Career preference and medical students' biographical characteristics and academic achievement

Background: We know that medical students' biographical characteristics and academic achievement influence career preference. Less is known about the differential association of these characteristics with preference for distinct specialties at different stages of medical training. Aim: To investigate the association between biographical characteristics and academic achievement with preference for specific medical specialties among first year medical students, before the clerkships, during clerkships and at the end of medical school. Methods: A written questionnaire was completed by medical students from two Dutch medical schools in 2002. Five medical specialties were selected for analysis (general practice, internal medicine, surgery, paediatrics and psychiatry). Biographical characteristics (gender, parental education and profession, and academic achievement were used to construct a prognostic model related to the preference for a medical career. Results: Being female and having a parent in general practice was positively associated with a preference for a career in general practice. Male gender was positively associated with a preference for a career in surgery. In first-year students, and in students with no clerkship experience, male gender was positively associated with a preference for a career in internal medicine. Among students with clerkship experience and final-year students the duration of study was positively associated with a preference for a career in internal medicine. For all students together, female gender was positively associated with a preference for a career in paediatrics. In first-year students, and in students with no clerkship experience, female gender was positively associated with a preference for a career in psychiatry. Conclusions: Our findings show that the medical background of the parents and gender are positively associated with a preference for a career, especially for general practice. Work experience in health care, personal experience with medical care and academic achievement plays a minor role in the career preference of medical students.