Clinical Elective Choices and Motivations for Future Career Specialty Selection of Medical School Trainees and Junior Doctors of the University of the West Indies, Jamaica


  • Jean Williams Johnson BSc (Hons) MB BS MSc DM (Emerg. Med), Postgrad Diploma Med Ed (Dundee), The Department of Surgery, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica
  • Leohrandra Graham Bachelors of Basic Medical Science in Pharmacology, MSc in Biomedical Research, Faculty of Medicine, University of the West Indies, Mona, Kingston, Jamaica
  • Eric Williams BSc (Hons) MB BS MSc DM (Emerg. Med), The Department of Surgery, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica
  • Colleen Campbell BSc MSc (Forensic Toxicology) MBBS, The University Hospital of the West Indies Mona, Kingston, Jamaica
  • Nidhi Thomas MBBS, The University of the West Indies, Faculty of Medical Sciences, Jamaica Medical Students’ Association Standing Committee on Medical Education, International Federation of Medical Students' Associations, IFMSA
  • Maxine Gossell-Williams BSc, MPhil, PhD, Section of Pharmacology and Pharmacy, The University of The West Indies, Mona Campus, Kingston, Jamaica



Electives, Medical students, Career choices, Medical specialty


Background: Clinical electives provide opportunities toward future careers. This study aimed to examine whether students at the University of the West Indies used clinical electives to help with specialization choice and determine factors that influence trainee decisions for specialty training.

Methods: A cross-sectional prospective study was conducted between July 2019 and March 2020, at The University of the West Indies and the University Hospital of the West Indies involving senior medical students and junior doctors.  Paper questionnaires were administered using convenience sampling. Participants voluntarily agreed and were kept anonymous.

Results: 193 participants, aged 20 to 35 years, completed the questionnaire 133 (68.9%) females.  Preferred electives were internal medicine specialties (80, 41.5%), then surgical specialties (53, 27.5%). Sixty-four (33.2%) participants reported using electives to gain experience for their future career; other reasons included filling knowledge gaps (101, 52.3%) and repeating failed clerkships (19, 9.8%). Career preferences included surgery (75, 40.8%), internal medicine (41, 22.3%), anesthetics (20, 10.4%), and obstetrics & gynecology (18, 9.3%). Males showed preference for surgical specialties (p=0.002). Elective choice for determining career path significantly correlated with future likely specialty choice (likelihood ratio chi-square test (32)=98.37, p<0.001). Motivational factors that correlated significantly with future likely specialty choices were intellectual challenge (p=0.025), income (p=0.010), prestige (p=0.015) and working hours (p=0.012).

Conclusions: Of the participants surveyed, only 33.2% used clinical electives for their intended purpose of informing future career paths. Surgical specialties were the top selections for postgraduate training and intellectual challenge was the top motivational factor.


Metrics Loading ...


Hauer KE, Durning SJ, Kernan WN, Fagan MJ, Mintz M, O’Sullivan PS et al. Factors associated with medical students' career choices regarding internal medicine. JAMA. 2008 Sep 10;300(10):1154-64.

Navarro AM, Taylor AD, Pokorny AP. Three innovative curricula for addressing medical students' career development. Academic Medicine. 2011 Jan 1;86(1):72-6.

Baboolal NS, Hutchinson GA. Factors affecting future choice of specialty among first?year medical students of the University of the West Indies, Trinidad. Medical Education. 2007;41(1):50-6.

Jones MD, Yamashita T, Ross RG, Gong J. Positive predictive value of medical student specialty choices. BMC medical education. 2018 Dec;18(1):1-7.

Branday JM, Carpenter RA. The evolution of undergraduate medical training at the University of the West Indies, 1948-2008. West Indian Med J. 2008 Dec 1;57(6):530.

Andrews MA, Paolino ND, DeZee KJ, Hemann B. Perspective of the graduating medical student: the ideal curriculum for the fourth year of undergraduate medical education. Military medicine. 2016 Nov 1;181(11-12):e1455-63.

Van den Broek WS, Wijnen-Meijer M, Ten Cate O, Van Dijk M. Medical students' preparation for the transition to postgraduate training through final year elective rotations. GMS journal for medical education. 2017;34(5).

Marshall DC, Salciccioli JD, Walton SJ, Pitkin J, Shalhoub J, Malietzis G. Medical student experience in surgery influences their career choices: a systematic review of the literature. Journal of surgical education. 2015 May 1;72(3):438-45.

Alawad AA, Khan WS, Abdelrazig YM, Elzain YI, Khalil HO, Ahmed OB, Adam OA. Factors considered by undergraduate medical students when selecting specialty of their future careers. Pan African Medical Journal. 2015;20(1).

Lefevre JH, Roupret M, Kerneis S, Karila L. Career choices of medical students: a national survey of 1780 students. Medical Education. 2010;44(6):603-12.

Alshahrani M, Dhafery B, Al Mulhim M, Alkhadra F, Al Bagshi D, Bukhamsin N. Factors influencing Saudi medical students and interns’ choice of future specialty: a self-administered questionnaire. Advances in medical education and practice. 2014;5:397

Kanmounye US, Temgoua M, Endomba FT. Determinants of residency program choice in two central African countries: an internet survey of senior medical students. International Journal of Medical Students. 2020 Apr 30;8(1):20-5.

Ali A, Rasheed A, Zaidi SM, Alsaani SM, Naim H, Hamid H, Farrukh S. Recent Trend in Specialty Choices of Medical Students and House Officers from Public Sector Medical Universities, Karachi. JPMA. 2019 Apr;69(489).

Onyemaechi NO, Bisi?Onyemaechi AI, Omoke NI, Odetunde OI, Okwesili IC, Okwara BO. Specialty choices: Patterns and determinants among medical undergraduates in Enugu Southeast Nigeria. Nigerian journal of clinical practice. 2017;20(11):1474-80.

Rukewe A, Abebe WA, Fatiregun AA, Kgantshang M. Specialty preferences among medical students in Botswana. BMC research notes. 2017 Dec;10(1):1-5.

Dossajee H, Obonyo N, Ahmed SM. Career preferences of final year medical students at a medical school in Kenya–A cross sectional study. BMC medical education. 2016 Dec;16(1):1-10.

Aslam M, Ali A, Taj T, Badar N, Mirza W, Ammar A, Muzaffar S, Kauten JR. Specialty choices of medical students and house officers in Karachi, Pakistan. EMHJ-Eastern Mediterranean Health Journal. 2011; 17 (1):74-79.

Kumar, R., & Dhaliwal, U. Career choices of undergraduate medical students. The National medical journal of India. 2011;24(3):166-169.

AbouZaid L, Nabil N, Al-Fadil S, Alatmi A, Saeed AA. Career choice and its influencing factors: perception of senior medical students. J Contemp Med Educ. 2014;2(3):168-73.

Abdulrahman M, Makki M, Shaaban S, Al Shamsi M, Venkatramana M, Sulaiman N, Sami MM, Abdelmannan DK, Salih AM, AlShaer L. Specialty preferences and motivating factors: A national survey on medical students from five uae medical schools. Education for Health. 2016 Sep 1;29(3):231.

Yang Y, Li J, Wu X, Wang J, Li W, Zhu Y, Chen C, Lin H. Factors influencing subspecialty choice among medical students: a systematic review and meta-analysis. BMJ open. 2019 Mar 1;9(3):e022097.

McCartney, T., Lee, M. G., Roberts, R., & SinQuee, C. (2019). Tracking Medical Graduates in Jamaica and The Bahamas. West Indian Medical Journal. 2019; 68(1):47-52.

Ng-Sueng LF, Vargas-Matos I, Mayta-Tristán P, Pereyra-Elías R, Montenegro-Idrogo JJ, Inga-Berrospi F, Ancalli F, Bonilla-Escobar F, Diaz-Velez C, Gutierrez-Quezada E, Gomez-Alhach J. Gender associated with the intention to choose a medical specialty in medical students: a cross-sectional study in 11 countries in Latin America. PloS one. 2016 Aug 12;11(8):e0161000.

Riska, E. Gender and medical careers. Maturitas. 2011; 68(3): 264-267.

Peel, J. K., Schlachta, C. M., & Alkhamesi, N. A. (2018). A systematic review of the factors affecting choice of surgery as a career. Canadian Journal of Surgery. 2018; 61(1):58-67.

Trinh, L. N., O'Rorke, E., & Mulcahey, M. K. Factors Influencing Female Medical Students’ Decision to Pursue Surgical Specialties: A Systematic Review. Journal of Surgical Education.2020;78(3):838-849.

van Tongeren-Alers, M., van Esch, M., Verdonk, P., Johansson, E., Hamberg, K., & Lagro-Janssen, T. Are new medical students’ specialty preferences gendered? Related motivational factors at a Dutch medical school. Teaching and learning in medicine.2011;23(3):263-268.

Organisation for Economic Co-operation and Development (OECD) /The World Bank. “Health Care Resources and Activities”, in Health at a Glance: Latin America and the Caribbean 2020. OECD Publishing, Paris. 2020.

Hur Y. Development of a career coaching model for medical students. Korean journal of medical education. 2016 Mar;28(1):127.

Farkas AH, Allenbaugh J, Bonifacino E, Turner R, Corbelli JA. Mentorship of US medical students: a systematic review. Journal of general internal medicine. 2019 Nov;34(11):2602-9.


2021-11-04 — Updated on 2022-04-13


How to Cite

Williams Johnson, J., Graham, L. ., Williams, E. ., Campbell, C., Thomas, N., & Gossell-Williams , M. (2022). Clinical Elective Choices and Motivations for Future Career Specialty Selection of Medical School Trainees and Junior Doctors of the University of the West Indies, Jamaica. International Journal of Medical Students, 10(1), 49–55. (Original work published April 5, 2022)



Original Article