Factors influencing subspecialty choice among medical students: a systematic review and meta-analysis

ObjectiveTo characterise the contributing factors that affect medical students’ subspecialty choice and to estimate the extent of influence of individual factors on the students’ decision-making process.DesignSystematic review and meta-analysis.MethodsA systematic search of the Cochrane Library, ERI...

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Bibliographic Details
Published in:BMJ open 2019-03, Vol.9 (3), p.e022097-e022097
Main Authors: Yang, Yahan, Li, Jiawei, Wu, Xiaohang, Wang, Jinghui, Li, Wangting, Zhu, Yi, Chen, Chuan, Lin, Haotian
Format: Article
Language:English
Subjects:
Career Choice
Careers
Clinical decision making
Decision Making
Developing countries
Evidence-based medicine
Humans
LDCs
Medical Education and Training
Medical schools
Medical students
Medicine
Meta-analysis
Pediatrics
Physicians
Psychiatry
Specialists
Student debt
Students
Students, Medical - psychology
Students, Medical - statistics & numerical data
Surgery
Systematic review
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Summary:ObjectiveTo characterise the contributing factors that affect medical students’ subspecialty choice and to estimate the extent of influence of individual factors on the students’ decision-making process.DesignSystematic review and meta-analysis.MethodsA systematic search of the Cochrane Library, ERIC, Web of Science, CNKI and PubMed databases was conducted for studies published between January 1977 and June 2018. Information concerning study characteristics, influential factors and the extent of their influence (EOI) was extracted independently by two trained investigators. EOI is the percentage level that describes how much each of the factors influenced students’ choice of subspecialty. The recruited medical students include students in medical school, internship, residency training and fellowship, who are about to or have just made a specialty choice. The estimates were pooled using a random-effects meta-analysis model due to the between-study heterogeneity.ResultsData were extracted from 75 studies (882 209 individuals). Overall, the factors influencing medical students’ choice of subspecialty training mainly included academic interests (75.29%), competencies (55.15%), controllable lifestyles or flexible work schedules (53.00%), patient service orientation (50.04%), medical teachers or mentors (46.93%), career opportunities (44.00%), workload or working hours (37.99%), income (34.70%), length of training (32.30%), prestige (31.17%), advice from others (28.24%) and student debt (15.33%), with significant between-study heterogeneity (p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-022097