Factors predictive of medical students' career choices at matriculation: Longitudinal case study of the graduating class of 1997 at Hahnemann University School of Medicine

This study examined the medical student career specialty choice process as a longitudinal study of one cohort of students. How these medical students develop their career choice and how the career choice might be predicted during the medical school admissions process should be of interest to medical schools in being more responsive to the needs of society, therefore training enough physicians to fill a deficit in a given field.;A series of four survey instruments was developed to obtain non-demographic data on attitudinal factors, self-descriptive adjectives, alternate career choices, and specialty choice interest at the prematriculation stage, second year orientation, third year orientation and fourth year orientation. A total of 172 respondents returned the prematriculation survey (100% return rate). One hundred and twenty respondents returned the second year orientation survey (70% return rate). The third and fourth year orientation survey had 110 and 128 respondents (64% and 74% return rate), respectively. One hundred and fifty-six respondents completed the prematriculation survey and fourth year orientation survey (91%). Fifty-two respondents returned all four surveys and had residency placement data (30%). The analysis suggests that the four research surveys used were both internally valid and reliable.;The study concluded there are some classification models which suggest predictability of residency specialty choice category (generalist, medical, surgical, or support) from the prematriculation survey. The attitudinal questions on the fourth year orientation survey were found to be most predictive. The self-descriptive adjectives were most predictive at the prematriculation stage. The first alternate career choices were most significant on the prematriculation survey. The specialty career choice at the fourth year orientation was most predictive of the residency career specialty choice category. Although there were some attitudinal changes between prematriculation and fourth year orientation, the data did not suggest any differences between those who changed their top choice of discipline and those who did not. Although not predictive of residency specialty choice, there appeared to be little difference between the distribution pattern of the range of educational indebtedness between the four groups. The fourth year orientation survey suggested that the medical group had the lowest average total educational indebtedness, while the generalist group had the highest. Lastly, the study suggests a classification model using the data collected on the prematriculation survey which correctly classified 65% of those who selected a residency discipline in the defined medical category, 63% of those who selected a surgical category, 59% and 28% of those who went into a generalist category and support category, respectively.