Does applicant specialty ambition influence medical school choice?

Background The NHS is critically short of doctors. The sustainability of the UK medical workforce depends on medical schools producing more future GPs who are able and willing to care for under-served patient populations. The evidence for how medical schools should achieve this is scarce. We know medical schools vary in how they attract, select, and educate future doctors. We know some medical schools produce more GPs, but it is uncertain whether those school recruit more students who are interested in general practice.

Aim This study seeks to explore how applicants’ future speciality ambitions influence their choice of medical school.

Method One-to-one semi-structured interviews and focus groups were conducted with medical applicants and first year medical students at eight medical schools around the UK. Interviews were audiorecorded and transcribed verbatim. Transcripts were analysed through thematic analysis by one researcher. A sample of 20% of transcripts were analysed by a second researcher.

Results Sixty-six individuals participated in 61 individual interviews and one focus group. Interviews lasted a mean of 54 minutes (range 22–113). Twelve expressed interest in general practice, 40 favoured other specialities, and 14 were unsure. Participants’ priorities varied by speciality aspiration; those interested in general practice described favouring medical schools with early clinical experience and problem-based learning curricula, and were less concerned with cadaveric dissection and the prestige of the medical school.

Conclusion Many applicants consider future speciality ambitions before applying to medical school. Speciality aspiration appears to influence priority of medical schools’ attributes.