Confidential Career Advising for Medical Students: A Qualitative Study

Medical students must navigate specialty career decisions and residency applications amid perceptions of conflicting faculty roles. Research is lacking concerning students' interaction with confidential advisors in these high-stakes contexts.

This study explored student and faculty perceptions of how students work with confidential career advisors for career exploration and decision-making within a comprehensive advising programme.

This qualitative study queried the perceptions held by medical students and faculty confidential career advisors at the University of California, San Francisco, gathered in interviews between October 2022 and 2023. Interview questions, guided by social cognitive career theory (SCCT), addressed career decision-making. Authors analysed data from interviews with 12 fourth-year students and nine faculty using thematic analysis with sensitizing concepts. Researchers achieved trustworthiness through credibility, reflexivity, triangulation and diverse team expertise, minimizing bias. Three themes characterized how confidential advisors facilitated students' decision-making around specialty career choice: One, trusting relationships enabled students to share openly with limited self-monitoring about their questions, goals and identities; two, supporting students' values strengthened advising within these trusting relationships; three, advising conversations promoted consideration of student-specialty fit as advisors helped students imagine themselves in careers. These themes support the self-efficacy component of SCCT.

Findings suggest confidential advising addresses unique student needs that traditional advising may not satisfy. Other medical schools may consider implementing similar confidential advising models to provide support to student decision-making. Future research should examine optimal advisor training, the impact of advisor approach on student outcomes and long-term career satisfaction among users of confidential advising services.