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Background: Medical students develop interest in a specialty career during medical school based on knowledge and clinical experience of different specialties. How valid this knowledge is and how this knowledge relates to the development of preference for a specialty is not known. We studied their "subjective" knowledge of a specialty (students' reported knowledge) with "objective" knowledge of it (students actual knowledge as compared to reports of specialists) and their preference for this specialty at different stages of education, and used youth health care as a case study., Methods: Students from all years in two medical schools (N = 2928) were asked to complete a written questionnaire including (a) a statement of their knowledge of youth health care (YHC) ("subjective knowledge"), (b) their preference for a YHC career and (c) a list of 47 characteristics of medical practice with the request to rate their applicability to YHC. A second questionnaire containing the same 47 characteristics were presented to 20 practicing youth health physicians with the request to rate the applicability to their own profession. This profile was compared to the profiles generated by individual student's answers, resulting in what we called "objective knowledge.", Results: Correlation studies showed that "subjective knowledge" was not related to "objective knowledge" of the YHC profession (r = 0.05), but significantly to career preference for this field (r = 0.29, P < 0.01). Preference for a YHC career hardly correlated with objective knowledge about this profession (r = 0.11, P < 0.05). Students with YHC clerkships showed no better "objective knowledge" about the profession than students without such experience., Conclusion: Career preference aren't always related to prior experiences, or to actual knowledge of the area. This study shows how careful we should be to trust students' opinions and preferences about specialties; they probably need much guidance in career choice.

Background: In view of the current shortage of psychiatrists in the Netherlands it is important to find out what attracts medical students and recently qualified doctors to a career in psychiatry., Aim: To discover what aspects of psychiatry are of interest to medical students and recently qualified doctors and to determine what interest profile is suited to the practice of psychiatry., Method: Medical students and recently qualified doctors from the Free University medical school in Amsterdam and from Utrecht University medical school completed a questionnaire which investigated why certain specialisms, including psychiatry, were chosen as future careers, and which also examined the appeal of 47 aspects of a career in medicine., Results: About 30% of the students expressed an interest in becoming psychiatrist. The interest was slightly greater among first-year students but decreased in the course of their medical training. About 6% of recently qualified doctors actually work in psychiatry and a larger percentage want to become psychiatrist in five years' time. The interest profile of persons interested in psychiatry differs from that of persons not interested in psychiatry and is different for men and women., Conclusion: The interest of students in a career in psychiatry decreases in the course of their medical training. This is in keeping with the general decrease in interest in any other career in medicine and probably reflects the current increasing focus on only one single medical specialism. The interest profile of persons interested in a career in psychiatry lies more in the communicative and psychosocial sphere and is focused in relationships that develop during long-term treatment rather than on medical-technical aspects. After qualifying as doctors, women with an interest in psychiatry often develop an interest in improvisation, diagnostics and pharmacotherapy.

Purpose: Students vary in their strength of motivation to start and pursue medical training. This study was conducted to investigate the psychometric properties of a Strength of Motivation for Medical School (SMMS) questionnaire., Method: The questionnaire was designed using an iterative method. The instrument was applied to medical students (N= 296) at the start of medical school and to potential applicants (N= 147). The stability of the concept over a six month's time and associations with other motivation measures were studied. A separate group of potential applicants and their parents (N= 169) were asked to validate the items of the questionnaire., Results: Cronbach's alpha reliability of .79 was found. Test-retest reliability of SMMS-scores with a six months interval was .71. Little to no association with specific dimensions of motivation was found, except for a negative correlation with 'ambivalence towards studying'. SMMS-scores were associated with potential applicants' plans to apply for medical school (Spearman's rho .65) and differentially with potential applicants' and their parents' judgements of item validities (.13 to .57)., Conclusions: The SMMS-questionnaire appears to be a reliable and valid instrument to measure strength of motivation for medical training in students who have just entered medical school. It may be used to evaluate the validity of selection procedures and to identify associated variables that could be used in selection procedures.

The aim of this study was to identify factors that are associated with the choice of a spe-cialty, the moment of the definitive choice, and the stability of the choice over time. The focus was on recently graduated doctors in European countries. A review of the literature from October 1994 to October 2004 was conducted. Most of the identified studies were of good quality. Enthusiasm, self-appraisal of skills, human interest and domestic circumstances were the main factors associated with the choice for medical specialization. Female doctors paid a great deal of attention to reasonable working hours and part-time jobs. They were also less certain about their career choice, and made this choice later than men. Most doctors with a preference for general practice at the time of qualification as a medical doctor achieved their aim. Women, who preferred a clinical specialization, had less opportunity than men to achieve their career satisfactorily.