Introduction

Research in undergraduate studies is helpful and considered to motivate students towards successful career and advanced grades in various fields (1, 2). In clinical and biomedical area, research maintains the direct relation with sick people and clinical environment (3). Research training or experience had a progressive impact on research performances and it also significantly effect on the advancement of career (4). Kassebaum et al assessed that the graduating students who participated in research activities could publish their work in their first two years and were more interested in research careers, while those who were never involved had least contribution in all four years of medical education. According to studies, students who aimed to go for surgery after graduation were having high rates of research involvement during medical school (5).

Paiva and Haley perceived in their study that research was the best productive and knowledgeable experience for majority of medical students (6). Students and young doctors have to take the decision about future specialties in their life, which is among one of the difficult choice. Many factors influenced career selections and majority of students aim to start choosing their profession in early educational life (7, 8). Certain norms such as esteem, working hours of respective field, financial incentives and practice location encourage the student’s future career choices (9). Students have different ideas and planning for their future at the time of their admission in medical field (10). Undergraduate students are exposed to variety of medical specialties but their decision depends upon experiences mainly after the completion of basic medical sciences (11).

Preferences for post graduate medical specialty by medical students and doctors have significant role in the development of health care structure, particularly when there is a lack or surplus physicians. Investigating and studying the future career selections can be supportive in organizing a better educational structure and management. Knowledge obtained by such study will be helpful in the advancement of health care system (11).

Numerous researches have been done on finding the career selection of medical students and the factors that stimulate them to follow their career options (3). Diminutive researches have been conducted to evaluate the research career choices among medical students and especially in developing countries. Medical education research is mainly based on educational structure rather than clinical aspect but majority of work has been done on clinical practice (6).

Our main objective of this study was to evaluate the research career preferences and trends among undergraduate students of Jinnah Sindh Medical University (JSMU). We assessed factors persuading their choices, student’s involvement in research and research environment in their medical school.

Methods                                                                                     

Study Settings and Participants:

This was a cross sectional survey on the students of JSMU. Students from 1^st to final year were included in this study and a total of 256 students participated after giving verbal consent. Inclusion criteria was all those students who were present at the time of survey and gave verbal consent were included in the study and exclusion criteria was all absentees and those who refused to participate were excluded.

An organized questionnaire was designed by the authors in English language, which is the official language of university. Eighteen questions were asked including age, gender, year of study, postgraduate plans and their undergraduate work on research. An online form was also created for the students of first and fourth year as due to their exams, they were not able to come to college.

Statistical Analysis:

Data was presented in the form of valid percentages. Frequency percentages were also calculated for the Likert scale variables. Cronbach’s alpha for the variables was also measured to about 0.78, which showed the internal consistency and reliability of the questionnaire. The analysis was performed using IBM SPSS software version 20.

Results

Total 256 students were enrolled in the study from Jinnah Sindh Medical University, out of which 52 were males and 204 were females. All the participants were asked to select parent’s income range in order to know about their socioeconomic status. Highest number of students (57.42 %) belonged to the middle class family; some (25.0 %) were associated with high class and few (17.58%) students lied under the category of low socioeconomic status.

Field of Study after Graduation:

In response to the question of field of study after graduation, majority of the medical students had decided to do both clinical practice and research, while some were interested in clinical practice only. Least response came for research in biomedical sciences and clinical research (Table 1)

Table. 1: Preference for field of study and research after graduation.

Future Specialty Choices for Researchers:

The first four chosen specialties for the future research work were surgery, gynecology, internal medicine and neurology. Highest percentage of students had decided to do research in surgery after graduation (Table 2). 

Table. 2: Research field preference after graduation.

 Factors Persuading Career Choices:

For the question about the factors influencing career choices among medical students, family’s wish had strong degree of influence followed by financial incentives and then good marks in that subject. Job opportunities, good teaching atmosphere in university and serving rural areas were less persuading factors (Table 3).

Table. 3: Factors effecting career choices.

Research Interests and Student’s Involvement:

A question about the reason of selecting research as a career was asked particularly from those students, who opted for research work in future. Maximum number of students wanted to do research to explore the knowledge about various scientific aspects, many students were interested in research and few were more concerned about publications, while according to few it is less competitive field. Most of the students (66.80%) had never done any research work, while 23. 83% were aware of it and had already done research studies. It was noticed that many of the student’s research projects were not published and only few had any publication (Table 4)

A likert scale was used to identify the student’s perception on importance of research and need of mentor in building successful career. More than half students agreed the need of mentor along with the significance of research in building fruitful career, whereas others were neutral and some disagreed.

Table. 4: Likert chart about different research related questions.  

Research Environment and Future Plans:

A higher percentage of students marked the environment of research as poor (Table 5), while some rated as average. Remaining students were satisfied with the research settings by appraising as good; however few also rated as excellent.

Majority students had not decided their postgraduate future plans, however some students preferred to continue their postgraduate studies, though few want to move abroad for higher studies or practice.

Career counseling is essential in every field of study. Participants were asked to answer a question related to the need of career counseling for choosing medical specialty during medical education. Maximum numbers of students were in favor of career counseling during medical education (Table 5). It was good to observe that research institute in our university was on the top selected preference to acquire research training. Second choice was their own mentor/supervisor followed by the research institutes abroad and then online research courses.

 Table. 5: Research environment and future plan of students.

Discussion:

Different projects have been conducted to know the future career choices for medical students but very less work has been done on student’s choices for future research trends in medical students. Most of studies have identified career specialty preferences but they are related to clinical specialties. An international study was conducted in 2011 by Tan et al on inclination towards a research career among first year medical students. They concluded that majority of the first year learners were not influenced towards a career in research (3). According to this study, most of the first year students aimed to pursue their career in both research and clinical practice, although they were not involved in research work yet. The student’s hard work in research activity gives fruitful results and enhances the likelihoods of making their aims true for their bright career in medicine. In addition, it also help in data search as well as medical writings (12). Russel et al reported that an undergraduate research opportunity boosts up confidence, mindfulness and thoughtfulness (1). Our study assessed the student’s perception on significance of research and concluded that majority of students approved the role of research for successful career.

Students’ involvement in research activities is increasing with time and growth of technology. We observed that young medical students of 1^st and 2^nd year were more inclined towards research along with the clinical practice. However, final year students were more interested in doing clinical practice only as compared to junior batches. Tan et al concluded in their study that those students who had previous research experiences or joining graduate medical school programs were more inclined towards research as career choice. They also noticed that first year students were not much fascinated to pursue research career (3).

Career guidance must be provided in the early years of medical education with strong suggestion and in accordance with the basic desires and physiognomies of an individual (16). According to this study, bulk of students supported the need of career counseling for choosing career during medical tutoring. It helps in knowing trends of various fields and lead to selection of correct path.

Migration of medical student from developing countries is a universal problem and present an alarming situation (8). It was observed that significant numbers of medical students were interested in moving abroad for postgraduate studies.

. Clinician scientists are vital companions of a research communal. Research community provides many chances to resolve the primary and critical issues of patients. We determined the research setting at JSMU and perceived that many students were not satisfied with it mainly due to the lack of proper research oriented atmosphere and research staff.  According to Say-Beng Tan et al, Medical Schools should encourage students to involve in research activities and get publications before graduation. These steps will convince them to follow a scientific profession (13, 14)

Medical students usually decide their research career during medical education. They are mostly convinced by research events or some personalities. James R. McPherson, and Merlin Mitchell clinched that students can be motivated towards research in an undergraduate level if medical institute provides them concerned staff, administrative and speculative support (14). Most of medical universities and colleges in Pakistan lack the systemic process of career guidance to medical students. Therefore there is dire need to make a proper system to let the students know about current trends of research in basic and clinical specialties. Medical students studying in highly research oriented universities with the supportive environment were more likely to gain interests in research work (15). Our study noticed the deprived research environment has influence and hence very few individuals showed concern in biomedical and clinical research. 

The study suggested that, young medical students of new batches are more inclined towards research along with clinical practice. Although, they are not yet exposed to clinical settings but they have planned to carry on both research and clinical practice together. Most of the students were not involved in research, while some had research experiences but only few published their research work. Trends of Research are increasing with time due to enhanced competency and interest in research work. Research environment was rated as average and poor by majority of the students, it indicates that much effort is required to build a strong research setting in the medical schools. It will be interesting to see similar studies in other medical institutes of the country to have a better and elaborative picture of research trends among medical students of Pakistan.

Acknowledgements

We would like to acknowledge Hateem Kayani (Microbiology and Molecular Genetics (MMG) Punjab University Lahore) for her support in reviewing this research paper that significantly improved the manuscript.