1. The Development of Medical Students’ Career Preferences During Medical School
Dibdin. P, Burford. B, Alberti. H, Kennedy. D, Wilson. P, Feng. J. Newcastle University School of Medical Education 

2. Background
Reducing number of doctors going straight into specialty training
Certain specialties undersubscribed
Workforce planning
Recruitment to GP low
Falling short of government targets for number of extra GPs by 2020

3. Background Factors influencing career choice Student demographics
Student perceptions of specialty characteristics
Student held values
Medical school characteristics
Newton et al., Goldacre et al., 2004 Cleland et al., 2014

4. Background
Important to understand relationship between medical school and career choice as can influence workforce as a whole
Need for a longitudinal study to explore how career preferences change during time at medical school
Cleland et al., 2014

5. Aim
To explore the development of medical students’ career preferences during medical school

6. Methods Qualitative study
Purposive sampling of 14 medical students at Newcastle University
Semi-structured interviews
2 interviews in first year (beginning and end)
1 interview in second, third and fourth year
Thematic analysis

7. Results Internal External Student Experience Career Choice
Work-life balance
Competition for jobs
Political environment
Research into specialty
Personal perceptions
Student characteristics
Results
Student Experience
Career Choice

8. 1. Clinical experience Positive clinical experience
‘we just did cardiac medicine, I think ohh that’s really interesting, maybe I’ll be a cardiologist’
Negative clinical experience
‘I saw a bit of surgery…..I remember like just holding someone’s leg and just freaking out….I just don’t like it at all’
Add examples of each

9. Clinical experience Work experience
‘surgery was always on the horizon I guess because the work experience I did’
Role models encountered during clinical experience
‘I know what to do having seen this fantastic example. I feel I can hopefully mimic it.’
Lecture experience
‘‘we’ve had two really good lectures and quite instantly were a game changer…..I never particularly thought I wanted to be a haematologist but that seemed really interesting.’

10. 2. Student characteristics
Personality
‘ I like things to be quite fast and I like how fast paced it is’
Ability/aptitude for a specialty
‘whether I think I have an aptitude for the clinical science’
‘I just don’t think it suits my skills, my natural ability’
Personal interests
‘I want to be a generalist rather than a true specialist’
Gender
‘I know I want to have children before I’m 35’
‘I had a conversation with her afterwards and she was saying ‘radiology is really female family friendly’’

11. 3. Personal perceptions Preconceived ideas
‘ if I told people I was thinking about becoming a neurosurgeon they might say ‘ oh that sounds pretty cool, that’s pretty awesome’ and they might think quite highly of you….if I told people I just wanted to be a psychiatrist…… I think people don’t think that highly of psychiatrists as they think about neurosurgeons’
‘surgery is definitely the coolest thing in the world’
‘it just looks boring. It looks like an office job’
Early ruling in or out of specialties
‘I know that I don’t really want to be a GP. And I know that I do want to work in a hospital and become a consultant’

12. 4. Research into specialty
‘The other day I was on the internet looking at different surgical specialties’
‘I think it’s quite important to take the initiative yourself do some research in specialty’
‘I originally wanted to be a forensic psychiatrist because I was reading a lot around it’

13. 5. Competition for jobs
‘it’s got quick training, it takes four years to do specialty training, there’s absolutely loads of jobs in it. It’s so undersubscribed.’
‘I think I would lean away from surgery at the moment for a variety of reasons. Firstly, I know it’s very competitive’

14. 6. Work life balance
‘would I be able to be a surgeon if I want to have children…….I don’t know like is it a child, like family friendly career path.’
‘you have to be a little bit selfish long term, for instance, obs and gynae has the absolute worst rota because babies come any time of the day and I just don’t think I could do it’
‘maybe I just wanna be a GP and have the sort of you know, easier on the hours I suppose, you know 9 to 5 sort of doctor job’

15. 7. Political environment
‘I would consider training in a place that I can get into that is best for me regardless of where that is in the world’
‘I’ve always been interested in politics…..but you read about things and they don’t necessarily apply to you whereas this is the first thing…..it’s going to affect us…..because of that I would then consider options like private medicine, or working abroad instead….I considered Sports medicine’

16. Conclusion Career choices are complex and dynamic
Confirms factors influencing medical students’ career choices
Identifies some less well documented factors that may be contributing
Some factors may be fixed prior to medical school thus highlighting admissions as key to future workforce planning

17. Next steps Complete final round of interviews (fifth year)
Analyse the data from a longitudinal perspective to try and identify the factors influencing change in career choice throughout time at medical school

18. Questions?