This study investigated the career preferences of 801 medical students in Bangladesh.
Our results show, majority of the students’ (65%) overall preference was medicine, while surgery was the most popular ‘first’ choice (30.21%) among the participants. The least preferred career choices were non-clinical such as basic sciences, public health, medical administration, etc. These findings are consistent with two studies conducted in India and Pakistan [17, 18] which showed inclination of undergrad medical students towards medicine and surgery.
Our findings indicate that female medical students exhibit a greater predisposition to gynecology & obstetrics as compared to their male counterparts. This aligns with prior research studies conducted in India and Saudi Arabia revealing female medical students’ greater preference for gynecology and obstetrics than their male counterparts [19, 20]. while male students preferred general surgery and internal medicine [20]. The higher tendency of female medical students to choose gynecology and obstetrics as their future specialty can be attributed to various factors, including social norms, cultural beliefs and personal interests. For example, women are often socialized to be more nurturing and caring, advocating women’s health and comfortable and safe dealing with same gender populations may thus be drawn to specialties that involve caring for women’s health and reproductive needs.
Conversely, male students display a significantly higher proclivity towards general practice when compared to female medical students. A Scottish study reported that male medical students were more motivated to pursue surgery than general practice, whereas female students were equally or more likely to choose general practice [21]. However, evidence from past studies stated female students are more likely to choose general practice as their first choice than male students [22]. Our study revealed male students are more attracted to medicine than female students, while female students showed more undecided trends. This finding is similar as reported by several studies [18, 23, 24] attributing cultural norms constraining girls’ opportunities to pursue higher education. These findings highlight the need for medical education programs to provide career guidance and support to students, particularly to female students who may face more challenges in choosing and practising their preferred specialities after the graduation.
However, according to two studies conducted in Jordan and Kenya, male students are more inclined to choose surgery and internal medicine, and orthopaedics, whereas female students preferred obstetrics and gynaecology the most [25, 26]. Another study from China stated similar insights that surgery and orthopaedics were male-dominated specialities, whereas the choices of female students are considerably fluctuating such as internal medicine, ophthalmology, neurology, dermatology, radiology, anaesthesia, pathology, gynaecology and obstetrics, and paediatrics [27]. On the other hand, few studies conducted in England, Netherlands, and the USA reported both male and female students were equally interested in internal medicine [28,29,30,31, 23, 24].
Our research reveals some interesting trends in the career preferences over time among medical students in Bangladesh. One trend that stands out is the increasing interest in pursuing a career in medicine over time. This trend has also been observed in other studies, which suggests that medical students are becoming more attracted to the field of medicine [32,33,34]. This could be due to various factors, such as the growing demand for medicine due to more opportunities for private practice or more job opportunities, perceived income potential, the scope of attending a wide range of patients, lifestyle, prestige etc. Another trend observed in this study is the decreasing interest in pursuing a career in surgery over time. This observation is supported by another study conducted among medical students in Greece [35]. It may be due to the challenging and demanding nature of surgical careers, which may not be appealing to all medical students [35, 36]. On the contrary, some studies reported increased interest in general surgery over time [32,33,34].
The results of this study indicate that the interest of medical students in public health as a career option increases significantly in the 5th year [26]. A similar trend was also found in a previous study ( [26, 37]). The reason behind this could be high salaries and facilities in NGOs and INGOs [38], competitive post-graduation training position etc. [37]. Additionally, this study also highlights a decreasing interest in non-medical careers among medical students from 1st year to the final year, which is in line with the results of other studies [33, 34]. It may be due to increased interest in clinical practice due to more clinical exposure over the course of their study However, an opposite trend was observed in a South Korean study reporting a significant proportion of medical students considering non-medical careers, such as business administration, law, and finance, indicating a potential shift in career aspirations over time [39].
One important finding of this study is the medical student’s preference of non-health cadres in Bangladesh Civil Service (i.e., any cadre, administration cadre, foreign cadre, police cadre). The main reason behind this phenomenon is inter-cadre disparity [40]. The reason for this trend could be attributed to mandatory posting in rural areas, lack of resources, safety etc. [37]. In contrast, administrative jobs come with a personal assistant, a separate office, access to a car, and prospects for ongoing promotion [41, 42].
We observed that professional prestige, the influence of role models, the potential for financial gain, the ability to maintain a work-life balance, time for personal interests, opportunities for fast promotion, the income level for a desirable lifestyle, and the chance for research are some important considerations for medical students when choosing their future careers. In a study conducted in Iran, professional prestige was identified as one of the most important factors influencing career choice among medical students [43]. Similarly, the current study found that professional prestige was significantly different between academic years, with first-year students having the highest mean score and fourth-year students having the lowest mean score. Role models (i.e., favourite faculties, senior/ renowned doctors with national/ international recognitions) have also been identified as a significant factor in career choice for medical students in this present study. In a study conducted in Pakistan, medical students reported that observing and interacting with a role model had a significant influence on their career choice [44].
Having fixed hours of work, and having enough time for spouses and families were significant factors in the selection of future career options across gender and academic years. These factors are important in work-life balance [45] and a study found that work-life balance was one of the most important factors influencing career choice among medical students [46]. However, the current study’s findings also highlight some factors that did not show significant differences between academic years. For example, personal passion, availability of postgraduate training, short duration of a post-graduation course, and the possibility of working abroad did not show any significant differences between academic years. This finding is consistent with past research studies that have identified these factors as important considerations for medical students regardless of their academic year [25, 47].
The present study indicates a notable difference between male and female medical students in their responses to certain factors that influence their career preferences. Those factors are such as professional prestige, being influenced by a role model, which will provide easy money, having enough time for spouse and family, having time for other personal interests, which will allow faster promotion, income will allow an enjoyable lifestyle, and research opportunity, which is consistent with previous research studies. For instance, a study conducted by Querido et al. found that male and female medical students have differing perceptions and preferences on the importance of work-life balance and family responsibilities [48]. Additionally, Lambert et al. reported that female medical students were more likely than male students to take lifestyle factors into account when choosing a specialty [36]. However, a study found that male and female medical students did not differ in their preferences for certain specialties based on the factors like job security, intellectual challenge, and opportunities for research [35].
This study was a cross-sectional study, thus, causal inference between the outcome and independent variables cannot be demonstrated. Moreover, career preferences can be changed over time. Due to the small sample size, the findings may not be representative of all medical students throughout the country. Further studies including all medical colleges of Bangladesh are recommended to draw conclusions. Another limitation of this study is that we did not follow up with students, so, the reasons for changes in career preferences throughout the course cannot be established. Despite some limitations, this study highlighted some important insights into the medical student’s future career choice pattern. The inclusion of medical students from all five academic years is also another strength of this study. The findings from this study will guide further studies involving all medical colleges of Bangladesh to understand the reasons for evolving medical students’ career choices.