Medical students' and prospective medical students' uncertainties about career intentions: cross-sectional and longitudinal studies.
BACKGROUND
Policy prompts medical students' earlier career awareness.


OBJECTIVE
To explore changes and uncertainty in medical (and prospective medical) students' career intentions in a 5-year problem-based curriculum.


METHODS
Six postal questionnaire surveys of medical students and one survey of prospective medical students sought career intentions from three entry-cohorts (one also seeking why they chose medicine, and one, the reason for the career intention).


RESULTS
From the 973 (91.4%) 2001/02 admission interviewees responding, 74/189 (39.2%) of those admitted and remaining 'in-year' re-reported career intentions 5 years later (2006/07). Of the 1999 entrants (start-Year 1; end-Year 1; and mid-Year 3) and 2001 entrants (start-Year 1 and end-Year 1), 61.2-77.9% responded. Up to mid-programme, only 9.5-18.8% reported general practice, significantly more of whom described altruistic reasons for choosing medicine (2001 entrants). Tracked longitudinally, career intentions stayed relatively stable, but a small significant retreat from general practice over Year 1 predated clinical placements. From pre-admission to mid-Year 5, uncertainty decreased significantly, but 14.9% replied 'do not know' both times. Significantly more prospective students from the least affluent English or Welsh postcodes specified a career intention.


CONCLUSIONS
Many students might delay considering career intentions, particularly general practice. Socioeconomic determinants of early medical career decision making merit further study.
Maudsley
Gillian
G
Division of Public Health, The University of Liverpool, Liverpool L69 3GB, UK. phenq@liverpool.ac.uk
Williams
Lyn
L
Taylor
David
D
D000533:Altruism; D001290:Attitude; D002321:Career Choice; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003479:Curriculum; D003625:Data Collection; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D018794:Problem-Based Learning; D012959:Socioeconomic Factors; D013337:Students, Medical / Q000706:statistics & numerical data*; D013340:Students, Premedical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D035501:Uncertainty; D006113:United Kingdom; D055815:Young Adult