What is the evidence for medical school applicants’ reasons for choosing medicine? A qualitative study

Abstract

Abstract Background It is important for medical school applicants and faculties to identify applicants’ reasons for choosing medicine as a career. Several studies suggest that there is a discrepancy between applicants’ real reasons for choosing medicine and those presented in entrance examinations. This discrepancy can be addressed in terms of evidence in which applicants identify reasons as their own. This study thus aims to explore applicants’ evidence for their real and stated reasons for choosing medicine. Methods The paradigm of this study is constructivism. We carried out individual semi-structured interviews with 15 medical students or physicians who had entered medical school through graduate-entry programs in Japan. In the interviews, we explored the participants’ real and stated reasons, including evidence for these reasons. We analyzed the data by conducting a reflexive thematic analysis on applicants’ evidence for their real and stated reasons. Results The thematic analysis on applicants’ evidence for their real reasons revealed six themes: (a) an idea since childhood or adolescence; (b) an episode of disease in one’s family or patient; (c) further development of one’s past major; (d) a comparison of the meaning and value of work; (e) an absence of evidence; and (f) an inability to identify one’s reasons or evidence. Moreover, the thematic analysis on applicants’ evidence for their stated reasons revealed four themes: (a) an episode of disease in one’s family or patient; (b) further development of one’s past major; (c) a comparison of the meaning and value of work; and (d) no explanations in the entrance examination. Conclusions This study clarified medical school applicants’ evidence for their real and stated reasons for choosing medicine as a career. The most important finding is the possibility that applicants may not even be able to justify their real reasons with evidence. Moreover, they can arbitrarily present their stated reasons and evidence for them in entrance examinations regardless of whether their real and stated reasons coincide. Medical faculties should reconsider why and how they ask applicants about their reasons for choosing medicine in the student selection process.