View of Gendered Choice of Post Graduate Speciality among Undergraduate Indian Medical Students – A Cross Sectional Study

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Gendered Choice of Post Graduate Speciality among Undergraduate Indian Medical Students – A Cross Sectional Study.

1Chella Devanand, ^2*A.V.Anuja, ³A.Sangeetha, ⁴J.Thanalakshmi, ⁵Samuel Sundar Doss

1 II MBBS student, Department of Physiology, Saveetha Medical college & Hospital, Thandalam, Chennai, India

2*Assistant Professor, Department of Physiology, Saveetha Medical college & Hospital, Thandalam, Chennai, India

3Assistant Professor, Department of Physiology, Saveetha Medical college & Hospital, Thandalam, Chennai, India

4Tutor, Department of Physiology, Saveetha Medical college & Hospital, Thandalam, Chennai, India

*Corresponding author:

Dr. A.V.Anuja, Abstract:

To become an exemplary doctor, one should always hard work, undergo longer periods of training both at the undergraduate and post graduate levels, pledge personal and family time and commitment lifelong learning. Aim: The present study was designed to analyse gender-based specialty preferences among undergraduate medical students in a south Indian medical college. Methods: A questionnaire-based survey was carried out among 388 students in various medical colleges to find out their speciality preferences. Results: The most preferred speciality among female students was Obstetrics and gynaecology (28%) followed by General surgery (22.5%), Paediatrics (11%), General medicine (9%), Internal medicine (8%), Radiology (8%), Dermatology (8%), Psychiatry (7%), Neurology (2%) & Orthopaedics (0.5%). The most preferred specialty preference in males was General surgery (41%), General medicine (13%). Conclusion: We demonstrated a significant gender differences in specialty preferences and factors influencing this preference. While the majority of participants agreed that undergraduate medical students should be able to pursue any medical specialty they desire regardless of gender.

Keywords: Medical students, speciality preferences, Teaching methodology, INTRODUCTION:

Studying medicine is a noble profession which empowers people to support and to be valued others with their work. In recent years many medical colleges have mushroomed

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across India [1]. Bachelor of medicine and Bachelor of surgery course of four and- a-half years including one year internship followed by compulsory rural service for one year.

Simple MBBS degree in medicine is however not enough for making a fruitful and palatable career. During the preclinical and clinical experiences medical students should build their professional identity [2]. One needs to do specialization in any of the branches of medicine or surgery to have bright career. Much research has focussed on the personal characteristics of individuals choosing individual careers and on context childhood factors that affect carrier choices, and the connexions of different forms of personality [3-7]. Selecting a career option between these specialities typically depends on various intrinsic (Personal qualities &

preferences) and Extrinsic (work environment factors and these include personal health, gender controllable style, financial reward, reputation, work pressure, working hours, job security [8-10].

It is important to make your choice represent a compromise between your interests, capacities, values as well as the available opportunities and their limitations. In addition, personal life experiences, interest in community-based settings, and passion for providing continuous care to patients may also pave the way to a specialty choice Advances in medical sciences have led to diverse career options. Research studies have observed that in growing countries like India, educational loans and life style factors may be the determining factors for the choice of specialty by the students [11]. In most cases, it is observed that students never wish to take up basic science specialty, as their knowledge and skills become limited to teaching and learning activities [12]. There’s a need to figure out what motivates the students to take up some of the specialities of their choosing, so that they can maintain medical harmony between different specialities. The objectives of our survey were to identify medical students' choice of specialty and the factors considered to choose their speciality by the medical students in a south Indian medical college.

METHODOLOGY:

A cross sectional questionnaire survey was carried out among 388 medical undergraduate students in a south Indian medical college to know their speciality preferences post MBBS. The study performed obtaining ethical approval by the board of the institute (SMC/IEC/2019/21). All the participants responded to questionnaire which elicited demographic profile, place of residence urban or rural, parents’ qualification and the

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student’s speciality preference to pursue in post graduation and why they have chosen the subject. The students were asked to complete 8-item questionnaire, which consisted of three parts. The first part collected Demographic details, place of residence and year of study.

Parent’s qualifications and professions were also included in the questionnaire, questions about their interest in pursuing post-graduate studies and why. The final part of questionnaire was collected to know which teaching methodology inspired the most. Students were asked to consider 14 specialty options and select the most preferred career preference. Specialties listed were surgery, obstetrics and gynaecology, paediatrics, internal medicine, psychiatry, orthopaedics, ophthalmology, dermatology, anaesthesiology, radiology, public health, family medicine, basic sciences, and ear, nose, and throat (ENT). Students were informed of the study goal and that participation is voluntary and anonymous. All questions pertaining to the study were answered and verbal consent was obtained. Students were handed a paper copy of the survey for completion. Results were analysed frequency was calculated.

RESULTS:

The current study shows top 10 speciality preferences between female and male medical students. Categorical variables were presented as percentages. Out of 388 participants, 72% were female and 28% were male (Table 1& 2). In the figure we clearly noticed a difference of choosing their speciality among the female and male counter parts.

The most preferred speciality among female students was Obstetrics and gynaecology (28%) followed by General surgery (22.5%), Paediatrics (11%), General medicine (9%), Internal medicine (8%), Radiology (8%), Dermatology (8%), Psychiatry (7%), Neurology (2%) &

Orthopaedics (0.5%). The most preferred specialty preference in males was General surgery (41%), General medicine (13%), paediatrics (11%), internal medicine (7%), orthopaedics, Dermatology (Figure 2 & 3). A specialty that I like and find interesting (55%) was most preferred major reason in both genders for choosing their speciality. Followed by advice from parents, Physician patient relationship, clinical experience, work pressure, good quality of life and flexibility in their speciality were the other factors motivated to choose their PG speciality (Figure 4). When it comes to preferred teaching methodology 60% of female chose blackboard and 55% of male students chose power point as preferred teaching methodology (Figure 5).

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Table I shows gender and age wise analysis of participants

Age (Yrs) Female (72%) Male (28%)

18 40 16

19 80 32

20 72 20

21 44 12

22 44 28

Table II shows the association of gender wise analysis with parent qualification

Father’s Profession P Value Mother’s profession P Value

Med Non– med

0.40

Med Non – Med

0.24

Female 42 90 22 126

Male 15 43 11 39

Figure I: Shows Gender Wise Distribution Among First To Final Year MBBS Students.

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Figure II: Shows the Gender Wise Geographical Location of Medical Students

URBAN RURAL

Female 202 78

Male 78 30

0 50 100 150 200 250

Number of students

Figure 3: shows the gender-wise analysis in choosing subjects in Post-Graduation

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Figure 4: Shows the Motivation for Opting the Respective Speciality Among Undergraduate Students

Clinical

Experience Interest

Physician patient Relationshi

p

Work Pressure

Advice from parents

Good quality of

life

Flexibility of speciality

Female 30 140 20 28 28 14 20

Male 10 30 14 12 10 10 12

0 20 40 60 80 100 120 140 160

Number of students

Figure 5 shows the teaching methodology preferences among medical undergraduates:

DISCUSSION:

In our study, gender differences were noted in the preference for certain specialties.

Gender may be considered the natural selector of specialties due to the wide variance between males and females in their choices. In our study majority of male participants preferred surgical speciality most over medical Studies. These results were similar to Jordan

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and Greece who showed the students preferred surgical speciality most over medical [13,14]

It has been reported in multiple studies that males usually prefer surgical specialties, in contrast to the females who prefer the medical ones [15,16]. Study conducted in Israel reported both male and female medical students opted for clinical subjects as their specialty and none opted for basic medical sciences [17]. Female students chose Obstetrics &

Gynaecology where in the male respondents predominantly chose general surgery these results were consistent with studies done in various institutions [18,19]. Study conducted by Subba etal showed that male medical students opt for surgery and females opt for OBG and internal medicine which concurred with our study [20]. In addition, cultural and religious backgrounds may play a role in preferring some specialties such as obstetrics and gynecology, especially in Islamic countries women generally prefer to consult a female doctor for pregnancy or gynecological problems. More women might be inclined toward Ob/Gyn for this reason. Studies have been done on the options of specialty preferences and factors that influence to choose their subject [15].

CONCLUSION:

The journey to a strong match specialization is challenge for any medical student. One should make a real effort and attention to make the most of carrier speciality choices early in medical school. Taking part in elective clerkships or other clinical events will allow medical students to understand what everyday clinical life is like in various specialties and help a student to explore their skills and abilities.

LIMITATION OF THE STUDY:

In our study female participants were more when compared to male participants. The study would extent to do as a mass survey and to list the motivating factors.

SOURCE OF FUNDING: Self

CONFLICT OF INTEREST: Nil

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