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      Medical career expectations of academically talented high school students: a nationwide cross-sectional study in China

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          Academically talented high school students (ATHSSs), an exceptional cohort, are not well studied for their career expectations, especially for those with medical career expectation (MCE). Nowadays, the public perception of the medical profession is changing in China. The purpose of this study was to answer questions about ‘is medicine attractive for ATHSSs and ‘what factors affect medical career expectations (MCE) for ATHSSs’ in China.


          A total of 16,479 representative ATHSSs in senior three completed a questionnaire and four different academic tests. Frequency statistics showed the proportion of ATHSSs with MCE. Unpaired t-tests were performed to find out the differences in demographics, family background, and academic performance between students with and without MCE. The logit models analysis were applied to explore the potential factors that affected the MCE of this exceptional group of students.


          ATHSSs with MCE accounted for 20.6% (ranking 7/18) of the respondents. They were more likely to be female, came from relatively poorer families, lived in a rural area, and performed significantly worse in all academic tests except for mathematics, compared with those without MCE. In addition, the results revealed that gender (β = − 0.436, p < 0.01), region of hometown (β = − 103, p < 0.1), mother’s years of schooling (β = − 0.019, p < 0.05), and father’s occupational status (β = − 0.005, p < 0.01) contributed significantly to the MCE of academically talented students. Better performance in mathematics affected the MCE of ATHSSs taking the liberal arts and science tests differently.


          We found the medical career is becoming unattractive to academically talented students and the medical career may be losing their aura in China. Students who have medical career expectations are likely to be females and to have a weak family background.

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          Most cited references 25

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          A standard international socio-economic index of occupational status

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            China's human resources for health: quantity, quality, and distribution.

            In this paper, we analyse China's current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses-in 2005, there were 1.9 million licensed doctors and 1.4 million nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Most of China's doctors (67.2%) and nurses (97.5%) have been educated up to only junior college or secondary school level. Since 1998 there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce. Inter-county inequality in the distribution of both doctors and nurses is very high, with most of this inequality accounted for by within-province inequalities (82% or more) rather than by between-province inequalities. Urban-rural disparities in doctor and nurse density account for about a third of overall inter-county inequality. These inequalities matter greatly with respect to health outcomes across counties, provinces, and strata in China; for instance, a cross-county multiple regression analysis using data from the 2000 census shows that the density of health workers is highly significant in explaining infant mortality.
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              Social cognitive model of career self-management: toward a unifying view of adaptive career behavior across the life span.

              Social cognitive career theory (SCCT) currently consists of 4 overlapping, segmental models aimed at understanding educational and occupational interest development, choice-making, performance and persistence, and satisfaction/well-being. To this point, the theory has emphasized content aspects of career behavior, for instance, prediction of the types of activities, school subjects, or career fields that form the basis for people's educational/vocational interests and choice paths. However, SCCT may also lend itself to study of many process aspects of career behavior, including such issues as how people manage normative tasks and cope with the myriad challenges involved in career preparation, entry, adjustment, and change, regardless of the specific educational and occupational fields they inhabit. Such a process focus can augment and considerably expand the range of the dependent variables for which SCCT was initially designed. Building on SCCT's existing models, we present a social cognitive model of career self-management and offer examples of the adaptive, process behaviors to which it can be applied (e.g., career decision making/exploration, job searching, career advancement, negotiation of work transitions and multiple roles).

                Author and article information

                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                24 May 2020
                24 May 2020
                : 20
                [1 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Institute of Medical Education/National center for Health Professions Education Development, , Peking University, ; Beijing, China
                [2 ]GRID grid.194645.b, ISNI 0000000121742757, Faculty of Education, , The University of Hong Kong, ; Hong Kong SAR, China
                [3 ]GRID grid.14709.3b, ISNI 0000 0004 1936 8649, Department of Educational and Counselling Psychology, , McGill University, ; Montreal, Canada
                [4 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Peking University, , Graduate School of Education, ; No.5 Yiheyuan Road, Haidian District, Beijing, 100871 China
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funded by: National Educational Examination Center
                Award ID: GJK2017046
                Award Recipient :
                Research Article
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                © The Author(s) 2020


                china, high school students, talented students, medical career, career expectations


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