A thematic network for factors affecting the choice of specialty education by medical students: a scoping study in low-and middle-income countries

Abstract

Background: Medical specialty selection is a complex phenomenon that can affect the performance of health systems, community health, and physicians’ lives. It is essential to identify the key factors influencing the choice of specialty for evidence-based policymaking. This scoping review aimed to provide a comprehensive map of evidence regarding the factors influencing the choice of specialty by medical students (MS) in low-and middle-income countries (LMICs) and also to determine knowledge gaps. Methods: We carried out a systematic search on six online databases from January 2000 to May 2020. We used a five-step scoping review method proposed by Arksey and O’Malley. We synthesized the data using a quantitative content analysis approach. Then, we developed a thematic network as a conceptual map for a better understanding of the concept. Results: The analysis led to the development of five main themes, including personal determinants, life fulfillment aspects, influential career aspects, educational determinants, and interpersonal effects. Moreover, the most frequent sub-themes were specific personal factors, controllable lifestyle, quality of working life, and future working conditions. Conclusion: This review provided evidence on the factors influencing the choice of specialties. In order to support physician workforce policy with more precise evidence, it is necessary to explore the weight and ranking of these factors based on the socioeconomic contexts of the countries. This study also indicated that factors such as ethical values, various aspects of medical philosophy, and immigration tendencies are areas for further investigations.