[Changes in career plans of medical students during the first half of medical school].

A cohort of Norwegian medical students was followed through the pre-clinical part of medical school to study the development of specialty and leadership preferences. A questionnaire was sent to medical students immediately after they started their medical training in 1993, and again early in 1997 when the students had just started their clinical curriculum. 283 of 415 (68%) responded at both points in time. In order to investigate the relationship between various motivational variables and specialty and leadership preferences, five latent variables were identified through factor analysis: defensive, active, comprehensive, career-oriented and detached. Based on previous research in Norway, an index of prestige was constructed, where medical specialties and subspecialties were ranked according to the opinions of physicians and other health personnel. The intention was to explore the possible impact of prestige on specialty preferences. Career preferences were unstable on the individual but stable on the aggregate level. Interest in psychiatry, public health and laboratory medicine decreased during the first years of medical school, and high-prestige specialties became more appealing. Gender differences in career plans were distinct, stable and traditional. For future hospital physicians, leadership ambitions were much higher among men at both points in time. Our findings were that factors with bearing on choice of career are different for women and men, and preferences half-way through medical school are clearly related to such factors.