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      Specialty preferences among final year medical students in medical schools of southeast Nigeria: need for career guidance

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          Abstract

          Background

          In resource-poor settings with low doctor-population ratio, there is need for equitable distribution of healthcare workforce. The specialty preferences of medical students determine the future composition of physician workforce hence its relevance in career guidance, healthcare planning and policy formulation. This study was aimed at determining the specialty preferences of final year medical students in medical schools of southeast Nigeria, the gender differences in choice of specialty and the availability of career guidance to the students during the period of training.

          Methods

          A descriptive cross-sectional study was conducted among final year medical students in the six accredited medical schools in southeast Nigeria using self-administered semi-structured questionnaire. Information on reason for studying Medicine, specialty preference and career guidance were obtained. Chi-square test of statistical significance was used in the analysis.

          Results

          A total of 457 students participated in the study with a response rate of 86.7 %. The mean age was 25.5 ± 2.9 years and 57.1 % were male. Majority (51 %) opted to study Medicine in-order to save lives while 89.5 % intended to pursue postgraduate medical training. A higher proportion (51.8 %) made the decision during the period of clinical rotation. The five most preferred specialties among the students were Surgery (24.0 %); Paediatrics (18.8 %); Obstetrics and Gynaecology (15.6 %); Internal Medicine (11.0 %) and Community Medicine (6.8 %) while Pathology (2.0 %); Anaesthesia (0.7 %) and Ear, Nose and Throat (0.2 %), were the least preferred. Compared to females, a higher proportion of male students intended to specialise in Surgery (32.3 % vs 13.0 %, p < 0.001) in contrast to Paediatrics (11.2 % vs 28.8 %, p < 0.001). Majority of the students, 74.6 % had no form of career guidance during their stay in medical school and 11.2 % were undecided on choice of specialty.

          Conclusion

          In spite of the high proportion of students willing to pursue specialist medical training after graduation, most opted for the four core clinical specialities of Surgery, Paediatrics, Obstetrics and Gynaecology and Internal Medicine. Majority of the students made these decisions during clinical rotations. Also, majority had no form of career guidance throughout their stay in medical school. To ensure an equitable distribution of a limited physician workforce in a resource-poor setting, there is need for proper career guidance for the students and this should be in line with the national health needs.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12909-016-0781-3) contains supplementary material, which is available to authorized users.

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          Most cited references38

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          Factors affecting medical students in formulating their specialty preferences in Jordan

          Background In recent years there has been a growing appreciation of the issues of career preference in medicine as it may affect student learning and academic performance. However, no such studies have been undertaken in medical schools in Jordan. Therefore, we carried out this study to investigate the career preferences of medical students at Jordan University of Science and Technology and determine factors that might influence their career decisions. Methods A cross-sectional questionnaire-based survey was carried out among second, fourth and sixth year medical students at the Jordan University of Science and Technology, Irbid, Jordan during the academic year 2006/2007. A total of 440 students answered the questionnaire which covered demographic characteristics, specialty preferences, and the factors that influenced these career preferences. Possible influences were selected on the basis of a literature review and discussions with groups of medical students and physicians. Students were asked to consider 14 specialty options and select the most preferred career preference. Results The most preferred specialty expressed by male students was surgery, followed by internal medicine and orthopaedics, while the specialty most preferred by female students was obstetrics and gynaecology, followed by pediatrics and surgery. Students showed little interest in orthopedics, ophthalmology, and dermatology. While 3.1% of females expressed interest in anesthesiology, no male students did. Other specialties were less attractive to most students. Intellectual content of the specialty and the individual's competencies were the most influential on their preference of specialty. Other influential factors were the "reputation of the specialty", "anticipated income", and "focus on urgent care". Conclusion Surgery, internal medicine, pediatrics, and obstetrics and gynaecology were the most preferred specialty preferences of medical students at Jordan University of Science and Technology.
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            Specialty preferences: trends and perceptions among Saudi undergraduate medical students.

            The exploration of specialty choices by medical students is a hot debate as it affects several important determinants of health care delivery. This study was carried out to determine variation in specialty preferences during medical school training and the perceptions that affect students' specialty choice.
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              The decline in child mortality: a reappraisal.

              The present paper examines, describes and documents country-specific trends in under-five mortality rates (i.e., mortality among children under five years of age) in the 1990s. Our analysis updates previous studies by UNICEF, the World Bank and the United Nations. It identifies countries and WHO regions where sustained improvement has occurred and those where setbacks are evident. A consistent series of estimates of under-five mortality rate is provided and an indication is given of historical trends during the period 1950-2000 for both developed and developing countries. It is estimated that 10.5 million children aged 0-4 years died in 1999, about 2.2 million or 17.5% fewer than a decade earlier. On average about 15% of newborn children in Africa are expected to die before reaching their fifth birthday. The corresponding figures for many other parts of the developing world are in the range 3-8% and that for Europe is under 2%. During the 1990s the decline in child mortality decelerated in all the WHO regions except the Western Pacific but there is no widespread evidence of rising child mortality rates. At the country level there are exceptions in southern Africa where the prevalence of HIV is extremely high and in Asia where a few countries are beset by economic difficulties. The slowdown in the rate of decline is of particular concern in Africa and South-East Asia because it is occurring at relatively high levels of mortality, and in countries experiencing severe economic dislocation. As the HIV/AIDS epidemic continues in Africa, particularly southern Africa, and in parts of Asia, further reductions in child mortality become increasingly unlikely until substantial progress in controlling the spread of HIV is achieved.
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                Author and article information

                Contributors
                +234 803 6675417 , ossai_2@yahoo.co.uk
                drkenuwa@yahoo.com
                ucheanyanwagu@gmail.com
                ntatibiok@yahoo.com
                bnazuogu@yahoo.com
                ekekengozi@gmail.com
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                4 October 2016
                4 October 2016
                2016
                : 16
                : 259
                Affiliations
                [1 ]Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakaliki, Nigeria
                [2 ]Department of Community Medicine, College of Medicine, Imo State University Owerri, Owerri, Nigeria
                [3 ]Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
                [4 ]Epidemiology and Public Health Division, School of Medicine, University of Nottingham, Nottingham, UK
                [5 ]Department of Community Medicine, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria
                [6 ]German Leprosy and TB Relief Association Enugu, Enugu, Nigeria
                Article
                781
                10.1186/s12909-016-0781-3
                5050581
                27716155
                88b3790e-f625-4f64-b27f-fd48e4b761a2
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 May 2016
                : 27 September 2016
                Funding
                Funded by: the Authors
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Education
                Education

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