Mapping medical careers: Questionnaire assessment of career preferences in medical school applicants and final-year students

Information on between 24 and 28 specialities was collected in three UK cohorts of medical students (1981, 1986 and 1991 entry), in applicants (1981 and 1986 cohorts, N = 1135 and 2032) or entrants (1991 cohort, N = 2973) and in final-year students (N = 330, 376, and 1437). Mapping used Individual Differences Scaling (INDSCAL) on sub-groups broken down by age and sex. The method was validated in a population sample using a full range of careers, and demonstrating that the RIASEC structure could be extracted.Medical specialities in each cohort, at application and in the final-year, were well represented by a two-dimensional space. The representations showed a close similarity to Holland's RIASEC typology, with the main orthogonal dimensions appearing similar to Prediger's derived orthogonal dimensions of 'Things-People' and 'Data-Ideas'.There are close parallels between Holland's general typology of careers, and the structure we have found in medical careers. Medical specialities typical of Holland's six RIASEC categories are Surgery (Realistic), Hospital Medicine (Investigative), Psychiatry (Artistic), Public Health (Social), Administrative Medicine (Enterprising), and Laboratory Medicine (Conventional). The homology between medical careers and RIASEC may mean that the map can be used as the basis for understanding career choice, and for providing career counselling.Medical careers begin as undifferentiated, and postgraduate training ends with most doctors specialised for a specific area of practice. Relatively little is known about the transition from the medical student, who can be seen as a relatively undifferentiated, totipotent 'stem doctor' [1,2], potentially capable of entering any speciality, through to the final, fully-differentiated specialist who is almost entirely restricted to one specialised area of medical work. Although medical career specialisation has been subject to a moderate amount of research (for reviews see e.g. [3,4]), some of it going back