Personal and Contextual Influences on African Medical Students' Career Choices in Primary Care: A Cross-Sectional Mixed-Methods Study.

Abstract

Background and objectives: The choice of specialty by medical students is pivotal for their careers and the health care system. The shortage of trained medical providers makes this choice particularly salient in Africa. Understanding the motivations and preferences of African medical students can inform interventions to improve the distribution and retention of doctors across specialties and regions. This study aims to explore the factors influencing specialty selection among medical students across Africa using a cross-sectional, mixed-methods approach.

Methods: A survey conducted from June to October 2023 included 1,044 students from 152 medical schools. Descriptive statistics summarized sample characteristics, and linear regression models identified predictors of primary care selection. Thematic analysis was performed on qualitative data.

Results: Students interested in primary care were, on average, older and reported higher anxiety levels compared to their counterparts. Key factors influencing specialty choice across all students included personal interest, scope of practice, and intellectual stimulation, with prestige being least important for those choosing primary care. Additionally, the importance of mentorship was lower among primary care aspirants. Country-specific analysis revealed that students from Benin, Botswana, Ivory Coast, Senegal, and Sierra Leone were more likely to choose primary care.

Conclusions: This study provides an overview of the motivations behind specialty choice among African medical students, highlighting the need for tailored interventions to address regional health care needs. Understanding these preferences can help in designing strategies to enhance the distribution and retention of medical professionals in various specialties, ultimately improving health care outcomes.