Change in choices regarding the residency of Turkish medical students during the course of medical education

Background: Medical students’ choices depend on their moral values and expectations from their future profession. Although this choice is a personal one it has impacts on the health system. In Turkey, the misdistribution of doctors by specialty has become a significant problem and a risk for the sustainability of the health provision system.Objectives: The aims were to understand how medical students’ up-to-date perceptions and choices of specialization change during their educations, and which moral values have an impact on this process. Material and Methods: An online survey was conducted on 706 medical students. The questionnaire included questions on specialization, career aspirations, the national examination on specialization in medicine (SIM), and compulsory service. After the analysis of this survey, 2 focus groups with a total number of 19 were conducted for further analysis of the data that was collected previously. 50 minutes-long focus group discussions were held on campus between October 24 and October 25, 2019. Findings: Almost all students (98.81%) stated they are planning to get specialty training. Most of the clinical phase students’ (74.01%) specialty preference has changed compared to their first year at medical school. They explained during the focus group sessions that this change was because of their internships during the clinical stage phase (4th, 5th, and 6th year). Significantly more male students stated “financial reasons” as their reason for undergoing specialty training (p=0.016). Focus-group discussions revealed the fact that first three year students tend to choose surgical specialties more, but last three years students tend to choose medical sciences considering their standard of living. Conclusion: We must acknowledge that medical students’ choices on specialization change from surgical specialties towards medical sciences during medical education due to the heavy workload, financial issues, malpractice lawsuits and mobbing. In order to prevent the misdistribution of doctors by specialty, improvement in work conditions should be made.