General physicians: born or made? The use of a tracking database to answer medical workforce questions

The aim of the study was to use a tracking database to investigate the perceived influence of various factors on career choices of New Zealand medical graduates and to examine specifically whether experiences at medical school may have an effect on a decision to become a general physician.

Questionnaires were distributed to medical students in the current University of Auckland programme at entry and exit points. The surveys have been completed by two entry cohorts and an exit one since 2006.

The response rates were 70 and 88% in the entry and exit groups, respectively. More than 75% of exiting students reported an interest in pursuing a career in general internal medicine. In 42%, this is a 'strong interest' in general medicine compared with 23% in the entry cohort (P < 0.0001). There is correlation between a positive experience in a clinical rotation and the reported level of interest in that specialty with those indicating a good experience likely to specify career intentions in that area. Having a positive experience in a clinical rotation, positive role models and flexibility in training are the most influential factors affecting career decisions in Auckland medical students. Only 11% of study respondents reported that student loan burden has a significant influence on career decisions.

Quality experiences on attachments seem essential for undergraduates to promote interest in general medicine. There is potential for curriculum design and clinical experiences to be formulated to promote the 'making' of these doctors. Tracking databases will assist in answering some of these questions.