University Institute for Primary Care, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Genève 4, Geneva, Switzerland.
Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
BMC Med Educ. 2023 Feb 27;23(1):131. doi: 10.1186/s12909-023-04102-w.
Medical students' career intentions often change between matriculation and graduation, yet little is known about the precise timing and dynamics of individual students' career decisions. This study expands on previous research by exploring the stability of individual students' career intentions over four years and by analyzing associations between unstable career intentions and students' characteristics.
Medical students from two classes were recruited into a cohort during their first academic year and completed a yearly survey over a four-year period (end of pre-clinical curriculum to graduation). Measures included career intention (specialty and practice type), personality, coping strategies, empathy, and motives for becoming a physician. The authors developed a score ranging from 0 to 10 quantifying instability of career intentions (0 = stable; 10 = unstable). The distribution of the score was analyzed descriptively, and the association between the score and other variables was quantified using a stepwise beta regression model.
The sample included 262 students (61% females). The mean score was 3.07 with a median of 3. 18% of students (N = 46) did not change their specialty intention over the four years, whereas 10% (N = 26) changed every year. No further subgroups were identified between these extremes. An intention to work in private practice in year 3 and the motive care for patients were significantly associated with more stable career intentions.
Most students are situated on a continuum between the two extremes of being firmly committed and undecided. Extrinsic factors may be more important drivers of these fluctuations than personal characteristics and should be explored in future research. This study's findings also provide avenues for supporting students in their career decision-making.
医学生的职业意向在入学和毕业之间经常发生变化，但对于个别学生职业决策的具体时间和动态变化知之甚少。本研究通过探讨个体学生职业意向在四年内的稳定性，并分析不稳定职业意向与学生特征之间的关系，扩展了以往的研究。
在第一学年，从两个班级中招募了医学生进入一个队列，并在四年内完成了每年一次的调查（临床前课程结束至毕业）。测量包括职业意向（专业和执业类型）、人格、应对策略、同理心和成为医生的动机。作者开发了一个从 0 到 10 的分数，量化职业意向的不稳定性（0=稳定；10=不稳定）。分析了分数的分布，并使用逐步 beta 回归模型量化了分数与其他变量之间的关联。
样本包括 262 名学生（61%为女性）。平均分数为 3.07，中位数为 3.18%的学生（N=46）在四年内没有改变他们的专业意向，而 10%（N=26）每年都在改变。在这两个极端之间没有进一步的细分。第三年的私人执业意向和照顾患者的动机与更稳定的职业意向显著相关。
大多数学生处于坚定承诺和犹豫不决这两个极端之间的连续体上。外部因素可能是这些波动的更重要驱动因素，而不是个人特征，应该在未来的研究中探讨。本研究的结果还为支持学生的职业决策提供了途径。
