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This study aimed to investigate the arguments given by Swiss residents for …


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Results
- Swiss residents' arguments for and against a career in medicine

Categories of statements for and against a career in medicine

The 567 residents gave a total of 3,343 responses (5.90 per subject on average) in terms of both "statements for" and "statements against" a career in medicine. Of these, there were 1,640 "statements for" (mean 2.89, range 1 – 6) and 1,703 "statements against" (mean 3.00, range 1 – 6). I.e. some of the subjects gave more than three arguments, some less in terms of "statements for" and "statements against" a career in medicine respectively. The content analysis of the residents' answers resulted in eight categories with arguments both for and against a career in medicine. (The following order of the categories follows the ranking of the frequency distribution of the arguments given in favour of a career in medicine.)

- Personal experiences in day-to-day working life

- Interpersonal experiences in professional relationships

- General work-related structural conditions

- Further training and speciality qualification conditions

- Enjoyment/Meaning

- Social prestige and health-policy aspects

- Income

- Leisure/Private life

Non-distinctive statements such as "curiosity", "science", "the human being", "challenge" were assigned as not codable.

Ranking and frequency distribution of statements for and against a career in medicine by gender

Table 1 shows the allocation of the responses to the eight categories differentiated according to "statements for" and "statements against" content by gender, and ranked by frequency of the "statements for" arguments.

Of all "statements for" responses of both men and women, 70% fell into the categories of Personal experiences in day-to-day working life (41.2%) and Interpersonal experiences in professional relationships (28.8%), which occupied first and second place in the ranking for both genders. The top-ranking "statements against" responses were in the category General work-related structural conditions (32%), followed by Social prestige and health-policy aspects (21%). The frequency distributions of the eight categories and the "statements for" or "statements against" differ greatly according to their respective content.

The ranking of the arguments for a career in medicine categories was the same for male and female residents, while there were some differences in ranking between men and women in the arguments against categories: males rank negative arguments concerning Income in third place and Leisure towards the bottom, while females rank Personal experiences in day-to-day working life in third place and Leisure/Private life in fourth place.

Gender differences

Male participants gave significantly more "statements for" and "statements against" answers for the Social prestige and health-policy category than female residents, and also made significantly more critical statements vis-à-vis Income. Women named significantly more "statements against" answers for Leisure/Private life and Personal experiences in day-to-day working life.

Table 2 gives examples of residents' responses – both "statements for" and "statements against" a career in medicine – for each category (see also Additional file 1). The arguments for and against can be summarized as follows:

Main statements in favour of a career in medicine

The medical profession ...

- is an interdisciplinary challenge

- combines basic sciences and interpersonal concerns

- provides an opportunity to help suffering people

- covers a broad field of practice

- offers job security.

Main statements against a career in medicine

The medical profession ...

- is characterized by high workload, time pressure and emotional stress

- offers poorly structured speciality-qualification training

- is shifting away from work with patients to administrative work

- entails a work-life imbalance with limited quality of life

- is rewarded neither by adequate income nor by social acknowledgement.

Frequency distribution of statements for and against a career in medicine by residents in different speciality fields

In a further step, we investigated whether the arguments for and against a career in medicine differed according to the residents' speciality field. As seen in Table 3.1 and 3.2, there were almost no differences between the statements of residents of the various medical fields, apart from significant differences for statements against a career in medicine in the category Further training and speciality qualification conditions for residents in High-technology medicine and Psychiatry; more negative entries were given in this category than for residents in the other speciality fields.

Frequency distribution of statements for and against a career in medicine by residents who would choose to become a doctor all over again and those who would not

In addition, we were also interested in whether the frequency distribution of the given arguments for and against a career in medicine would vary according to whether or not residents would all over again decide to go into medical training (Table 4.1 and 4.2). Of the present study sample (n = 567), 442 (78%) participants (231 females, 76.2%; 211 males, 79.9%) would choose to become doctors again, while 117 (22%) residents (67 females, 22.1%; 50 males, 18.9%) would not. Five (1.7%) of the women doctors and 3 (1.1%) of the male doctors have not given a response. There were no significant gender-relevant differences.

As expected, residents who would not choose to go into medicine again named significantly more "statements against" in terms of Personal experiences in day-to-day working life (p Enjoyment/Meaning (p 4.2). They reported significantly fewer "statements for" in terms of Enjoyment/Meaning (p General work-related structural conditions (p 4.1).


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