title: The impact of clerkships on students' specialty preferences: what do undergraduates learn for their profession?
abstract: OBJECTIVE
  Clinical experiences and gender have been shown to influence medical students' specialty choices. It remains unclear, however, which aspects of experiences make students favour some specialties and reject others. This study aimed to clarify the effects of clerkships on specialty choice and to identify explanatory factors.
  
  
  METHODS
  We carried out a longitudinal cohort study to collect data on career preferences and attitudes towards future careers among 3 cohorts of students before and after clerkships in surgery (n = 200), internal medicine (n = 277) and general practice (n = 184). Regression analyses were performed to identify the determinants of career choice and the role of gender.
  
  
  RESULTS
  Exposure to clinical settings encourages students to opt for a career in the corresponding specialty. Men were more stimulated than women by the general practice clerkship. Gender had no clear role as a predictor of career preference. The major predictor of career choice in all 3 specialties was positive evaluation of work-intrinsic factors. A preference for working with acute patients and technology-oriented work, prestige orientation and insignificance of a controllable lifestyle were determinants of a preference for surgery. Students with a preference for general practice had almost opposite preferences. Those who chose internal medicine favoured a controllable lifestyle.
  
  
  CONCLUSIONS
  Factors other than gender appear to drive specialty decisions. Work content, type of patients and lifestyle options play major roles. Consequently, along with teaching about the practice of medicine, the matching of specialty preferences with reality is an essential outcome of clerkships.
authors.affiliation: Institute of Medical Education, Faculty of Medicine, University of Maastricht, Maastricht, The Netherlands.
authors.forename: Tanja
authors.initials: T
authors.lastname: Maiorova
authors.forename: Fred
authors.initials: F
authors.lastname: Stevens
authors.forename: Albert
authors.initials: A
authors.lastname: Scherpbier
authors.forename: Jouke
authors.initials: J
authors.lastname: van der Zee
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D002982:Clinical Clerkship; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands; D012737:Sex Factors; D013038:Specialization; D013337:Students, Medical / Q000523:psychology*