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Objective: Research on the preference of medical specialty among medical students in the Netherlands and the attractiveness of aspects of the medical profession during the period 2009-2013., Design: Retrospective, descriptive research., Method: Data from medical students in the Netherlands who participated in the computer programme Inventory Medical Professionals Choice (IMBK) were analyzed with respect to their preference of medical specialty and the attractiveness of various aspects of the medical profession. The IMBK programme was available free of charge through the Royal Dutch Medical Association (KNMG) website 'Arts in Spe' (Future Physician) during the period 2009-2013. The content of the IMBK programme was based on the questionnaire from the medical profile book developed by the pharmaceutical company GlaxoSmithKline (GSK)., Results: General practice was the most popular specialty, particularly among female medical students, with interest increasing during the undergraduate medical curriculum. Hardly any students were interested in insurance medicine, occupational medicine and elderly medicine. Direct patient care was the most attractive professional aspect for medical students. Female students were more attracted to direct and prolonged patient contact than their male counterparts. The number of hours students wished to work in future declined during the course of the undergraduate curriculum, and women were more inclined to prefer regular working hours with adequate leisure time than men., Conclusion: During the course of the undergraduate medical curriculum, medical students changed their preference for medical specialty. Major differences exist between male and female students in terms of preference of medical specialty and attractiveness of aspects of the medical profession.

Objectives: The aims of this study were to investigate: (1) opinions of medical students regarding quantity and content of education on end-of-life care in the curriculum, (2) medical students' knowledge of different aspects of the euthanasia act, and (3) factors associated with positive opinions about the quantity and content of education on end-of-life care in the curriculum., Methods: A total of 204 medical students received a questionnaire; 176 completed it (response rate, 86%)., Results: Approximately half of the students (55%) considered the quantity of end-of-life care education in the curriculum moderate; 35% rated it as good. Half of the students rated the content of end-of-life care education as moderate (50%); 47% rated it as good. Fourteen percent of the students gave correct answers to 6 or 7 of the 8 questions about the euthanasia act. Students who took the elective course "Terminal and Palliative Care," students who had experience with a patient requesting euthanasia and physician-assisted suicide in their personal lives, and students with more knowledge of the euthanasia act were more positive about the quantity of end-of-life care education. Students who completed fewer clerkships and totally agreed with the statement, "Everyone has the right to decide about their own life and death" were more positive about the content on end-of-life care education., Conclusions: The data of this study suggest that more attention can and should be paid to education on end-of-life care in the medical curriculum, so students are well prepared to provide adequate end-of-life care.

Objectives: In The Netherlands, approximately 12% of medical graduates spend their professional life in public health, but it is the authors' belief that few of them become interested in such a career during medical school. The aim of this study was to investigate students' development of interest in a career in a public health specialty during medical school., Methods: A written questionnaire was completed by students of all years at a Dutch medical school in 2002 (n=1371) and 2003 (n=1293). Students indicated their interest in a career in 37 Dutch medical specialties. Three public health specialties were distinguished and compared with the least popular specialty, the most popular specialty and with the average interest over all specialties., Results: Interest in a career in occupational health and social insurance health was low throughout medical school. However, almost 15% of students indicated a high level of interest in youth health care in the first year of medical school, which is over twice as many as for the average specialty. This percentage decreased dramatically during medical school. At graduation, all three public health specialties had interest figures well below the average., Conclusions: Students have little interest in careers in public health. However, given that approximately 12% of medical graduates spend their professional life in public health, the factors that influence career preferences should be investigated. Targeted measures may yield more primary career preference in this direction. Reasons for the loss of interest in youth health care need to be investigated.

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.

Objective: To obtain insight into the career choice of recently graduated physicians and the factors that influence this choice., Design: Descriptive., Method: Questionnaires were sent to 1091 physicians who graduated from the VU University in Amsterdam or the University Utrecht between 1 July 1999 and 30 June 2002. Graduates were asked to provide the following information: current occupation, number of days that they have worked in current occupation, 5-year career goals, prerequisites for obtaining a residency, time spent on patient care and research, and the extent to which certain factors have influenced their career choice. Respondents were subdivided into three groups: clinical specialists, general practitioners, and public or occupational health professionals., Results: The response was 70%, and approximately half of the respondents were engaged in additional resident training: 68% in a clinical specialty, 23% in general practice, 9% in public or occupational health, and 2% in another occupation. Most of the respondents worked full-time but would prefer to work less in the future. Full-time availability was the most important prerequisite for a clinical residency. Work experience after graduation was also considered important to obtain a residency in general practice or public or occupational health. Among clinical and general practitioner residents, the most important factor influencing career choice was interest in the specific field. For public and occupational health residents, the most important factor was working within office hours, particularly for female respondents., Conclusion: Various factors influence career choice in recently graduated physicians, and these factors are specialty-dependent. Graduates are interested in the possibility of working part-time in their present occupation and in the near future.

Students' beliefs and attitudes towards the medical profession have been studied in relation to career choices, but most research has been restricted to either predetermined aspects or to a limited number of specialties. This study aimed at getting unprompted insight in the students' perceptions of their future profession in dimensions that may be determinants of study success and career choice. Undergraduate and graduated medical students were interviewed and asked to characterize the medical profession in general and four contrasting specialties in particular. Grounded Theory methodology was used to analyse the data. Participants were medical students at the start of their training (n = 16), during clerkships (n = 10) and after graduation (n = 37). Beginning students perceive the medical profession in limited dimensions: the activities of a physician, their relationship to patients and the physician's knowledge, skills and personality. They do not see many differences between specialties, in contrast with students with clinical experience and graduate students. Undergraduate students' perception is focussed more on social aspects of the profession compared to graduates.

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.