dastjerdi R, Sorush Z, Mouhebati M. Influential Factors in Medical StudentsAttitudes towards Studying Medicine in 2002. Iranian Journal of Medical Education, 2003; 3(2): 47-55.
18- Kwon OY, Park SY. Specialty choice preference of medical students according to personality traits by Five-Factor Model. Korean journal of medical education, 2016 Mar; 28(1): 95.
19- Heiligers PJ. Gender diferences in medical students’ motives and career choice. BMC Med Educ, 2012; 23(12): 82. https://doi.org/10.1186/1472- 6920-12-82 PMID:22913471;PMCID:PMC3575371.
20- Barbosa-Camacho FJ, Miranda-Ackerman RC, Vázquez-Reyna I, Jimenez-Ley VB, Barrera-López FJ, Contreras-Cordero VS, Sánchez-López VA, Castillo-Valverde TJ, Lamas-Abbadie CD, González-Adán BA, Cortes-Flores AO. Association between HEXACO personality traits and medical specialty preferences in Mexican medical students: a cross-sectional survey. BMC psychology, 2020 Dec; 8: 1-9.
21- Alizadeh Y, Khoshbakht Pishkhani M, Kazemnezhad Leily E, Khoshrang H, Behboudi H, Mohammadi M, et al. Factors Associated with Medical Students Tendency to Choose a Medical Specialty. Journal title, 2014; 23 (89): 29-36 URL: http://journal.gums.ac.ir/article-1-566-fa.html
22- Hadadgar A., Yousefie A.R., Sabouri Masih, Richard G. Psychometric Properties Of A Persian Version Of The Specialty Indecision Scale: A Preliminary Study. Iranian Journal Of Medical Education[Internet], 2008; 8(2 (20)): 229-236. Available from: https://sid.ir/paper/393413/en
23- NEJAT S, EMAMI RS, Rashidian A, YAZDANI S, Majdzadeh R. The motives of medical students in Tehran university for choosing medicine field and their outlooks for their profession: Qualitative versus quantitative approach.
24- Zhou L, Liu B, Fu W, Wu W, Wang Y, Ju P, Zhang X, Liu G. Surgical career choices of medical students in China: does gender bias play a role?. BMC Medical Education, 2022 May 17; 22(1): 378.
25- Asaad M, Zayegh O, Badawi J, Hmidi ZS, Alhamid A, Tarzi M, Agha S. Gender diferences in specialty preference among medical Students at Aleppo University: a cross-sectional study. BMC Med Educ, 2020; 20(1): 184. https://doi.org/10.1186/s12909-020-02081-w PMID:32503519; PMCID: PMC7275529.
26- Kawamoto R, Ninomiya D, Kasai Y, Kusunoki T, Ohtsuka N, Kumagi T, Abe M. Gender diference in preference of specialty as a career choice among Japanese medical students. BMC Med Educ, 2016; 16(1): 288. https://doi. org/10.1186/s12909-016-0811-1 .
27- Puertas EB, Arósquipa C, Gutiérrez D. Factors that influence a career choice in primary care among medical students from high-, middle-, and low income countries: a systematic review. Rev Panam Salud Publica, 2013; 34: 351–8.
28- Krishnaswami S, Nwomeh BC, Ameh EA. The pediatric surgery workforce in low-and middle-income countries: problems and priorities. InSeminars in pediatric surgery, 2016 Feb 1; 25(1): 32-42. WB Saunders.
29- Levaillant M, Levaillant L, Lerolle N, Vallet B, Hamel-Broza JF. Factors influencing medical students’ choice of specialization: A gender based systematic review. EClinicalMedicine, 2020 Nov 1; 28.
30- Madu AJ, Ubesie A, Madu KA, Nonyelu C, Ibegbulam OG. Medical specialist preferences and reasons among fresh Nigerian interns. Annals of medical and health sciences research, 2014; 4(3): 223-7.
31- Abdulghani HM, Al-Shaikh G, Alhujayri AK, Alohaideb NS, Alsaeed HA, Alshohayeb IS, Alyahya MM, Alhaqwi AI, Shaik SA. What determines the selection of undergraduate medical students to the specialty of their future careers?. Medical teacher, 2013 Apr 1; 35(sup1): S25-30.
32- Ugezu A I, Modekwe V I. House officers’ choice of specialty in Nnewi, South East, Nigeria. Afrimedic J, 2012; 3: 17–9.
33- Madu AJ, Ubesie A, Madu KA, Nonyelu C, Ibegbulam OG. Medical specialist preferences and reasons among fresh Nigerian interns. Annals of medical and health sciences research, 2014; 4(3): 223-7.
34- Vo A, McLean L, McInnes MD. Medical specialty preferences in early medical school training in Canada. International journal of medical education, 2017; 8: 400.
35- Heikkilä T, Hyppölä H, Kumpusalo E, Halila H, Vänskä J, Kujala S, Virjo I, Mattila K. Choosing a medical specialty–Study of Finnish doctors graduating in 1977–2006. Medical teacher, 2011 Aug 1; 33(8): e440-5.
36- virko E, Goldacre MJ, Lambert T. Career choices of the United Kingdom medical graduates of 2005, 2008 and 2009: questionnaire surveys. Med Teach, 2013; 35(5): 365–75.
37- Martins RS, Fatimi AS, Ladak S, Jehanzeb H, Saleh R, Kumar G, Kaleem S, Saad M, Akbar I, Abbas M, et al. Factors influencing the intention to pursue surgery among female pre-medical students: a cross-sectional study in Pakistan. World J Surg, 2022; 46(9): 2063–72.