Nguyen Quang Thanh, Bui Nhi Yen, Nguyen Minh Phan Ngoc, Nguyen Hoang Viet, Thuy Minh Ha
College of Health Sciences, VinUniversity, Hanoi, Viet Nam
Department of Pediatric Surgery, Vietnam National Hospital of Pediatrics, Hanoi, Viet Nam.
BMJ Open. 2025 May 14;15(5):e099815. doi: 10.1136/bmjopen-2025-099815.
This longitudinal study aimed to document shifts in specialty preferences, career pathways and intended practice locations among medical students following the implementation of structured career initiatives during the 2023-2024 academic year.
A longitudinal observational survey study.
A private, not-for-profit institution, VinUniversity in Hanoi, Vietnam during the 2023-2024 academic year.
All year 2, year 3 and year 4 medical students (n=144 eligible), of whom 105 (73%) completed both baseline and follow-up surveys.
Structured career counselling initiatives introduced at the start of the academic year, including academic mentoring, clinical mentoring, hands-on clinical exposure in year 4 and multiple career counselling activities.
The primary outcome was change in specialty preference over time, measured by students' self-reported first-choice specialty at baseline and follow-up. Secondary outcomes included shifts in factors influencing career decisions (eg, personal interest, income and family expectations), intended practice location (domestic or international) and preferred career pathways (residency, Specialist Level I, master's degree or direct workforce entry).
Personal interest remained the strongest influence on specialty choice from baseline to follow-up (mean scores 4.27 vs 4.36 on a 5-point scale). A notable decrease occurred in the importance of income (3.82 to 3.22; p<0.001). Students showed increased openness to both domestic and international practice, while the number of undecided students dropped (17.1% to 1.9%). Internal medicine nearly doubled in popularity (12.4% to 24.8%), and surgery maintained the highest stability in specialty preference over the 1-year period (66.7%). Students also shifted towards advanced training pathways, with more pursuing specialist qualifications or master's degrees instead of immediate workforce entry.
Noticeable shifts in specialty preferences and career pathways were observed after a series of career initiatives were implemented. Although these trends coincided with the new programmes, further qualitative research is needed to elucidate how and why these career initiatives may have influenced decision-making. Informed by these findings, medical educators can refine interventions to support students' evolving preferences and ultimately strengthen healthcare workforce distribution.
这项纵向研究旨在记录2023 - 2024学年实施结构化职业发展举措后，医学生在专业偏好、职业道路和意向执业地点方面的变化。
纵向观察性调查研究。
2023 - 2024学年期间，越南河内的私立非营利性机构——文大大学。
所有二年级、三年级和四年级医学生（n = 144名符合条件），其中105名（73%）完成了基线调查和随访调查。
学年开始时引入结构化职业咨询举措，包括学业指导、临床指导、四年级的实践临床接触以及多项职业咨询活动。
主要结局是随时间变化的专业偏好变化，通过学生在基线和随访时自我报告的首选专业来衡量。次要结局包括影响职业决策的因素（如个人兴趣、收入和家庭期望）的变化、意向执业地点（国内或国际）以及首选职业道路（住院医师培训、一级专科医师、硕士学位或直接进入劳动力市场）。
从基线到随访，个人兴趣仍然是对专业选择影响最大的因素（5分制下平均得分分别为4.27和4.36）。收入的重要性显著下降（从3.82降至3.22；p<0.001）。学生对国内和国际执业的接受度都有所提高，而未做决定的学生数量减少（从17.1%降至1.9%）。内科的受欢迎程度几乎翻倍（从12.4%升至24.8%），在1年期间外科在专业偏好方面保持了最高的稳定性（66.7%）。学生也转向了进阶培训途径，更多人追求专科资格或硕士学位，而不是直接进入劳动力市场。
在实施一系列职业举措后，观察到专业偏好和职业道路出现了显著变化。尽管这些趋势与新计划相吻合，但仍需要进一步的定性研究来阐明这些职业举措如何以及为何可能影响了决策。基于这些发现，医学教育工作者可以改进干预措施，以支持学生不断变化的偏好，并最终加强医疗劳动力的分配。
