Response to ‘An uninformed methodology’

Dear Sir

Hereby, we would like to extend our gratitude for the comments received on our article. Two questions were used to determine the students who had an informed choice of studying medicine. We designed the first question in order to compare “personal interest” with some other choices like family pressure, physicians’ social prestige, etc. There is a questionnaire guide in which these items are explained. The second question asked the students to score their liberty while choosing medicine as their major. Those who assessed the questionnaires were faculty members of the Educational Development Center of Tehran University of Medical Sciences who had formal education in this field. “Having prior medical experience” for medical students is not usual in Iran, because the only criterion for medicine is the university entrance exam which is just an academic score (Farrokhi-Khajeh-Pasha et al. 2012). Because of its highly competitive nature, the students are not required to have any other activity. Though, the “physician relatives” as an option may have been included.

We believe that the informed choice is a complicated subject which makes it almost impossible to assess with a usual quantitative questionnaire. The vignette approach, for example, can be used to find the real reason of choosing medicine (Taylor 2006). We have another paper on the reasons for choosing medicine as a major from the point of view of medical students. In this paper, we have compared the findings of qualitative and quantitative approaches which didn’t confirm each other, in the quantitative section conducted with a valid questionnaire the main reason for choosing medicine was their scientific interest in medicine. However, when we conducted a focus group discussion with them, they mentioned social and family pressures as their main reason for choosing medicine (Nejat et al. 2006). Therefore, it seems that the determination of the reason for choosing medicine could not be done much more accurately than this through usual quantitative approach.

With regards to study population, medical students interns who would graduate after 1.5 years and who had started their work in hospitals were studied. It is possible that post-graduate physicians with different experiences may have other viewpoints about medicine; however, this can be a subject of another study. To us, it is not possible to find the entrance exam scores of graduated doctors in different cohorts. Thus, we selected interns in this study because internship, in general, is the last period during which the last medical student cohorts with the common experience can be followed. Besides, after graduation, the physicians will have diverse careers which will affect their viewpoints and make any precise conclusions impossible. The “unpreparedness on transition to working life” could happen to both study groups which can compensate the potential selection bias.

We had compared the number of informed choice medical students in different ranking universities but there isn’t any significant difference between them.

Declaration of interest: The authors report no conflicts of interest.