The purpose of this study was to improve the understanding of how perceptions of practicing specific medical specialties contribute to career decisions. Participants included medical students and residents from training programs in West Virginia. Focus groups were conducted between September 2013 and February 2015. Thematic content analysis of focus group interviews was used to identify phrases indicating perceptions of person- versus technique-oriented personality medical specialties.
“Self-focused” and “other-focused” themes emerged within person-oriented comments. Factors affecting “self”, including work/life balance and salary and practice environment, made certain specialties more appealing. Technique-oriented comments included working in a hospital setting, performing technical procedures, and solving immediate problems as opposed to long-term management. Technique-oriented comments from students emphasized learning about disease, and resident comments emphasized treatment as their primary focus.
The majority of participants’ comments suggested that a strong patient-doctor relationship and continuity of care are rewarding components of primary care and more compatible with person-oriented personalities. Participants selecting person-oriented specialties viewed rural practice locations more favorably, especially the opportunity to become an integral part of a community. Participants selecting technique-oriented specialties preferred limited interactions with patients and stated that problem-solving and learning about disease states were the most appealing aspects of practicing medicine.
Conflict(s) of Interest
References with DOI
1. National Rural Health Association Policy Brief. Health care workforce distribution and shortage issues in rural America 2012. https://www.ruralhealthweb.org/getattachment/Advocate/Policy
2. Petterson SM, Liaw WR, Phillips RL, Rabin DL, Meyers DS, Bazemore AW. Projecting US primary care physician workforce needs: 2010-2025. Ann Fam Med. 2012;10(6):503-509. https://doi.org/10.1370/afm.1431
3. Kaiser Family Foundation. Primary Care Physicians by Field September 2016. http://kff.org/other/stateindicator/primary-care-physicians-by-field/?currentTimeframe=0. Accessed December 29, 2016.
4. Grobler L, Marais BJ, Mabunda S. Interventions for increasing the proportion of health professionals practicing in rural or other underserved areas. Cochrane Database Syst Rev. 2015;6:1-81. https://doi.org/10.1002/14651858.cd005314.pub3
5. Health Resources & Services Administration (HRSA) Data Warehouse Health Profession Shortage Area Find. https://datawarehouse.hrsa.gov/tools/analyzers/hpsafind.aspx. Accessed December 16, 2016.
6. Pollard C. West Virginia state health plan: rural health. http://www.hca.wv.gov/policyandplanning/Documents/Background%20Material/shpRurPollard.pdf. Accessed December 29, 2016.
7. Borges NJ, Gibson DD. Personality patterns of physicians in person-oriented and technique-oriented specialties. J Vocat Behav. 2005;67:4-20. https://doi.org/10.1016/j.jvb.2003.12.015
8. Brooks RB, Walsh M, Mardon RE, Lewis M, Clawson A. The roles of nature and nurture in the recruitment and retention of primary care physicians in rural areas: a review of the literature. Acad Med. 2002;77(8):790-798. https://doi.org/10.1097/00001888-200208000-00008
9. Laven G, Wilkinson D. Rural doctors and rural backgrounds: how strong is the evidence? A systematic review. Aust J Rural Health. 2003;11:277-284. https://doi.org/10.1111/j.1440-1584.2003.00534.x
10. Patterson DG, Andrilla CHA, Larson EH. Graduates of rural-centric family medicine residencies: determinants of rural and urban practice. Policy Brief #159. Seattle, WA: WWAMI Rural Health Center, University of Washington, July 2016.
11. Rabinowitz HK, Diamond JJ, Markham FW, Santana AJ. The relationship between entering medical students’ backgrounds and career plans and their rural practice outcomes three decades later. Acad Med. 2012;87(4):493-497. https://doi.org/10.1097/acm.0b013e3182488c06
12. Jackson J, Shannon CK. Validity of medical student questionnaire data in prediction of rural practice choice and its association with service orientation. J Rural Health. 2015;31:373-381. https://doi.org/10.1111/jrh.12123
13. Compton MT, Frank E, Elon L, Carrera J. Changes in U.S. medical students’ specialty interests over the course of medical school. J Gen Intern Med. 2008;23(7):1095-1100. https://doi.org/10.1007/s11606-008-0579-z
14. Senf JH, Campos-Outcalt D, Kutob R. Factors related to the choice of family medicine: a reassessment and literature review. J Am Board Fam Pract. 2003;16:502-512. https://doi.org/10.3122/jabfm.16.6.502
15. Teitelbaum HS, Ehrlich N, Travis L. Factors affecting specialty choice among osteopathic medical students. Acad Med. 2009;84(6):718-723. https://doi.org/10.1097/acm.0b013e3181a43c60
16. Grayson MS, Newton DA, Thompson LF. Payback time: the associations of debt and income with medical student career choice. Med Educ. 2012;46:983-991. https://doi.org/10.1111/j.1365-2923.2012.04340.x
17. Phillips JP, Wilbanks DM, Salinas DF, Doberneck DM. Educational debt in the context of career planning: a qualitative exploration of medical student perceptions. Teach Learn Med. 2016;28(3):243-251. https://doi.org/10.1080/10401334.2016.1178116
18. Maron BA, Fein S, Maron BJ, Hillel AT, El Baghdadi MM, Rodenhauser P. Ability of prospective assessment of personality profiles to predict the practice specialty of medical students. Proc (Bayl Univ Med Cent). 2007;20:22-26. https://doi.org/10.1080/08998280.2007.11928228
19. Borges NJ, Savickas ML. Personality and medical specialty choice: a literature review and integration. J Career Assess. 2002;10:362-380. https://doi.org/10.1177/10672702010003006
20. Motowidlo SJ, Van Scotter JR. Evidence that task performance should be distinguished from contextual performance. J Appl Psychol. 1994;79(4):475-480. https://doi.org/10.1037/0021-9010.79.4.475
Vestal, April L.; Boone, Laura; Walker, Robert; Sheppard, A. Brianna; Morris, Dakota; and Noland, Ashley J.
"Perceptions of Specialties and Primary Care Careers: Findings from West Virginia Medical Student and Resident Focus Groups,"
Marshall Journal of Medicine:
4, Article 10.
Available at: https://mds.marshall.edu/mjm/vol4/iss4/10