Caribbean Medical Journal (Jun 2023)
Choice of medical speciality: a cross-sectional study of medical students and comparison with existing practice.
Abstract
Objective: The objectives of this study were to determine specialty choices, influencing factors, and migration intent among medical students, and to compare this with current specialist practitioners in Trinidad and Tobago (TT). Methods: A Cross-sectional study using an online survey was conducted at the School of Medicine, Faculty of Medical Sciences, University of the West Indies, St Augustine Campus, TT. Descriptive statistics were presented for choice of specialty, its predictors, and comparisons with specialists in practice were done. Results: Overall, 273 (response rate 21.36%) students responded with 73.6% females and an average age of 22.5(SD3.3) The ten most popular responses for specialty of first choice were unsure (9.5%), cardiothoracic surgery (8.7%), general paediatrics (8.7%), general surgery (7.5%), neurosurgery (7.5%), obstetrics and gynaecology (6.7%), cardiology (4.8%), emergency medicine (4.4%), family medicine (4.4%) and orthopaedics (4.4%). The top three factors influencing their choices were, general interest in the field (95.9%), job security (81.3%) and job availability (70.3%), Most respondents (72%) expressed intent to migrate to specialize. Compared to specialist practitioners, significantly more students aspired to do cardiothoracic surgery, neurosurgery, pediatric surgery, and cardiology, while significantly less students chose internal medicine, anaesthesia and critical care, and ophthalmology. (P< 0.05 for all) Conclusions: A minority of students was uncertain about speciality choice, however most intended to migrate to specialize. A mismatch between student aspirations and current practice was also found. These findings warrant student sensitization to specialties for which there is a need and workplace planning, if we are to retain locally trained doctors.