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Table of Contents
Year : 2022  |  Volume : 5  |  Issue : 2  |  Page : 130-136

Comparison between final-year medical students' career choices before and after the conduction of a mentorship activity

1 Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
2 Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; Department of Forensic Medicine and Clinical Toxicology, College of Medicine, Cairo University, Cairo, Egypt

Date of Submission12-Jul-2021
Date of Decision08-Nov-2021
Date of Acceptance27-Nov-2021
Date of Web Publication28-Apr-2022

Correspondence Address:
Samah Fathy Ibrahim
Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jnsm.jnsm_83_21

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Background: The elective specialty's selection significantly impacts the graduates' acceptance rate in a preferable postgraduate specialty training program. This selection has a multifactorial nature of the decision-making process that worries the undergraduate students and alters their academic lives. Objective: This study aimed to assess final-year undergraduate medical students' specialty choices before and after the conduction of a mentorship activity. Methods: The mentorship activity was organized in the academic year 2019–2020 to help the 71 final-year medical students choose their preferred future specialty. Two self-reported pre- and postactivity surveys, including demographics, the chosen specialty, location, factors that influenced their top-ranked choices, needs/feedback about the activity, were used. Results: Sixty-six female students, with a mean age of 23.5 ± 0.8 years, participated in mentoring activity, with a response rate of 92.95%. Most of the participants (73%) decided to be trained in one local residency training program. Surgery (31.8%) and family medicine (28.8%) were the most popular specialties. Personal interest (88%) was endorsed as the most influential factor influencing their choices. The internship mentoring activity significantly increased participants' ability to choose the elective training specialty (P < 0.012) but did not substantially affect the future training selected places (P < 0.6).Conclusion: Professional medical training has various challenges at serial phases, and university mentoring activities should be tailored to meet students' desires and the need of the professional society.

Keywords: Activity, medical education, mentorship, selection, specialty

How to cite this article:
AlAteeq DA, Alzahrani NA, Alharbi RA, Hassounah NN, Ibrahim SF. Comparison between final-year medical students' career choices before and after the conduction of a mentorship activity. J Nat Sci Med 2022;5:130-6

How to cite this URL:
AlAteeq DA, Alzahrani NA, Alharbi RA, Hassounah NN, Ibrahim SF. Comparison between final-year medical students' career choices before and after the conduction of a mentorship activity. J Nat Sci Med [serial online] 2022 [cited 2022 Nov 27];5:130-6. Available from: https://www.jnsmonline.org/text.asp?2022/5/2/130/344213

  Background Top

The development of a medical specialist involves a long and devious journey through medical school and postgraduate training. At several stages, substantial obstacles should be met and overcome, starting with an elective internship medical specialty decision process that can significantly impact a given students' future life goals. This decision could influence graduates' acceptance rate in a chosen postgraduate specialist training program that is another significant step in the medical specialist's journey.[1] The modern high-tech innovations in medical care create a high number of medical specialties and subspecialties. Consequently, it is a challenge to narrow the graduates' choices down to one.[2] Choosing an elective internship training is a critical and stressful phase due to the complex, dynamic, and multifactorial nature of the decision-making process.[3] Moreover, this decision could be influenced by many factors such as psychological, lifestyle, specialty exposure, and the students' perceptions toward the specific specialty.[2],[4]

In Saudi Arabia, students spent 6 years in medical school before starting a 1 year of internship. During this year, students are supposed to select a specific field to become a specialist in this field.[4] The proper selection of the training specialty boosts their acceptance rate in the competitive Saudi residency programs.[5] Offering appropriate career orientation and counseling services could achieve the selection process.[6]

Researches on the specialty choices can provide energetic information that guides the actual planning of an appropriate medical education and health-care promotion.[7] Few studies were conducted in Saudi Arabia in different cities: Abha, Dammam, and Jeddah. These studies assessed students' specialty choices and factors that motivate them for their choices.[2],[8],[9] This study aimed to determine final-year medical students' specialty choices and the mentorship program's effect on specialty choices in Saudi Arabia.

  Methods Top

Study design and population

This cross-sectional study was conducted at the College of Medicine, Princess Nourah Bint Abdulrahman University (PNU) in Riyadh, Saudi Arabia, considered the largest female university in the world. College of Medicine was established in 2011, using a problem-based learning method. Students complete curriculums within 7 years for a bachelor of medicine and bachelor of surgery degree, including a preparatory year and an internship year. Ethical approval was obtained from the institutional review board at PNU. A 1-day internship mentorship activity was organized by the internship unit to help the final-year medical student to choose their preferred future specialty, plan their internship tracks, and elective rotations accordingly. The mentorship interactive lecture-based activity was conducted in PNU according to the students' choices. Lectures were presented by specialized residents and representatives from Saudi Commission for Health Specialties (SCFHS). It included orientation about various specialties and local versus international residency programs. The internship unit sent two self-reported surveys to all the final-year students' e-mails: the first survey (preactivity) in November 2020 and the second one (postactivity) in December 2020. Ethical approval was obtained in February 2020 from the Institutional Review Board at PNU, Riyadh, Saudi Arabia (IRB-PNU: 20-0081). Written informed consent was obtained from the students. The study procedures adhered to the ethical guidelines of the Declaration of Helsinki. The minimum required sample size was estimated using Raosoft software at the 95-confidence level with an estimated 50% response distribution and a margin of error of ±5% was 62.

Data collection tool

The authors adapted the surveys from a similar study, conducted at King Khalid University in Abha.[2] Both pre- and postactivity surveys included three parts. Part I contained questions related to demographic details of students, such as age and grade point average (GPA). Part II contained four questions related to their specialty decision, the location for future training, their specialty preferences that they need to know more about it, and factors influencing their preference. The first question was about their specialty's decision (yes or no question). The second question was about the location for future training (local or international). The third question was about their specialty preference that they need to know more about it, including internal medicine, surgery, pediatrics, obstetrics and gynecology, radiology, orthopedics, ophthalmology, otolaryngology, psychiatry, emergency medicine, neurology, dermatology, family medicine, anesthesiology, forensic medicine, urology, physical medicine, rehabilitation, and “other to be mentioned”. The subspecialties were not included as its choices are usually not made before finishing the residency program.

The fourth multiple response question was about the 23 factors influencing their top-ranked choices, including the personal interest, the marital status, the number of children, the family expectation, the teachers' advice, friends' advice, the field competition, the future job opportunities, the specialty's prestige, the specialists' shortage, the patients' diversity, the option to practise abroad, the clerkship experience, the research opportunities, the teaching opportunities in medical college, the perceived ability (inclination), the effect of a role model, the chance to serve people, the location of practice, the work-related risks and stress, the period of training, work independently, and high-income potential.

Moreover, the preactivity survey included two additional questions about the impact of the chosen specialty for the community and their career counseling needs in specialty selection during their medical education. However, the postactivity survey included additional five feedback questions about the activity. Participants responded to each of the feedback items on a 3-point Likert scale: 1 – disagree; 2 – neutral; and 3 – agree, while a 3-point Likert scale 1 – dissatisfied; 2 – neutral; and 3 – satisfied was used for the satisfaction question.

Statistical analysis

Descriptive analysis of all study variables was conducted in average and standard deviation or frequency and percentage. Comparison between variables was conducted using analysis of variance (ANOVA). P < 0.05 was considered statistically significant. All data analysis was performed by the Statistical Package for the Social Studies (SPSS 20 IBM Corp., New York, NY, USA).

  Results Top

Demographic information

In total, 66 students participated in the preinternship mentoring activity, with a response rate of 92.95%. All participants were female, with a mean age of 23.5 ± 0.8 years and the final medical college year. Their mean GPA was 4.14 ± 0.8 [Table 1].
Table 1: Preinternship mentoring program survey (n=66)

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Specialties preferences

Before starting the mentorship activity, 27% of the participants had not finalized their decision in choosing their elective training specialty, and 84.8% of them selected the local residency training programs. Surgery, family medicine, and pediatrics were the most popular specialties as 31.8%, 28.8%, and 24.2% of the participants were interested in them and wanted to know more about them, respectively.

Moreover, 77.3% of them believe that their chosen training specialty is significant to the community. The obtained marks in a particular subject influenced 30.3% of participant's specialty choice. Only 22.7% of them were satisfied with their medical college tenure's opportunities in exploring their potential career choices. Nearly all of the participants (94%) needed an internship mentoring program for specialty counseling before starting the internship [Table 1].

The internship mentoring activity significantly affected participants' ability to choose the elective training specialty (P < 0.012) but did not affect the future training selected places (P value < 0.6) substantially [Table 2]. Surgery, family medicine, pediatrics, internal medicine, ophthalmology, obstetrics, and gynecology were the top six elective training specialties selected by participants for the internship year (11, 10, 9, 7, and 5 participants, respectively) [Figure 1].
Figure 1: Students' decided elective training specialty for internship

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Table 2: The effect of the internship mentoring program on certain variables (n=66)

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Factors influencing the specialty choices

Personal interest was the most influential factor influencing choosing specialty as it was endorsed by 88% of the participants in pre- and postmentorship program surveys. The internship mentoring activity significantly clarified certain factors that could influence the specialty choices, such as future job opportunities, family expectations, teacher advice, and specialty prestige (P < 0.000, 0.004, 0.013, and 0.02, respectively). The factors affecting the top six future training specialties are illustrated in [Table 3]. Furthermore, the repeated ANOVAs indicated significant evidence that the patients' diversity, the effect of a role model, and a chance to serve people significantly affected the future specialty (P < 0.05). In contrast, GPA significance did not considerably influence their specialty selection.
Table 3: Top six choices for internship elective training and factors affecting them

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Internship mentorship activity's feedback

About two-third of the participants were overall satisfied with the internship mentorship activity (65.2%), and the rest of them were either neutral (30.3%) or dissatisfied (4.5%). The mentorship activity's topics, objectives, and length were relevant and appropriate for 84.8%, 75.8%, and 78.8% of them, respectively [Table 4]. SCFHS matching system explanation and viewing the residents' specialty experience rather than consultants were the most useful things mentioned by the participants. Inviting speakers for the less common specialties and inviting residents from other international training programs such as the USA, UK, and Canada were suggested by the participants.
Table 4: Internship mentorship program feedback survey (n=66)

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  Discussion Top

Our study suggested that the pregraduates mentoring activity could be repeated annually. It significantly helps the 5th-year medical students in their elective training specialty and career path selection. A recent Saudi study among medical students from governmental universities showed that elective clinical training had positively affected their future career choices.[10] Mentoring for medical students is an essential step in an individual's professional growth. It has been shown that the need for support, guidance, and professional and social counseling are the main objectives of undergraduate mentoring. Once approaching postgraduate training, making career choices and planning become the top main objectives.

Our study found that students appreciated the usefulness of having such an activity. It provided a general organized review on the targeted specialties by discussing the most suited personality types, training methods, lifestyles, and imminent subspecialties.

More than two-third of the students seemed to be satisfied with the mentoring activity's topics, objectives, and organization in this study. This satisfaction is related to their need for such activity. It could also be associated with presented mentors' ability to offer them practical advice that helps them in specialty training and career path selection.[11]

In our study, the specialty selection seemed to be influenced mostly and significantly by personal interests, which cannot be manipulated by the activity. Each personality type has individual preferences in the training specialty selection. Individuals' personalities, values, and interests seriously reflect making career selections.[12] In addition, being interested in a specialty may increase satisfaction or comfortable feeling.[13]

Furthermore, our study stated that teacher advice significantly influenced the specialty selection process. Previous studies in Saudi Arabia and Nepal emphasized the significant influence of the teachers' personality on future career choices. [10],[14]College's teachers emphasized the students' career selection as they play the role of careers' leaders who support young people in making critical life choices.[15]

Moreover, it was found that family career expectations and prestige significantly influenced the specialty selection process. The student's wish to achieve family expectations is another motivation in specialty and career selections regardless of their career satisfaction.[13] However, medical students who perceive high family expectations in choosing a prestigious specialty may be more hesitant in their specialty selection process and may also experience long-term burnout.[16]

Future job opportunities were also found to be a significant influencing factor in our study. Students may explore the advantages and disadvantages of their selection.[13] Similarly, the motivation categories of “future job opportunity” and “patient care” were found to drive the medical students' career selection process.[17] In addition, a Hungarian study identified that high-income potential is the most crucial factor that drives the medical specialty selection's motivations. The high market value of the medical graduates influenced their factor selection.[18]

Regarding medical specialties, female physicians preferred primary care medical specialties such as pediatrics, family practice more than highly technical specialties such as surgery.[19] However, the female participants in our study were found to be interested in exploring surgery specialties in addition to primary care medical specialties. Indeed, female physicians may have different considerations when approaching their specialty choice. However, pioneer female physicians, who entered the highly technical medical specialties that have been exclusively occupied by men, encourage female medical students to follow their paths.[19]

Concerning the different influencing factors, patients' diversity, the chance to help people, and a role model's effect showed statistically significant differences among the chosen surgical, family medicine, and medical specialties. Many researchers investigated the association between influencing motivational factors and specialty selection. Scott et al. reported that Canadian medical students who chose surgery as their best career path were males and young single females who can withstand unfavorable lifestyles. In contrast, students choosing family medicine were females who have concerns about medical lifestyle and have more family ties.[20] In other studies, the specialty's prestige and income potential had implications on surgical career's selection.[21],[22],[23]

Family medicine is still one of the most popular female preferred specialties, and the patient care motivations influenced its selection. The breadth of practice motivates students to select family medicine as their career. Managing patients with diverse clinical and social complaints can be practised in family medicine.[19]


This study is limited by the small sample size of female students only, which limits its generalizability. Further studies with larger numbers, including several universities across Saudi Arabia, would help calculate more accurate results. Another possible weakness of this study is that it is a cross-sectional study without monitoring students' individual opinions through the years of their medical education or comparing them with another university that is not applying for the activity as a control group.

  Conclusion Top

Personal interest was the most influential factor influencing students' future specialty choices. Surgery and family medicine were the most popular specialties. Internship mentorship activity was useful for senior medical students. It provided them a general organized review on the targeted specialties and increased their ability to choose the elective training specialty. The transition from a medical school to an entire medical field necessitates much support, guidance, and professional and social counseling to make specialty training choices. Professional medical training has various challenges at serial phases, and the existence of a dependable colleague's experience with mentor's guidance is needed to assist in career planning. University mentoring activities should be tailored to meet students' desires and the need of the professional society.

Financial support and sponsorship

This research was funded by the Deanship of Scientific Research at Princess Nourah Bint Abdulrahman University through the Fast-Track Research Funding Program.

Conflicts of interest

There are no conflicts of interest.

  References Top

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  [Figure 1]

  [Table 1], [Table 2], [Table 3], [Table 4]


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