Paiva R E, Vu N V, Verhulst S J
J Med Educ. 1982 Sep;57(9):666-74. doi: 10.1097/00001888-198209000-00002.
Medical students' specialty choice decisions are usually made by the middle or end of the clinical year. In the study here, the authors investigated the extent to which various factors during clinical clerkships affected specialty choice. Debts, other financial considerations, and length of residency had little overall effect on students' choices. The order of clerkships was of particular significance for the undecided students. Members of the clinical teaching faculty exercised a strong role-modeling effect throughout medical school. During clerkships, however, the greatest influence on specialty choice came first from the interplay of faculty members and experiences and second from faculty members by themselves; experiences alone affected few students. The influence of faculty members and clerkship experiences was greatest among students who chose psychiatry. Additionally, most students who selected psychiatry had originally intended to enter other specialties. The large majority of those who chose family practice, internal medicine, and surgery had made their decision prior to emerging clerkships and, therefore, clinical experiences and the faculty tended to affect them the least.
医学生的专业选择决定通常在临床学年的中期或末期做出。在本研究中，作者调查了临床实习期间各种因素对专业选择的影响程度。债务、其他经济因素和住院医师培训时长对学生的选择总体影响不大。对于尚未决定的学生来说，实习顺序尤为重要。临床教师在整个医学院校阶段都发挥着强大的榜样作用。然而，在临床实习期间，对专业选择影响最大的首先是教师与实习经历的相互作用，其次是教师自身；仅实习经历对少数学生有影响。教师和临床实习经历的影响在选择精神病学专业的学生中最为显著。此外，大多数选择精神病学的学生原本打算进入其他专业。绝大多数选择家庭医学、内科和外科的学生在开始临床实习之前就做出了决定，因此，临床实习经历和教师对他们的影响往往最小。
