Does Community-based Experience Alter Career Preference

New Evidence from a Prospective Longitudinal Cohort Study of Undergraduate Medical Students

Context: Previous studies have shown that most medical students want a hospital-based career, but the protagonists of community-based teaching predict that increased community exposure within undergraduate curricula will alter subsequent career preferences.

Objectives: To evaluate the impact on career preference and other attitudes of a year with substantial community exposure, compared with a year of hospital-based learning.

Design: Questionnaire to student cohort before and after two consecutive levels of the course, one with, and the other prior to, substantial community placement.

Setting: Sheffield Medical School.

Subjects: Total of 260 students in the third and fourth year of the MBChB degree.

Results: There were significant differences in career preference and attitude to primary care after the year with a community placement, with more students expressing a preference for a community-based career. This was particularly true for women, and less true for non-European students. Conversely, the hospital-based students, especially men, showed a significant change toward hospital-based careers.

Conclusion: The findings support the hypothetical advantages of shifting medical education to primary care settings, both in encouraging a career in general practice and in the retention of appropriate professional attitudes.

Citation: Howe A, Ives G. Does community-based experience alter career preference? New evidence from a prospective longitudinal cohort study of undergraduate medical students. Med Educ. 2001;35(4):391-7.

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