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Table of Contents
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 83-84

What are the factors influencing interns' deciding on their specialties?

Department of Medical Education, Curriculum Development and Research Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Date of Submission13-Mar-2021
Date of Decision18-Mar-2021
Date of Acceptance19-Mar-2021
Date of Web Publication13-Apr-2021

Correspondence Address:
Samy A Azer
Department of Medical Education, Curriculum Development and Research Unit, College of Medicine, King Saud University, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jnsm.jnsm_31_21

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How to cite this article:
Azer SA. What are the factors influencing interns' deciding on their specialties?. J Nat Sci Med 2021;4:83-4

How to cite this URL:
Azer SA. What are the factors influencing interns' deciding on their specialties?. J Nat Sci Med [serial online] 2021 [cited 2022 Aug 11];4:83-4. Available from: https://www.jnsmonline.org/text.asp?2021/4/2/83/313649

This question might be of interest to the medical students who do not know how to select a specialty? On what grounds? It is also attractive to academics and clinicians who teach medical students and would like to understand these factors and what motivates or influences students in this process. The question is appealing to members of the medical and health workforces who oversee and allocate graduates to their specialties.[1]

The literature shows that the motives and decision-making made by students in selecting their specialties are heterogeneous.[2],[3] Several factors may be involved in the process and influencing such decisions. However, students tend to change their mind over time. What they decided to select as a specialty in the 1st year or even before joining the medical school might change in the clinical years or during the internship to something else.[4]

Based on what we know from the literature, let me group these factors into three categories:

First: What are students' dreams and their ego?

Second: What do students feel comfortable doing?

Third: What are the benefits versus work hours to do, length of training, and burden on health and family for the specialty they will select?

These three questions might include under each of them several sub-items. The first category is covering what are the students' dreams and their ego? Here the students are dependant on their fantasy, dreams, or even the parents' wishes for deciding on their speciality, without consideration for the second or the third categories. The second category is about what students feel comfortable doing as a subspeciality, influencing factors such as their interest, competencies, skills, and influence of their undergraduate medical school training. Furthermore, it may include the impact made by teachers or mentors who taught them and what they studied during the undergraduate program. The second category may explain the students' changes in their decisions as they match this category with the first category's factors and compare their dreams versus what they feel comfortable doing.

The third category is more about the realization of reality. The realization that selecting a specialty is not only about a dream but also we need to weigh things and explore each category's advantages and disadvantages and review our position. This realization might induce significant changes in their selection. Under this category, the students are considering essential factors related to the decision to make. They weigh each benefit, including their dreams and ego, against demands, such as work hours to do, length of training to complete their specialty, and burden on health and family.[5]

With these facts and process in our mind, colleges of medicine might learn several lessons:

First: Students change their selection over time and as they progress in the course. However, during the internship year, they are facing significant stress as they might be finding it difficult to balance things among these different interfering factors and come with the right decision.

Second: Mentors have responsibilities to realize the challenges students face in this area, even if they try not to open themselves and talk about it. We are responsible for discussing their fears and guiding them in this process using the model I stated here through these three critical categories of questions.

Third: The college should also have a working group with experts who can offer such services to the students and help answer their queries and guide them in selecting their specialty.

In this issue, we have an article written by AlSuwaidan et al.; the article looks into factors affecting medical interns' choice of specialties at several medical colleges in national universities in Riyadh.[6] These were King Saud University, Princess Nourah Bint Abdulrahman University, Imam Muhammad Bin Saud Islamic University, and King Saud bin Abdulaziz for Health and Science. The article is a cross-sectional questionnaire-based study. The authors explored in their questionnaire factors that may influence student's decision in selecting their specialty. The questionnaire was completed by students starting from their 3rd year to the internship. These factors included what students studied in their medical programs in the preclinical and clinical years, what educational tools used, the role of problem-based learning, research in the course, their block grades, the elective experiences, and the personality of instructors.[6] The article is exciting and covers students' responses from four key universities in Riyadh. I will leave for you reading the whole manuscript and critical findings.

However, the questionnaire focused on what students studied in the medical course and their experiences, which I believe relate partly to category two in the model I presented here. I recommend future research on this crucial area to cover these areas and answer our questions regarding the following:

First: There is a need for similar extensive studies including several universities but exploring other factors related to different categories, including what do students dream of being, what is their ego (category one questions), and what are the benefits versus work hours to do, length of training, and burden on health and family for the specialty they will select? (category three questions).

Second: It might be helpful to know if this process of selecting their specialty was stressful? In what way? And how they handled these uncertainties? Did they receive any help from a mentor or any other source in their colleges?

The answers to these questions will help us not just in the Kingdom but also in universities in the region and internationally.

  References Top

Cheek C, Hays R, Allen P, Walker G, Shires L. Building a medical workforce in Tasmania: A profile of medical student intake. Aust J Rural Health 2019;27:28-33.  Back to cited text no. 1
Sladek RM, Burdeniuk C, Jones A, Forsyth K, Bond MJ. Medical student selection criteria and junior doctor workplace performance. BMC Med Educ 2019;19:384.  Back to cited text no. 2
Bland KI, Isaacs G. Contemporary trends in student selection of medical specialties: The potential impact on general surgery. Arch Surg 2002;137:259-67.  Back to cited text no. 3
Boyle E, Healy D, Hill AD, O'Connell PR, Kerin M, McHugh S, et al. Career choices of today's medical students: Where does surgery rank? Ir J Med Sci 2013;182:337-43.  Back to cited text no. 4
Tolhurst HM, Stewart SM. Balancing work, family and other lifestyle aspects: A qualitative study of Australian medical students' attitudes. Med J Aust 2004;181:361-4.  Back to cited text no. 5
Al Suwaidan AT, Al Luhidan LA, Al Barrak KA, Al Mubrick RA, Al Suwaidan HI, Al Shammari RA, et al. Determining factors affecting the medical interns' choice of specialties among governmental universities in Riyadh. J Nat Sci Med 2020;4:112-7.  Back to cited text no. 6


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