Medical students' career choices, preference for placement, and attitudes towards the role of medical instruction in Ethiopia

Background: In Ethiopia, the health care delivery and the system of medical education have been expanding rapidly. However, in spite of the expansion, no studies have been carried out among medical students to identify their career choices and attitudes towards the medical instruction. Therefore, this study aimed to fill the gap in evidence in these specific areas. Methods: Pretested questionnaire was self-administered among fifth and sixth year medical students in six government owned medical schools in Ethiopia. A total of 959 students were involved in the study with a response rate of 82.2%. Career choices, intention where to work just after graduation, and attitudes towards medical instruction were descriptively presented. Binary logistic regression model was fitted to identify factors associated with the intention of medical students to work in rural and remote areas. Results: Majority, (70.1%) of the medical students wanted to practice in clinical care settings. However, only a small proportion of them showed interest to work in rural and remote areas (21% in zonal and 8.7% in district/small towns). For most, internal medicine was the first specialty of choice followed by surgery. However, students showed little interest in obstetrics and gynecology, as well as in pediatrics and child health as their first specialty of choice. Medical students' attitudes towards their school in preparing them to work in rural and remote areas, to pursue their career within the country and to specialize in medical disciplines in which there are shortages in the country were low. The binary logistic regression model revealed that a significantly increased odds of preference to work in rural and remote areas was observed among males, those who were born in rural areas, the medical students of Addis Ababa University and those who had the desire to serve within the country. Conclusion: This study showed that Ethiopian medical schools are training medical workforce with preferences not to work in rural and remote places, and not to specialize in disciplines where there are shortages in the country. Thus, attention should be given to influence medical students' attitude to work in rural and remote locations and to specialize in diverse clinical specialties.