Why medical students switch careers: changing course during the preclinical years of medical school.

Objective: To determine why students switch their career choices during the preclinical years of medical school.

Design: Two questionnaires were administered: the first at the beginning of medical school and the second about 3 years later just before students entered clinical clerkship.

Setting: University of British Columbia, University of Alberta, University of Toronto, University of Ottawa, Queen's University, University of Western Ontario, University of Calgary, and McMaster University.

Participants: Entering cohorts from 10 medical school classes at 8 Canadian medical schools.

Main Outcome Measures: Proportion of students who switched career choices and factors that influenced students to switch.

Results: Among the 845 eligible respondents to the second survey, 19.6% (166 students) had switched between categories of family medicine and specialties, with a net increase of 1.2% (10 students) to family medicine. Most students who switched career choices had already considered their new careers as options when they entered medical school. Seven factors influenced switching career choices; 6 of these (medical lifestyle, encouragement, positive clinical exposure, economics or politics, competence or skills, and ease of residency entry) had significantly different effects on students who switched to family medicine than on students who switched out of family medicine. The seventh factor was discouragement by a physician.

Conclusion: Seven factors appear to affect students who switch careers. Two of these factors, economics or politics and ease of residency entry, have not been previously described in the literature. This study provides specific information on why students change their minds about careers before they get to the clinical years of medical training.