ORIGINAL ARTICLE
Explaining the process of choosing clinical specialties in general medical graduates: A grounded theory
 
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1
MD, Ph.D. Professor, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Ph.D. Candidate of Medical Education, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Ph.D. Candidate of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4
Community medicine specialist, School of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Online publish date: 2018-07-14
Publish date: 2018-11-18
 
Electron J Gen Med 2018;15(6):em89
KEYWORDS:
ABSTRACT:
Objective:
Internationally, the distribution of specialized physicians is a growing concern. The choice of medical specialties is a central issue in attempts to change this problematic situation. The current study aimed to explain the process of choosing clinical specialties in Iran’s medical graduates.

Materials and Methods:
The authors used grounded theory methodology. In 2016-2017, they conducted 14 in-depth, face-to-face, semi structured interviews with a purposive and theoretical sample of 10 medical graduates based on two criteria (those who intended to participate in the medical assistant exam and those who participated in the exam and their test scores had not yet been announced).

Results:
After analysis of the interviews, 883 primary codes, 64 subcategories, 14 subclasses, and 4 main categories were obtained. The results of data collection and analysis at four levels by Strauss and Corbin (2008), which led to the theory and model in this field, showed the effectiveness of the process of choosing specialty results from the coordination between three dimensions of study, career, and favorable conditions imagined for the future life that takes place in a supportive environment with a developed welfare system and an inclusive academic culture.

Conclusion:
With the help of the findings of such a study, the process and the main elements involved in this process can be determined and the causal relationships and mechanisms can be identified and intervened, which in turn leads to choosing medical specialty in line with the national priorities.

 
REFERENCES (26):
1. de Souza LCL, Mendonça VR, Garcia GB, Brandão EC, Barral-Netto M. Medical specialty choice and related factors of Brazilian medical students and recent doctors. PloS one. 2015;10(7):e0133585. https://doi.org/10.1371/journa....
2. Ahmad OB, Lopez AD, Inoue M. The decline in child mortality: a reappraisal. Bulletin of the World Health Organization. 2000;78:1175-91.
3. Ossai EN, Uwakwe KA, Anyanwagu UC, Ibiok NC, Azuogu BN, Ekeke N. Specialty preferences among final year medical students in medical schools of southeast Nigeria: need for career guidance. BMC medical education. 2016;16(1):259. https://doi.org/10.1186/s12909....
4. Brotherton SE, Rockey PH, Etzel SI. US graduate medical education, 2003-2004. JAMA. 2004;292(9):1032-7. https://doi.org/10.1001/jama.2....
5. Ahmed SM, Majumdar MAA, Karim R, Rahman S, Rahman N. Career choices among medical students in Bangladesh. Advances in Medical Education and Practice. 2011;2:51. https://doi.org/10.2147/AMEP.S....
6. Ahmed SM, Majumdar MAA, Karim R, Rahman S, Rahman N. Career choices in preventive and social medicine and other non-clinical specialties among medical students: Bangladesh perspective. South East Asia Journal of Public Health. 2013;1(1):64-7. https://doi.org/10.3329/seajph....
7. Al‐Mendalawi MD. Specialty preferences of Iraqi medical students. The clinical teacher. 2010;7(3):175-9. https://doi.org/10.1111/j.1743....
8. Abdulrahman M, Makki M, Shaaban S, Al Shamsi M, Venkatramana M, Sulaiman N, et al. Specialty preferences and motivating factors: A national survey on medical students from five uae medical schools. Education for Health. 2016;29(3):231.
9. Önder E, Dag S, Önder G. Determining the Precedence Order of the Factors Influencing Doctors’ Choice of Specialty in Turkey. 2014.
10. Aslam M, Ali A, Taj T, Badar N, Mirza W, Ammar A, et al. Specialty choices of medical students and house officers in Karachi, Pakistan. 2011.
11. Ali S. Statistical Report of the hundred premiere Medical residency Exam Academic year 2016-2017. Center for measurement and Medical Education. 2016-2017.
12. Sadati AK. Money Based Reform and Distorted Doctor-patient Interaction: A Critique of the Recent Health Sector Evolution Plan in Iran. Iranian journal of public health. 2017;46(4):583.
13. Nasser Simforoosh M. Growth Trends in Medical Specialists Education in Iran. Archives of Iranian Medicine. 2014;17(11):771.
14. Ezatabadi MR, Rashidian A, Shariati M, Foroushani AR, Sari AA. Using Conjoint Analysis to Elicit GPs’ Preferences for Family Physician Contracts: A Case Study in Iran. Iranian Red Crescent Medical Journal. 2016;18(11).
15. Mosadeghrad AM. Factors influencing healthcare service quality. International journal of health policy and management. 2014;3(2):77. https://doi.org/10.15171/ijhpm....
16. Lawrence J, Poole P, Diener S. Critical factors in career decision making for women medical graduates. Medical Education. 2003;37(4):319-27. https://doi.org/10.1046/j.1365....
17. Saigal P, Takemura Y, Nishiue T, Fetters MD. Factors considered by medical students when formulating their specialty preferences in Japan: findings from a qualitative study. BMC Medical Education. 2007;7(1):31. https://doi.org/10.1186/1472-6....
18. Grove SK. The practice of nursing research: Appraisal, synthesis, and generation of evidence. Nursing Standard. 2013;27(31):30. https://doi.org/10.7748/ns2013....
19. Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks. 2008.
20. Lempert LB. Asking Questions of the Data: Memo Writing in the Grounded. The Sage handbook of grounded theory. 2007:245-64.
21. Birks M, Mills J. Grounded theory: A practical guide: Sage; 2015.
22. Alligood M, Tomey A. Numing Theorists and Their Work. St. Louis: Mosby. Elsevier; 2006.
23. Schwartz RW, Simpson WG, Strodel WE, Jarecky RK, Griffen WO, Young AB. Career change: in quest of a controllable lifestyle. Journal of surgical research. 1989;47(3):189-92. https://doi.org/10.1016/0022-4....
24. Takeda Y, Morio K, Snell L, Otaki J, Takahashi M, Kai I. Characteristic profiles among students and junior doctors with specific career preferences. BMC medical education. 2013;13(1):125. https://doi.org/10.1186/1472-6....
25. DeZee KJ, Maurer D, Colt R, Shimeall W, Mallory R, Powers J, et al. Effect of financial remuneration on specialty choice of fourth-year US medical students. Academic Medicine. 2011;86(2):187-93. https://doi.org/10.1097/ACM.0b....
26. Maiorova T, Stevens F, Scherpbier A, van der Zee J. The impact of clerkships on students’ specialty preferences: what do undergraduates learn for their profession? Medical Education. 2008;42(6):554-62. https://doi.org/10.1111/j.1365....
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