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The results on the right in Fig. In the program of their study, second-choice students changed their attitude toward PM more frequently than did first-choice students Of the students who changed their attitude toward PM, At the time of the survey, however, Another striking difference was the fact that Reasons making students appreciate PM more a and less b. This study reveals the differences between students in PM who, prior to enrolment, selected the program as their first choice and those who did not. We found that in the higher study years there were a higher proportion of second-choice students, while the earlier years, that is, the later intake, had a higher proportion of students for whom PM was the first study choice.

This reflects a trend of students increasingly selecting a study in PM at medical school as their first preference, which bodes well for the recruitment of students in PM. Previous studies on career choice have pointed that medical students who have a physician in the family are more likely than other students to choose non-primary care specialties [ 5 , 9 ]. The fact that barely half of the second-choice students collected information about PM before selecting the specialty makes sense, as PM was not their first preference.

At the same time, however, the number of first-choice students obtaining information was also surprisingly low—only The finding that more first-choice students had family already working in PM could explain partly for this low number, because they probably know things already without actively searching. However, the overall results suggest that students make their choices without being sufficiently informed about the specialty. A lack of information also arose as one of the factors influencing the tendency to prefer preventive specialties over other specialties [ 4 , 9 ]. Another finding was that students frequently appealed to the media and national career guide for information.

However, these sources only provide general and unsystematic information about, for example, the job of a PM doctor, the names of medical schools offering PM training, the number of training places per year, and so forth. In our study, that so many PM students selected general doctor as their first choice at the beginning This information gap could be bridged by improving the quality of career guidance services to cultivate interest in the health professions among high-school students [ 14 ] and by providing the media with more examples of the good work done by PM doctors.

In our study, first-choice students frequently turned to their high-school teachers or the national career guide for information about PM, underlining the important role such information sources play for students. Research on career choice has shown that the way in which students experience family medicine during the later years of the curriculum is a determinant of whether or not they will select this as their specialty [ 2 , 15 ].

Our data do not allow us to explain this relationship in the context of PM. However, the fact that more second-choice students than first-choice students changed toward a better appreciation of PM suggests that they were insufficiently informed about the profession at the start of the program. This could explain the changeable nature of their opinion about PM.

Our study shows that the incentives to study general medicine and PM, differed in focus. In their ambition to become a PM doctor, first-choice students were largely driven by extrinsic factors, such as: PM is a new profession and high-income job, it has low entry criteria and a low study burden compared to general medicine, and the desire to uphold their family tradition and fulfill the wish of having a doctor in their family.

Furthermore, second-choice students also preferred a job which could offer them further study opportunity and at a health care center at provincial level. This finding is consistent with results from a previous study on the PHC specialty choice of final year medical students in Hanoi Medical University, in which Kim et al. Intrinsic motivation results in high-quality learning and creativity, so if students do lack intrinsic motivation, educators should encourage more active forms of extrinsic motivation as an educational strategy [ 17 ].

From our study, second-choice students changed toward a better appreciation of PM after they were encouraged by PM teachers, as well as by realizing that PM suited their own personality better than initially expected, and the more positive social perception of the PM profession when they had more experiences during the clinical years years 3—4 and PM years years 5—6.

However, these were only our initial findings and testing this hypothesis could be an interesting new topic for future study. A limitation of this study was that the survey was conducted only in the four Northern medical universities in Vietnam. There may be differences in demographic characteristics and public perception about the medical profession between different regions of the country, but also between countries, that could influence the career choice of PM of students. Also, the study was a cross-sectional observation which did not include information about the final destinations of the students after graduation.

Further investigation in medical schools in other parts of the country and internationally, as well as a student cohort tracer study could reveal more insight in factors that impact on the decision by students to choose and to pursue PM. This study about motivation and career preferences of students in PM revealed differences between students who had PM as their first study preference and those who only selected it as their second choice. These two groups of students differed in the way they retrieved information about the profession, the stability of their opinion about PM, and their motivation to study and pursue a career in PM.

Improving information provision about the work of PM, diffusing knowledge, and otherwise acquainting students better with PM before and during the program may help to cultivate their interest and consequently to increase the number of health care staff working in the PM sector. The findings provided lessons from Vietnam which could be useful for other countries in the struggle to promote the fields of public health and preventive medicine.

Changes in U. J Gen Intern Med. Factors associated with the nature, timing and stability of the specialty career choices of recently graduated doctors in European countries, a literature review. Med Educ Online. Joint Annual Health Review Human Resource for Health in Vietnam. Joint Annual Health Review. Accessed 3 July Knowledge of primary health care and career choice at primary health care settings among final year medical students—Challenges to human resources for health in Vietnam.

Glob Public Health. Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature. Acad Med. Medical career choice: current status of research literature. Teach Learn Med. Willingness to work in rural areas and the role of intrinsic versus extrinsic professional motivations—a survey of medical students in Ghana.

BMC Med Educ. What predicts medical student career choice? Hum Resour Health. An approach to training and retaining primary care physicians in rural Appalachia. Appropriate training and retention of community doctors in rural areas: a case study from Mali. Experiences promoting healthcare career interest among high-school students from underserved communities.

J Natl Med Assoc. Curran V, Rourke J. The role of medical education in the recruitment and retention of rural physicians. Med Teach. Inter J Med Educ. Intrinsic and Extrinsic Motivations: classic definitions and new directions.

Contemp Educ Psychol. Download references. VATN contributed to the design, data collection, analysis and writing. AJJAS contributed to the design and writing. PW and HNL contributed to the data interpretation and writing.

Public Health and Preventive Medicine

All authors read and approved the final manuscript. We thank the Board of Directors and preventive medical students of four medical universities in Vietnam for their endorsement and willingness to participate in the study. We would like to thank Ms. Angelique van den Heuvel for her language revision of the manuscript.

The investigator also had the approval of the Scientific and Technical Committees of the other three universities to conduct the data collection.

Verbal consent was obtained from participants after the researchers explained that answering the questionnaire was optional and anonymity was guaranteed and that the results would be used to improve the quality of PM training. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Correspondence to Van Anh Thi Nguyen. The rate of participation was very high respondents, Of these respondents, The mean age of the respondents was A pilot study was performed with 12 PM students in Hanoi from different course years to improve the format and the clarity of the items.

The final version used incorporated the results from the pilot study Additional file 1. The questionnaire comprised a series of 33 questions in three parts. These items also asked whether students received any assurance or any other type of assistance from family, relatives, or friends, and whether they expect help to find a job in the health care sector after graduation. The second part contained 15 items about whether PM was their first or second choice when applying to the medical university, reasons for choosing to study PM, who had the biggest influence on their decision to study PM, and their perceptions of PM over time.

The last part consisted of three items about their expectations of future jobs. Participants were asked to tick those predefined options that best fitted their opinion; for some of the items, they were allowed to select more than one option but maximally three. We conducted a descriptive analysis of the answers. Due to the multiplicity of tests, the Bonferroni correction was applied to control for the risk of inflation of type I errors.

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Results were considered statistically significant if the two-tailed p value was less than. Subsequently, a post hoc analysis on standardized residuals was used to report exactly which differences were at a level of significance. In the higher years, there were more second-choice students, while in the basic years i. First-choice students more often had siblings working as preventive doctors; conversely, second-choice students more often had siblings who were medical students or clinical doctors.

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Of all students, First-choice students had made more efforts to obtain information from many sources about PM before deciding to choose the specialty than had second-choice students Among information sources as the media, the national career guide, parents, relatives, high school teachers and friends, students most frequently turned to the media for information about PM, including the Internet, television, and newspapers.

The results on the left in Fig. Reasons for students to enter medical school a and study PM b. Asterisks significant difference between first-choice and second-choice students with Bonferroni adjustment. The results on the right in Fig. In the program of their study, second-choice students changed their attitude toward PM more frequently than did first-choice students Of the students who changed their attitude toward PM, At the time of the survey, however, Another striking difference was the fact that Reasons making students appreciate PM more a and less b.

This study reveals the differences between students in PM who, prior to enrolment, selected the program as their first choice and those who did not. We found that in the higher study years there were a higher proportion of second-choice students, while the earlier years, that is, the later intake, had a higher proportion of students for whom PM was the first study choice. This reflects a trend of students increasingly selecting a study in PM at medical school as their first preference, which bodes well for the recruitment of students in PM.

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Previous studies on career choice have pointed that medical students who have a physician in the family are more likely than other students to choose non-primary care specialties [ 5 , 9 ]. The fact that barely half of the second-choice students collected information about PM before selecting the specialty makes sense, as PM was not their first preference. At the same time, however, the number of first-choice students obtaining information was also surprisingly low—only The finding that more first-choice students had family already working in PM could explain partly for this low number, because they probably know things already without actively searching.

However, the overall results suggest that students make their choices without being sufficiently informed about the specialty. A lack of information also arose as one of the factors influencing the tendency to prefer preventive specialties over other specialties [ 4 , 9 ]. Another finding was that students frequently appealed to the media and national career guide for information.

However, these sources only provide general and unsystematic information about, for example, the job of a PM doctor, the names of medical schools offering PM training, the number of training places per year, and so forth. In our study, that so many PM students selected general doctor as their first choice at the beginning This information gap could be bridged by improving the quality of career guidance services to cultivate interest in the health professions among high-school students [ 14 ] and by providing the media with more examples of the good work done by PM doctors.

In our study, first-choice students frequently turned to their high-school teachers or the national career guide for information about PM, underlining the important role such information sources play for students. Research on career choice has shown that the way in which students experience family medicine during the later years of the curriculum is a determinant of whether or not they will select this as their specialty [ 2 , 15 ].

Our data do not allow us to explain this relationship in the context of PM. However, the fact that more second-choice students than first-choice students changed toward a better appreciation of PM suggests that they were insufficiently informed about the profession at the start of the program. This could explain the changeable nature of their opinion about PM.

Our study shows that the incentives to study general medicine and PM, differed in focus. In their ambition to become a PM doctor, first-choice students were largely driven by extrinsic factors, such as: PM is a new profession and high-income job, it has low entry criteria and a low study burden compared to general medicine, and the desire to uphold their family tradition and fulfill the wish of having a doctor in their family. Furthermore, second-choice students also preferred a job which could offer them further study opportunity and at a health care center at provincial level.

This finding is consistent with results from a previous study on the PHC specialty choice of final year medical students in Hanoi Medical University, in which Kim et al. Intrinsic motivation results in high-quality learning and creativity, so if students do lack intrinsic motivation, educators should encourage more active forms of extrinsic motivation as an educational strategy [ 17 ].

From our study, second-choice students changed toward a better appreciation of PM after they were encouraged by PM teachers, as well as by realizing that PM suited their own personality better than initially expected, and the more positive social perception of the PM profession when they had more experiences during the clinical years years 3—4 and PM years years 5—6. However, these were only our initial findings and testing this hypothesis could be an interesting new topic for future study.

A limitation of this study was that the survey was conducted only in the four Northern medical universities in Vietnam. There may be differences in demographic characteristics and public perception about the medical profession between different regions of the country, but also between countries, that could influence the career choice of PM of students. Also, the study was a cross-sectional observation which did not include information about the final destinations of the students after graduation. Further investigation in medical schools in other parts of the country and internationally, as well as a student cohort tracer study could reveal more insight in factors that impact on the decision by students to choose and to pursue PM.

This study about motivation and career preferences of students in PM revealed differences between students who had PM as their first study preference and those who only selected it as their second choice. These two groups of students differed in the way they retrieved information about the profession, the stability of their opinion about PM, and their motivation to study and pursue a career in PM.

Improving information provision about the work of PM, diffusing knowledge, and otherwise acquainting students better with PM before and during the program may help to cultivate their interest and consequently to increase the number of health care staff working in the PM sector. The findings provided lessons from Vietnam which could be useful for other countries in the struggle to promote the fields of public health and preventive medicine.

Changes in U. J Gen Intern Med. Factors associated with the nature, timing and stability of the specialty career choices of recently graduated doctors in European countries, a literature review. Med Educ Online.


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Joint Annual Health Review Human Resource for Health in Vietnam. Joint Annual Health Review. Accessed 3 July Knowledge of primary health care and career choice at primary health care settings among final year medical students—Challenges to human resources for health in Vietnam. Glob Public Health. Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature.

Acad Med. Medical career choice: current status of research literature. Teach Learn Med. Willingness to work in rural areas and the role of intrinsic versus extrinsic professional motivations—a survey of medical students in Ghana. BMC Med Educ. What predicts medical student career choice? Hum Resour Health.