Factors that Influence the Choice of Medical Specialty by Medical Students of an Educational Institution in Curitiba (PR)

ABSTRACT Choosing a medical specialty is extremely important for medical students as it represents the choice of their day-to-day practice. While this choice is influenced by academic achievement, financial considerations and lifestyle preferences, intrapersonal aspects also have an impact on the decision. Objectives To evaluate the main factors that influence medical students in their choice of medical specialty, and to identify the areas of practice preferred by students in the first four years of a Higher Education Institution. Results Out of a total of 397 students, 307 answered a questionnaire previously prepared for this study, and of these, 291 were considered valid. 204 female, and 87 male. Influencing factors were compared among students from different years, and with results published in the literature. The main factors considered by the students in this decision were: broader or specific knowledge, contact with the patient, place of professional activity, and lifestyle after medical residency. For the women, the factors day-to-day stress of the specialty, the long-term relationship with the patient, and the ease of finding a job were significantly more relevant in the choice of specialty than for the men. Parents who were doctors also influenced the choice of specialty. The student’s financial profile influenced the choice when related to long-term financial returns, being more relevant for students with monthly family incomes at the higher or lower ends of spectrum, i.e., - between 6 and 15 thousand Brazilian reals, or more than 20 thousand Brazilian reals. The specialty General Surgery was the first choice , predominantly among the male students, followed by Pediatrics, Clinical Medicine and Psychiatry. Conclusions Lifestyle, place of professional activity and early financial returns were considered equally important by students across all the years evaluated. Due to the large number of variables evaluated, and the many factors that influence this decision, additional studies are needed, in order to make more significant comparisons with the literature.

摘要：对于医学生而言，选择医学专科（medical specialty）是关乎其未来执业方向的重要抉择。该决策不仅受学业表现、经济考量与生活方式偏好的影响，个人内在特质亦会对其产生作用。研究目的：本研究旨在评估影响医学生选择医学专科的核心因素，并识别某高等教育机构前四年在读医学生偏好的执业领域。研究结果：本研究共纳入397名医学生，其中307名完成了本研究预先设计的调查问卷，最终有效问卷为291份。有效受访者中女性204名，男性87名。研究对不同年级学生的影响因素进行了对比，并与已有文献的发表结果进行比对。本次研究中，医学生专科选择的主要考量因素包括：知识覆盖广度与专科针对性、与患者的接触机会、执业地点以及住院医师培训（medical residency）后的生活方式。相较于男性医学生，女性更看重专科的日常工作压力、长期医患关系以及求职便利性这三项因素。父母为医务人员的背景同样会影响专科选择。学生的经济状况与专科选择的关联体现在长期经济回报层面，对于月家庭收入处于分布区间两端（即6000至15000巴西雷亚尔，或超过20000巴西雷亚尔）的学生而言，该因素的影响更为显著。普通外科（General Surgery）是最受青睐的首选专科，该偏好主要集中于男性学生群体，其次依次为儿科学（Pediatrics）、临床医学（Clinical Medicine）与精神病学（Psychiatry）。研究结论：所有受访年级的医学生均认为生活方式、执业地点与早期经济回报同等重要。由于本研究涉及的变量与影响决策的因素较多，未来需开展更多相关研究，以实现与现有文献更具说服力的对比分析。