Introduction
A career in obstetrics and gynaecology was an unpopular choice in the
early 2000s and the specialty faced low levels of interest (1-4). In
2002, only 2.8% of graduates were considering obstetrics and
gynaecology as a career, with lower rates amongst men (1). Factors
affecting career choice included prior experience as a student and
influence from a teacher or clinician. Workforce planning and obstetric
litigation were also important considerations (1). More recently, UK
studies (5, 6) have highlighted concerns over a lack of work life
balance (7) and a persistent reduction in interest from male doctors (8)
as well as the influence of a clinical placement in obstetrics and
gynaecology (6, 9).
UK medical students attend a clinical placement in obstetrics and
gynaecology, often during the penultimate year of their studies, for
between six to eight weeks.
The Royal College of Obstetricians and Gynaecologists (RCOG) produced a
working party report in 2009 highlighting the importance of clinical
placements in facilitating the acquisition of competencies in
preparation for work as a foundation year doctor, Placements can also
provide a taster for the specialty, which can positively impact on
recruitment (10). During the clinical placement, students are exposed to
several clinical areas, including the labour ward and observe
childbirth. Previous studies have explored the impact of the length of
clinical placements on career choice, finding no significant association
(11) and factors affecting early career choice that did not equate to
postgraduate career choices (3).
Medical students, driven in their learning towards summative
examinations, often overlook the additional benefits of clinical
placements in the development of their professional identity (12) but
also in the consideration of their future career choices. This can be
partly attributed to the change in undergraduate curricula. A survey of
UK medical schools in 2006 highlighted the change in undergraduate
curriculum over recent years, commenting on the decrease in delivery
suite experience (10). In addition to this, there is lack of focus on
the hidden curriculum of professional working, as well as increasing
competition for foundation year jobs and intake to specialist training.
The aim of this study was to explore the experiences of medical students
on a clinical placement in obstetrics and gynaecology at a London
university, and the impact and influences of a clinical placement on a
career choices in obstetrics and gynaecology.