The 2017 reform to medical specialty training in Czechia: Exploring student career preferences

This article explores medical students' career preferences in the context of the 2017 reform to medical specialty training in Czechia, which aimed to stabilise the physician workforce. One of the changes introduced by the reform was the merging of specialty training for both primary-care and hospital-based paediatrics, facilitating easier transitions of physicians between hospital and outpatient settings. This article presents findings from a survey, conducted by the authors in 2020-2022, of over 3000 students from all medical schools in Czechia. A particular focus was placed on respondents interested in paediatrics. Key findings include: (i) training experience plays a critical role in students' career decisions; however, (ii) students report limited exposure to primary-care paediatrics during their studies; (iii) up to one-third of students who prefer paediatrics intend to leverage the flexibility facilitated by the reform and combine careers in primary-care and hospital-based paediatrics; (iv) family-work balance is a key consideration for students who prefer paediatrics; (v) support from employers during training and the quality of supervision are pivotal for choosing a medical facility. These insights into medical students' career preferences are valuable for policy-makers internationally and underline the importance of aligning health workforce reforms with the preferences of medical graduates' and young physicians' to ensure an impact.