Free choice and career choice: Clerkship electives in medical education

Medical education experiences, particularly in clinical years, are reported determinants of career choice. Less is known about features of clinical education experiences including length, discipline, setting and choice, which may serve as landmarks in career choice decisions. This study's purpose was to explore the benefits of a free choice clerkship elective, and more specifically, its role in clarifying career choice.

Using framework and content analysis methodology, we analysed University of British Columbia, third-year medical student anonymised assignments regarding free choice and 2-week clerkship elective experiences. This clerkship was designed to provide students with clerkship experiences outside the conventional curricular model, while encouraging student choice of ambulatory and community settings. Assignment questions included: reasons for choosing elective; whether learning objectives were met; influence of elective on career choice; and unique elective experiences. Iterative review, coding, analysis and indexing of assignments were carried out to identify themes and corroborate findings.

Emergent themes included: positive views of experience; transferable knowledge and skills; and influencer of future education and career choices. Although students were encouraged to choose clerkship experiences outside the conventional curricular model, most students chose the elective to clarify future career decisions.

This qualitative descriptive study highlights the influence of highly regarded, free choice clerkship elective experiences in the career decision making process in medical education. Further examination of the details of clerkship elective experiences which influence career choice is recommended.