This study is the first from Oman and one of the few from the region which investigates the factors that influence residency program selection. It well represents the target population and used a questionnaire that has been validated and tailored to suit local setting. The response rate was excellent.
The study reveals that the majority of respondents were female, mirroring the increasing trend of women graduating from medical school. In Oman, this is influenced by the demographics of the surveyed institutions, where female enrollment is notably higher, aligning with the global rise in women entering the medical workforce. Previous research has previously shown that women in healthcare tended to work fewer hours, see fewer patients, but spent more time with each patient and addressed a wider range of issues [22, 23]. However, there is no recent data available to determine if these patterns still hold true. Additionally, women face challenges related to family responsibilities and gender stereotypes, which may impact career progression. Although there is a trend toward part-time work among female physicians, this choice—often influenced by both personal factors and systemic barriers—has implications for workforce planning and patient care continuity [24]. Moreover, women remain underrepresented in certain specialties, not solely due to personal preferences but also potentially due to factors such as gender bias and structural constraints. While women bring strong empathy and relational skills that enhance patient care, these attributes may be undervalued in traditional productivity models. Current workplace structures may not fully address women’s specific challenges, underscoring the need for gender-equitable policies. Addressing these issues can contribute to a more balanced and effective medical workforce [25].
Most surveyed medical interns and students are single and has no children. Previous studies have shown that parenthood significantly influences specialty choice among doctors; women, in particular, frequently prefer family-friendly specializations [26, 27]. Parenthood also tends to diminish career focus and promote part-time work. Woman physicians who are mothers often have lower employment rates and view their career success as less than that of their man counterparts [28, 29].
A majority of the survey participants lived in urban areas, possibly due to the greater presence of medical schools and healthcare facilities there. Yet, a small percentage showed interest in rural employment, with a significant proportion willing to undertake short-term roles in less serviced areas. This hints at the possibility of future lack of healthcare professionals in rural areas. Healthcare professionals with rural origins are more inclined to serve in similar areas. Educational strategies, financial incentives, and professional support networks have shown effectiveness in retaining these professionals in rural areas [30]. The scarcity of healthcare workers in rural areas adversely impacts their health outcomes when compared to those residing in urban areas. These healthcare systems hold significant economic value for rural communities, and their downfall could negatively affect local economies [31]. Improvement measures include creating a supportive atmosphere with adequate supervision, close family proximity, and addressing feelings of isolation, coupled with clear recruitment and education policies, and incentives [29, 30].
A significant proportion of participants did not have physician parents or close connections with physicians, and no significant gender difference was observed in these factors. However, a notable percentage of participants identified a physician role model, which had a profound impact on their career decisions. Role modeling and mentorship remain crucial elements in shaping medical students’ career choices, including their interest in both primary and non-primary care specialties [32]. These relationships can positively or negatively influence students’ decisions, depending on the experiences and qualities of the role models. Exposure to exemplary clinicians as role models during medical school has been strongly associated with students’ decisions to pursue specific fields for residency training, emphasizing the pivotal role of mentorship in professional formation and specialty selection [33].
In this study, internal medicine was the most desired specialty among the surveyed participants, which is consistent with previous studies [14, 34, 35]. It has been shown that medical students pursue internal medicine as their preferred specialty for several reasons. Many students are genuinely interested in the field, finding it intellectually stimulating and rewarding [36]. Additionally, the perceived better work-life balance and lifestyle compared to other specialties, along with the good career opportunities and job security it offers, make internal medicine an attractive choice. It is also seen as a challenging and prestigious field [37, 38].
In this study, we identified additional factors affecting the decision to specialize in internal medicine. These factors included societal respect and a comfortable atmosphere in the specialized department. These findings reinforce the notion that career decisions are typically influenced by both personal passion and the perceived working environment within a field.
The findings of this study highlighted significant gender differences in the factors influencing career choices. Men showed greater interest in surgical procedures, mastering their specialty, and emphasized factors such as attainable lifestyle and the risk of malpractice lawsuits. Additionally, men placed more importance on the availability of residency or training programs in Oman. On the other hand, while women highlighted the comfort of the specialty department, this was not statistically significant. These findings suggest that gender may influence career priorities, with men focusing on procedural skills, career advancement, and external challenges, while women tend to consider aspects related to the working environment.
Previous studies have shown that gender significantly influences career choices within the medical field with differences existing in specialty selections, advancement possibilities, and work-life balance considerations [39, 40]. Male medical students often choose surgery or internal medicine, while woman medical students are more likely to favor specialties like gynecology, pediatrics, and general practice. Such preferences may be influenced by societal gender norms and expectations [40, 41]. Additionally, Laskin (2001) highlighted that men demonstrate a stronger interest in surgical procedures, perceive themselves as more suited to surgical specialties, and view the associated lifestyle as attainable, aligning with the findings of this study [42].
The presence of role models from the same gender significantly influences a student’s specialty choice. Mentorship programs play a crucial role in mitigating gender discrepancies in specialty selection and career progress. Moreover, women often consider work-life balance and family duties when choosing a specialty, leading to preference for fields that are perceived as family-friendly. Conversely, man medical students are less swayed by these considerations. Cases of gender discrimination and bias are often experienced by woman medical students and practitioners, especially in male-dominated fields like surgery. Organizational culture and invisible biases within healthcare institutions contribute to these disparities. Furthermore, man medical students and residents reported increased confidence in procedural skills, correlating with a preference for procedural specialties, whereas woman medical students’ confidence levels don’t greatly affect their specialty choice [43, 44].
Efforts to address physician shortages, especially in regional areas, require strategic workforce planning and capacity-building initiatives. According to the WHO’s recommendations for the Eastern Mediterranean Region, a strong healthcare workforce necessitates improving four key dimensions: availability, competence, responsiveness, and productivity [45]. Building these capabilities often involves not only enhancing educational and training opportunities but also implementing supportive supervision, feedback systems, and continuous learning. Within the Gulf Cooperation Council (GCC), countries like Saudi Arabia and Qatar have developed national strategies to strengthen their healthcare workforce through initiatives such as the Nursing and Midwifery Strategy in Qatar and Saudi Arabia’s National Transformation Program. These efforts underscore the importance of building local educational capacity to reduce dependence on expatriate workers, developing national recruitment strategies, and aligning healthcare training with local needs. Furthermore, establishing standardized indicators to monitor and evaluate healthcare performance, as seen in Qatar and the UAE, helps ensure quality improvement and supports sustainable workforce development across the region [46].
Several limitations should be acknowledged in this study. The cross-sectional design limits the ability to establish causality between the identified factors and career choices. The study relied on self-reported data, which may be subject to recall bias and social desirability bias. The sample may limit the generalizability of the findings related to interns’ responses to other settings, as it includes graduates from both international medical schools and the two national medical schools in Oman. Furthermore, the study did not investigate how profession decisions are influenced by financial concerns or individual health situations, which might offer more information.
Future research should think about carrying out longitudinal studies to monitor changes in profession preferences over time and pinpoint the causal linkages between influencing factors and career choices in order to improve on the findings of this study. Including qualitative research methods, such as interviews and focus groups, would help gain a deeper understanding of the motivations and barriers influencing career decisions. Investigating the impact of financial incentives, personal health experiences, and mentorship programs on career choices could help develop targeted interventions that support medical students and interns in making informed career decisions.
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