Where are they working? A case study of twenty Cuban-trained South African doctors

Background: The year 2017 marked the 21st anniversary of the South African Cuban Medical Collaboration (SACMC) programme that offers disadvantaged South African (SA) students an opportunity for medical training in Cuba. Graduates are expected to return to practice at a primary care level in rural communities; however, little is known about the professional trajectories and career choices of graduates from the programme. Aim: This study explored the reasons why students enrolled in the programme, their professional and career choices as graduates and their career intentions. Setting: The study setting was the whole of SA although participants were primarily drawn from KwaZulu-Natal. Methods: An exploratory, qualitative case study used a purposive sampling strategy to gather data through semi-structured interviews from participants. Results: Graduates (N = 20) of the SACMC programme were all practicing in local SA settings. Participants preferred the SACMC programme as it offered them a full scholarship for medical training. Nineteen doctors had fulfilled their obligation to work in rural areas. Thirteen doctors are engaged in primary healthcare practice, either as private practice generalists or as public service medical officers. Three doctors had completed specialty training: one doctor was training towards specialisation, one doctor was employed at national government and two doctors were employed as medical managers. At the time of the study, 11 doctors were practicing in rural locations and 19 had indicated a long-term intention to work and live within South Africa. Conclusion: The participants of this study who graduated from the SACMC programme are fulfilling their obligations in rural communities. They all intend to contribute to the SA medical workforce in the long-term

Causes of Blindness and Career Choice among Pupils in a Blind School; South Western Nigeria

Background: The causes of Blindness vary from place to place with about 80 of it been avoidable. Furthermore Blind people face a lot of challenges in career choice thus limiting their economic potential and full integration into the society. This study aims at identifying the causes of blindness and career choice among pupils in a school for the blind in South -Western Nigeria. Materials and Methods: This is a descriptive study of causes of blindness and career choice among 38 pupils residing in a school for the blind at Ikere -Ekiti; South Western Nigeria. Results: Thirty eight pupils comprising of 25 males (65.8) and 13 females (34.2) with age range from 6-39 years were seen for the study; The commonest cause of blindness was cataract with 14 cases (36.84) while congenital glaucoma and infection had an equal proportion of 5 cases each (13.16). Avoidable causes constituted the greatest proportion of the causes 27 (71.05) while unavoidable causes accounted for 11 (28.9). The law career was the most desired profession by the pupils 11 (33.3) followed by Teaching 9 (27.3); other desired profession includes engineering; journalism and farming. Conclusion: The greatest proportion of causes of blindness identified in this study is avoidable. There is the need to create public awareness on some of the notable causes particularly cataract and motivate the community to utilize available eye care services Furthermore there is need for career talk in schools for the blind to enable them choose career where their potential can be fully maximized

Rural practice preferences among medical students in Ghana: a discrete choice experiment

Objective To determine how specific job attributes influenced fourth year medical students' stated preference for hypothetical rural job postings in Ghana.Methods Based on discussions with medical student focus groups and physicians in practice and in the Ministry of Health; we created a discrete choice experiment(DCE) that assessed how students' stated preference for certain rural postings was influenced by various job attributes: a higher salary; free superior housing; an educational allowance for children; improved equipment; supportive management; shorter contracts before study leave and a car. We conducted the DCE among all fourth year medical students in Ghana using a brief structured questionnaire and used mixed logit models to estimate the utility of each job attribute. Findings Complete data for DCE analysis were available for 302 of 310 (97) students. All attribute parameter estimates differed significantly from zero and had the expected signs. In the main effects mixed logit model; improved equipment and supportive management were most strongly associated with job preference (a = 1.42; 95 confidence interval; CI: 1.17 to 1.66; and a = 1.17; 95CI: 0.96 to 1.39; respectively); although shorter contracts and salary bonuses were also associated. Discontinuing the provision of basic housing had a large negative influence (a = .1.59; 95CI: .1.88 to .1.31). In models including gender interaction terms; women's preferences were more influenced by supportive management and men's preferences by superior housing. Conclusion Better working conditions were strongly associated with the stated choice of hypothetical rural postings among fourth year Ghanaian medical students. Studies are needed to find out whether job attributes determine the actual uptake of rural jobs by graduating physicians

Factors influencing Choice of Paediatrics as a Career among Medical Students at the University of Nairobi; Kenya

Objective. We aimed to determine factors influencing choice of a career in paediatrics by medical students in Kenya. Methods. A cross-sectional survey of 450 medical students from the University of Nairobi; Kenya; was undertaken using aquestionnaire designed to assess their preferences with regard to future specialisation; and timing of and factors influencing this choice. The data were analysed using the Statistical Package for Social Sciences. Results. The response rate was 385/450 (85.6). Paediatrics was the second most preferred specialty after surgery; and was chosen by 50 students (13.0). Female students were five times more likely than males to select paediatrics. Choice of paediatrics as a career was mainly determined by perceived intellectual challenge; presence of a role model; and ease of combining a careerwith raising a family. Those who had completed a clerkship in the specialty reported that they were encouraged by the teaching and clinical staff (p=0.006); but found the specialty less prestigious than others (p=0.030). None of the male students but 12 of the female students (30) considered gender distribution to be a factor influencing their career choice (p=0.046). Conclusion. This study indicates that paediatrics is popular among female students and that several factors influence choice of this specialty. Understanding these factors may help medical school administrators and faculty plan future recruitment strategies

Attitudes towards psychiatry of undergraduate medical students at Bayero University, Nigeria

Background. This study determined and compared responses of 5th- and 6th (final)-year medical students on their attitudes to psychiatry as a profession. Also elicited were their choices of area of future medical specialisation. Method. A prospective and cross-sectional study using an adapted 27-item self-administered questionnaire to obtain responses from 91 5th- and 6th-year medical students at Bayero University, Kano, Nigeria. Results. More than 60% of the students' first choices for future specialisation were surgery, obstetrics/gynaecology or internal medicine. Psychiatry was the first preference for less than 2%. More than 75% of the students' views on the overall merits and efficacy of psychiatry were positive, although they felt that psychiatry had low prestige and status as a profession. In addition, the same proportion considered that psychiatry was scientific, making advances in the treatment of major mental disorders, and helpful in liaison practice. More than 50% stated that psychiatry would not be their choice of last resort for residency education and the same proportion felt that friends and fellow students rather than family members would discourage them from specialising in psychiatry. More than 50% would feel uncomfortable with mentally ill patients, felt that psychiatry would not be financially rewarding, and did not think that psychiatrists abuse their legal power to hospitalise patients. Attitudes of the two groups of students to psychiatry as a profession were not significantly different (p>0.05). Conclusion. A clinical clerkship in psychiatry did not influence the students' choice of future specialisation

Ophthalmology as a career choice of final year medical students in Nigeria

Background: There are 370 ophthalmologists and 200 diplomates in Ophthalmology inequitably distributed in Nigeria; giving a ratio of one ophthalmologist to 600;000 population. This is below the recommended ratio by World Health Organization. Despite obvious increase in medical graduates in the country; only a few select ophthalmology as a future career. Aim: To present the career preferences of final year medical students of the University of Port Harcourt Medical School; Rivers State with respect to Ophthalmology. Methodology: This is a cross-sectional descriptive study. After two weeks posting in Ophthalmology in 2006; a self-administered questionnaire; after informed consent to medical students in their final year; was used. Analysis was with SPSS version 11. Results: One hundred and fifty three students responded. There were 81 males and 72 females; a ratio of 1.1:1. Mean age was 25 + 2.2years. Ophthalmology ranked 6th as a career with less than 10[n=12(7.8)] choosing it for a career. Only 2(n=3)of the students declared it their best posting. More women were interested [n=7(58.3)].Twenty five percent of those who chose ophthalmology as a career wanted to qualify for the 2 available postgraduate colleges in Nigeria. None wanted to practice in the rural or general hospital setup. Conclusion: Less than 10of medical students are willing to consider ophthalmology as a career option. They need to be attracted to consider Ophthalmology as a viable career. Responses indicate that medical doctors do not want to offer service to the rural Nigerian