- Swiss residents' speciality choices – impact of gender, personality traits, career motivation and life goals

Residents' speciality choices at T3: Of the 522 physicians participating at the third assessment, 83 (15.9%) had not yet decided in which speciality they wanted to qualify. The remaining 439 residents had decided to qualify in the following specialities: 45 (8.6%) in primary care, 126 (24.1%) in internal medicine (including all sub-specialities of internal medicine), 68 (13.0%) in surgical disciplines, 31 (5.9%) in gynaecology & obstetrics, 40 (7.7%) in anaesthesiology and intensive care, 44 (8.4%) in paediatrics, 25 (4.8%) in psychiatry, and 60 (11.5%) in other specialities (such as dermatology, ENT, neurology, ophthalmology, radiology). The participants had a list of all 43 officially acknowledged medical specialities in Switzerland, marked with a code number, which they could fill in answering the question concerning the speciality choice.

The development of residents' speciality choices is shown in Figure 2. At the end of medical school 60% of the female and 51% of the male graduates had made their speciality choice. In their second year of residency, 71% of the female and 64% of the male residents had decided, and in the fourth year of residency, 83% of the female and 84% of the male participants named their speciality aspired to. The distribution of the different specialities within the gender group did not change much between the three measurements. However, the distribution of the specialities aspired to by the study participants is different from the speciality distribution represented by the working doctors who hold a speciality qualification. Compared to all working female specialists, there are significantly fewer female residents aspiring to become primary care physicians and psychiatrists; also the group of other specialities is smaller. It might be that some of the still undecided residents will choose one of those specialities later on. Looking at the male participants, fewer residents want to become primary care physicians, internists or psychiatrists but significantly more want to go into surgical disciplines compared to working male doctors.

The speciality choice depending on gender in the study sample at T3 is listed in Table 3. Male residents more often chose surgical specialities, whereas females decided on paediatrics, gynaecology & obstetrics (G&O), and anaesthesiology. In the group of other specialities there was no relevant gender-different distribution.

Residents' characteristics depending on speciality aspired to are shown in Table 4. Participants choosing surgical specialities or anaesthesiology comparably show the highest scores for sense of coherence, self-esteem and instrumentality; psychiatry residents give low scores on these three personality scales. With regard to the scores for expressiveness there are no significant differences between the groups. Physicians aspiring to surgical specialities have comparatively high values for intrinsic and extrinsic career motivation, but low values for extraprofessional concerns. Primary care physicians and psychiatrists rate extraprofessional concerns comparatively high. The life goal 'intimacy' is especially important for G&Os. Physicians in the surgical specialities as well as in G&O attach particular importance to 'power'. Future primary care physicians assess the life goal 'achievement' lowest. Subjects pursuing internal medicine show medium level values on all scales.

The multivariate analyses of the influence of gender, personality traits, career motivation and importance of life goals is shown in Table 5. The effect of gender remained significant after controlling for personality traits, career motivation and life goals as covariates. The same does not apply to the influence of personality traits on the speciality choice after controlling for career motivation and life goals. In other words, there are no direct significant influences of personality traits on the speciality choice. This means that career motivation and life goals can be considered as mediator variables.

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