The influence of internship training experience on Kenyan and Ugandan doctors' career intentions and decisions: a qualitative study.
Internship
career preference
labour market
medical education
workforce
Journal
Global health action
ISSN: 1654-9880
Titre abrégé: Glob Health Action
Pays: United States
ID NLM: 101496665
Informations de publication
Date de publication:
31 12 2023
31 12 2023
Historique:
medline:
10
11
2023
pubmed:
9
11
2023
entrez:
9
11
2023
Statut:
ppublish
Résumé
Medical internship is a key period for doctors' individual career planning and also a transition period for the broader labour market. We aimed to understand the complex set of factors influencing the career intentions and decisions of junior doctors, post-internship in Kenya and Uganda. We conducted semi-structured interviews with 54 junior medical officers and 14 consultants to understand doctors' internship experiences and subsequent employment experiences. We analysed the data using a mix of a direct content approach, informed by an internship experience and career intentions framework developed primarily from high-income country literature, alongside a more inductive thematic analysis. Echoing the internship experience and career intentions framework, we found that clinical exposure during internship, work-life balance, aspects of workplace culture such as relationships with consultants and other team members, and concerns over future job security and professional development all influenced Kenyan and Ugandan doctors' career preferences. Additionally, we added a new category to the framework to reflect our finding that interns might want to 'fill a health system gap' when they choose their future careers, based on what they witness as interns. However, often career intentions did not match career and employment decisions due to specific contextual factors, most importantly a shortage of job opportunities. We have shown how internship experiences shape medical doctors' career intentions in Kenya and Uganda and highlighted the importance of job availability and context in influencing doctors' career choices.
Sections du résumé
BACKGROUND
Medical internship is a key period for doctors' individual career planning and also a transition period for the broader labour market.
OBJECTIVES
We aimed to understand the complex set of factors influencing the career intentions and decisions of junior doctors, post-internship in Kenya and Uganda.
METHODS
We conducted semi-structured interviews with 54 junior medical officers and 14 consultants to understand doctors' internship experiences and subsequent employment experiences. We analysed the data using a mix of a direct content approach, informed by an internship experience and career intentions framework developed primarily from high-income country literature, alongside a more inductive thematic analysis.
RESULTS
Echoing the internship experience and career intentions framework, we found that clinical exposure during internship, work-life balance, aspects of workplace culture such as relationships with consultants and other team members, and concerns over future job security and professional development all influenced Kenyan and Ugandan doctors' career preferences. Additionally, we added a new category to the framework to reflect our finding that interns might want to 'fill a health system gap' when they choose their future careers, based on what they witness as interns. However, often career intentions did not match career and employment decisions due to specific contextual factors, most importantly a shortage of job opportunities.
CONCLUSION
We have shown how internship experiences shape medical doctors' career intentions in Kenya and Uganda and highlighted the importance of job availability and context in influencing doctors' career choices.
Identifiants
pubmed: 37942513
doi: 10.1080/16549716.2023.2272390
pmc: PMC10653699
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2272390Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 207522
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Références
Qual Health Res. 2000 Nov;10(6):819-28
pubmed: 11146861
BMJ Open. 2018 Mar 2;8(3):e019456
pubmed: 29500208
Lancet. 2018 Aug 4;392(10145):385
pubmed: 30102171
Hum Resour Health. 2020 Mar 30;18(1):26
pubmed: 32228587
BMC Med Educ. 2012 Aug 06;12:68
pubmed: 22867022
PLoS Med. 2011 Aug;8(8):e1001079
pubmed: 21886488
Hum Resour Health. 2021 May 19;19(1):69
pubmed: 34011364
Med Teach. 2023 Jan;45(1):97-110
pubmed: 35944557
BMJ Glob Health. 2022 May;7(Suppl 1):
pubmed: 35675966
Hum Resour Health. 2015 Sep 08;13:75
pubmed: 26350706
Hum Resour Health. 2021 Jan 14;19(1):10
pubmed: 33446218
Hum Resour Health. 2019 Nov 6;17(1):74
pubmed: 31690317
BMJ. 2011 Nov 23;343:d7031
pubmed: 22117056
BMJ Open. 2017 Oct 25;7(10):e018462
pubmed: 29074517
BMJ Open. 2022 May 6;12(5):e056426
pubmed: 35523483
Med Educ. 2008 Jan;42(1):61-8
pubmed: 18042189
BMC Med Educ. 2017 May 26;17(1):92
pubmed: 28549459
BMJ Glob Health. 2022 Jun;7(Suppl 1):
pubmed: 35772807
Int J Equity Health. 2017 Sep 15;16(1):169
pubmed: 28911328
BMJ Glob Health. 2022 Aug;7(Suppl 1):
pubmed: 36008084
BMC Health Serv Res. 2023 Aug 19;23(1):875
pubmed: 37596663