The effect of the undergraduate curriculum and intern rotation in anaesthesiology in making a career choice by interns at King Edward VIII Hospital, Durban in 2009.

Abstract

Introduction South Africa has a shortage of anaesthesiologists. This is worse elsewhere in Africa. With the Anaesthesiologist’s scope of practice becoming wider, the current shortage of trained anaesthesiologists is exacerbated. Exposure is limited during undergraduate training and internship, decreasing the chances of recruitment into the specialty. However, intern training in anesthesiology has increased from 2 weeks to 2 months. This may enable interns to make an informed career choice and improve recruitment. Aim To determine the perceptions recent medical graduates have of Anaesthesiology and whether exposure during internship helps in making a career choice. Methods This observational, analytic cohort study was done at King Edward VIII hospital from July 2009 – June 2010. Interns completed a structured questionnaire before and after completion of the anaesthesiology rotation. The analytical component compared pre and post rotation responses to selected questions. Results Of the 32 interns participating pre-rotation, majority were female (26), Asian (22) and UKZN graduates (12). Five were lost to follow-up. Anaesthesiology was one of top 3 career choices by 12 (3 of 13 1st year; 9 of 19 2nd year interns). After the rotation this increased to 16. There was a trend to older interns choosing Anaesthesiology. A significant factor in making a career choice was limited exposure to HIV. This was not reproduced in the post-rotation questionnaire. In both questionnaires factors more likely to influence career choice were: positive patient outcomes, satisfaction from immediate results seen, intellectual content, hours/working conditions and no ward round or clinics. Discussion There is a growing female predominance in the medical workforce and lifestyle factors are becoming more important in specialty selection. The factors that least influenced career choice were related to knowledge of Anaesthesiology and the role of the Anaesthesiologist prior to entering medical school and during undergraduate training. This implies that there is very limited knowledge in the general public and amongst medical students. Recommendations The study should be repeated at multiple sites with more participants. There should be a drive to have more time in Anaesthesiology during internship and in the undergraduate curriculum. Public perception of Anaesthesiology needs to be improved.