The impact of the current medico-legal and regulatory culture in Ireland on the decision of graduate entry medical school students to pursue a career in obstetrics and gynecology

• Published in: European journal of obstetrics & gynecology and reproductive biology 2024-12, Vol.303, p.42-47
• Main Authors: Tumelty, Mary-Elizabeth, Spain, Eimear, Cheema, Ayesha, Cinnamond, Kaitlyn, Hannigan, Ailish, Sharma, Santosh, Cotter, Amanda
• Format: Article
• Language: English
• Subjects: Adult; Career Choice; Decision Making; Female; Gynecology - education; Humans; Ireland; Law; Male; Medical education; Obstetrics - education; Obstetrics - legislation & jurisprudence; Recruitment; Regulation; Retention; Students, Medical - psychology; Surveys and Questionnaires; Young Adult
• ISSN: 0301-2115; 1872-7654; 1872-7654
• DOI: 10.1016/j.ejogrb.2024.10.015

•The medico-legal environment is recognised as a factor influencing the decision of medical students to pursue a career in gynecology and obstetrics.•Fears of being sued, being the subject of a complaint to the regulatory body, and potential criminal prosecution were reported.•Understanding the impact of the current environment is important from a policy perspective particularly in relation to recruitment and retention. Medico-legal and regulatory culture has a significant impact on medical practitioners, including the decision of graduates to enter high-risk specialties. This study explores the impact of the current medico-legal and regulatory culture in Ireland on the decision of graduate entry medical students to enter one high risk specialty, obstetrics and gynecology. We conducted a survey of 146 final-year, graduate-entry medical students pre- and post- a 6-week rotation in obstetrics and gynecology in Ireland. Participants were asked to rate the influence (on a four-point scale) of factors such as fear of being sued, being reported to the regulatory body or criminal prosecution on their decision to pursue a career in obstetrics or gynaecology. Data were matched pre- and post-rotation and McNemar-Bowker’s test was used to test for differences in related data. All analysis was conducted using SPSS for Windows version 25. The responses of 72 students to both questionnaires could be matched (response rate 49.3%). The majority of participants pre-rotation reported that fear of being sued (74%), fear of being reported to the regulatory body (70%) and fear of criminal prosecution (55%) were factors influencing their decision (somewhat or to a great extent) to pursue a career in obstetrics. There were no significant changes post-rotation. Compared to obstetrics, lower proportions of participants pre-rotation considered fear of being sued (54%), fear of being reported to the regulatory body (50%) and fear of criminal prosecution (40%) as factors influencing their decision to pursue a career in gynecology. There were no significant changes post-rotation. Medico-legal and regulatory culture is shaping the perceptions of graduate entry medical students of obstetrics and gynecology and influencing their decision to pursue a career in the speciality. Understanding the impact of medico-legal culture on career choices including a high-risk specialty such as obstetrics and gynecology is important from both a policy and reform context, and if the healthcare service i