title: Specialty preferences among final year medical students in medical schools of southeast Nigeria: need for career guidance.
abstract: BACKGROUND
  In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training.
  
  
  METHODS
  A descriptive cross-sectional study was conducted among final year medical students in the six accredited medical schools in southeast Nigeria using self-administered semi-structured questionnaire. Information on reason for studying Medicine, specialty preference and career guidance were obtained. Chi-square test of statistical significance was used in the analysis.
  
  
  RESULTS
  A total of 457 students participated in the study with a response rate of 86.7 %. The mean age was 25.5 ± 2.9 years and 57.1 % were male. Majority (51 %) opted to study Medicine in-order to save lives while 89.5 % intended to pursue postgraduate medical training. A higher proportion (51.8 %) made the decision during the period of clinical rotation. The five most preferred specialties among the students were Surgery (24.0 %); Paediatrics (18.8 %); Obstetrics and Gynaecology (15.6 %); Internal Medicine (11.0 %) and Community Medicine (6.8 %) while Pathology (2.0 %); Anaesthesia (0.7 %) and Ear, Nose and Throat (0.2 %), were the least preferred. Compared to females, a higher proportion of male students intended to specialise in Surgery (32.3 % vs 13.0 %, p < 0.001) in contrast to Paediatrics (11.2 % vs 28.8 %, p < 0.001). Majority of the students, 74.6 % had no form of career guidance during their stay in medical school and 11.2 % were undecided on choice of specialty.
  
  
  CONCLUSIONS
  In spite of the high proportion of students willing to pursue specialist medical training after graduation, most opted for the four core clinical specialities of Surgery, Paediatrics, Obstetrics and Gynaecology and Internal Medicine. Majority of the students made these decisions during clinical rotations. Also, majority had no form of career guidance throughout their stay in medical school. To ensure an equitable distribution of a limited physician workforce in a resource-poor setting, there is need for proper career guidance for the students and this should be in line with the national health needs.
authors.affiliation: Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakaliki, Nigeria. ossai_2@yahoo.co.uk.
authors.forename: Edmund Ndudi
authors.initials: EN
authors.lastname: Ossai
authors.affiliation: Department of Community Medicine, College of Medicine, Imo State University Owerri, Owerri, Nigeria.
authors.forename: Kenechi Anderson
authors.initials: KA
authors.lastname: Uwakwe
authors.affiliation: Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria.|Epidemiology and Public Health Division, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Uchenna Chidi
authors.initials: UC
authors.lastname: Anyanwagu
authors.affiliation: Department of Community Medicine, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria.
authors.forename: Ntat Charles
authors.initials: NC
authors.lastname: Ibiok
authors.affiliation: Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakaliki, Nigeria.
authors.forename: Benedict Ndubueze
authors.initials: BN
authors.lastname: Azuogu
authors.affiliation: German Leprosy and TB Relief Association Enugu, Enugu, Nigeria.
authors.forename: Ngozi
authors.initials: N
authors.lastname: Ekeke
mesh_terms: D002321:Career Choice; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004504:Education, Medical, Undergraduate; D006801:Humans; D009549:Nigeria / Q000453:epidemiology; D010820:Physicians; D012577:Schools, Medical / Q000458:organization & administration*; D013038:Specialization / Q000706:statistics & numerical data* / Q000639:trends; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014830:Vocational Guidance / Q000379:methods