• Rachel Yaffa Zisk-Rony, Charles Weissman, and Alexander Avidan.
• Faculty of Medicine, Hebrew University of Jerusalem - Hadassah Henrietta Szold School of Nursing, Jerusalem, Israel.
• Ann. Med. 2023 Dec 1; 55 (1): 22010122201012.

BackgroundThe future composition of a country's physician workforce depends on medical students' choices of specialties. Students' familiarity with the job market (the healthcare system) they are about to enter and the influence job market conditions have on their choices has not been well explored. This study focuses on whether and how the healthcare system's employment landscape is taken into consideration by medical students and whether this facet adds information about the specialty selection process.MethodsFifth-year medical students completed a questionnaire querying their knowledge and perceptions of the national healthcare system, selection criteria for choosing a specialty and a post-residency work position. Data were analyzed with two-tailed Student's t-tests and multivariable regression analysis.ResultsThe questionnaire was completed by 242 students (49% women). Forty per cent were interested in a specialty where it is 'easy to find work' and 64% in a specialty that 'provides job security'. Only 12% were attracted to specialties with empty positions due to a workforce shortage. A high salary was considered an important selection criterion by 45% of students, who were also not deterred by specialties with surplus workforce, especially, if accompanied by high salaries or controllable lifestyles. Only 17% thought it would be easy to find a residency in any hospital in the specialty they chose, reflecting the low rate (3%) of positive responses to the statement that 'there are sufficient residency positions in all specialties'.ConclusionsThis study demonstrated the utility of querying medical students about their market awareness when investigating the specialty selection process. Students' poor rating of selection criteria, such as specialties with ease in finding jobs because they are suffering workforce shortages and have empty positions, provide insights and concerns for healthcare leaders. It should aid them in approaching the challenge of attracting students to specialties with workforce shortfalls.KEY MESSAGESThis study demonstrated the feasibility and potential value of adding queries about market awareness when investigating the medical student specialty selection process.Medical students were more interested in a specialty that provides job security than one where it is easy to find work.It could be useful for the healthcare leadership and medical educators in all countries to learn what medical students know about their national healthcare system and whether they need to add more healthcare delivery and system subjects to their curricula.

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