MOTIVATION UNDERLYING CAREER CHOICE FOR INTERNAL-MEDICINE AND SURGERY

Self-determination theory (Deci and Ryan, 1985) was used to predict me dical students' career choices for internal medicine or surgery based on their experiences of the autonomy support provided by the instructo rs in the two corresponding third-year clerkships. Fourth-year medical students (n = 210) at three medical schools completed questionnaires that assessed (1) retrospective prior likelihood (as of the end of sec ond year) of their going into internal medicine and surgery, (2) their perceived competence with respect to these two medical specialties, ( 3) their interest in the problems treated in each specialty, (4) the a utonomy support of the instructors on the two corresponding rotations, (5) the current likelihood (late in the fourth year) of going into ea ch of the two specialties, and (6) their actual residency choices. For a subset (n = 64), actual prior likelihoods of going into the two car eers had also been assessed at the end of their second year. Structura l equation modeling confirmed, as hypothesized, (a) that perceived aut onomy support of the corresponding clerkship would predict students' c hoices of internal medicine or surgery, even after the effects of retr ospective (and actual) prior likelihood had been removed, and (b) that this relationship between perceived autonomy support and career choic e was mediated by perceived competence and interest. The present study suggests that students' experiences on clerkships do affect the likel ihood that they will select particular specialties, and that students' interest in the areas are good indicators of the selections they will make. (C) 1997 Elsevier Science Ltd.