Future priorities of interns in public and private tertiary care hospitals of a mega city in a developing country.

Objective: To determine the future priorities of young medical doctors in tertiary care hospitals in a major urban centre.

Methods: This multi-centre cross-sectional study was conducted at four tertiary care hospitals of Karachi, Pakistan, from January to June 2015, and comprised medical interns. A questionnaire-based survey was conducted. The participants were inquired about their demographics, preferred places and hospitals for training in the future and reason for their choices. Differences in future choice for going abroad between gender, relationship status, household monthly income, etc. were analysed. SPSS 16 was used for data analysis.

Results: Of the 308 participants, 228(74%) were females and 80(26%) were males. The overall mean age was 24.56±1.18 years. Moreover, 118(38.3%) participants wanted to go abroad for their postgraduate training. Of them, 46(39%) wished to return to Pakistan after completing the training from abroad. Top five reasons for going abroad included better quality of training 60(50.8%), better environment and facilities 35(29.7%), security and safety 29(24.6%), better career growth 24(20.3%) and fiancé/spouse settled there 18(15.3%). Preference of pursuing postgraduate training abroad outside Pakistan was significantly higher among doctors who were males (p=0.026), had graduated from medical colleges in Karachi (p=0.003), had household monthly income of greater than Rs100,000 (p<0.001) and had an immediate family member abroad (p<0.001). Besides, 190(61.7%) doctors wanted to pursue their training in Pakistan. Of them, 85(44.7%) wished to do their postgraduate training in public sector hospitals while 105(55.3%) had their preference for private hospitals. Main reasons for joining private hospitals included quality of training 40(38.1%), clean environment 25(23.8%), facilities 25(23.8%) and familiarity with environment 25(23.8%).

Conclusions: Almost half of the female doctors were planning not to pursue their careers in the future, whereas half of the male doctors wished to go abroad for training with only one-third among them planning to return.