Finding direction: What influences medical students in their final career speciality choices?

Dear Sir

After entering medical school, the next most difficult career decision for most is which speciality-training programme to enter. It is important to investigate the factors that influence students’ career direction in order to tailor advice and advisory tools.

Interestingly, over past 10 years the proportion of females entering medical school has significantly increased in the UK with females outnumbering males by a proportion of 3 : 2 (Medical Schools Council 2007). We hypothesised that the influencing factors for males and females vary, and therefore careers advice should not be generic.

A cross-sectional study was completed at the University of Birmingham to investigate what influences medical students in their career choices, and more specifically what are the gender differences. In total 519 questionnaires responses were received from across the year groups.

The results demonstrated that females prioritised a work life balance and personal interest. Many were deterred from jobs with antisocial hours, even if the financial rewards and prestige were high. The evidence showed a reduction in females wanting to do more antisocial specialities with more clinical exposure. Having an option of less than full-time training was also a big influencing factor.

In contrast for males, prestige, competitiveness and projected income were more influential than work life balance. These factors were further pronounced in students who had at least one parent who is a doctor. Males were also more fixed on their choices and were less likely to change with clinical exposure.

For both males and females personal interest and role models were important factors. Over 50% of the respondents agreed that they would benefit from bespoke careers advice throughout their medical school training and foundation jobs.

The decisions made by students and doctors at a young age can dictate their whole lives. Therefore it is of paramount importance to deliver bespoke careers advice to each person with specific variation on gender. It will be interesting to see the gender difference in the UK medical workforce over the next 20 years.