120824P - MEDICAL CAREERS

Written and prepared by Professor Omar Hasan Kasule Sr.

GENERAL FACTORS OF CAREER CHOICE

Personal interest: Many factors, some unknown and unrecognized, play a role in the career choice decision. A study with disturbing findings showed that student career choice was not guided by previous experience or knowledge of the area meaning that trust of expressed choices should be taken with caution[i][1]. On entry into medical school the students are idealists wanting to study medicine for intellectual and personal fulfillment, getting community respect, financial security as well as admiration for the doctor as a committed, smart, decisive leader with interpersonal skills[ii][2]. As they progress through their studies to eventually choose their careers, their choices are driven by more pragmatic considerations. Lifestyle and earning potential were rated higher than research opportunities in career selection[iii][3]. 'Personal interest' was rated by 80% of students as important in influencing their choice, followed by stability (58%), reputation of the specialty (56%) and lifestyle (55%)[iv][4]. Career choices change and evolve with time. A UK prospective study showed that one quarter of post graduates were working in specialties other than what they chose at the start of their training[v][5].

Public interest: Career choices do not always match the needs of the country they tend to reflect student priorities. Graduates of a medical college in 1982 Bombay either went abroad (one quarter) and 90 percent of those who stayed in India went into private practice where they were satisfied with their career[vi][6]. Career intentions of medical students in Sub Saharan Africa were not aligned to local health priorities[vii][7]. A Canadian study showed a mismatch between student career preferences on entry into medical school and the needs of the different specialties[viii][8].

Academic interest: US medical schools offered more research tenured tracks than educational or clinical tracks[ix][9]. The proportion of US students planning full time clinical practice careers is decreasing[x][10]. Mistreatment in medical school turned students off academic careers[xi][11]. Factors influencing choosing an academic career in hematology were presenting and publishing research, mentorship, intellect, and practice type. Those choosing a non-academic career were more concerned with lifestyle.[xii][12].

Effect of prior exposure to the discipline: Dutch medical students who attended periods of training in a US academic center had a high chance of developing academic careers[xiii][13]. The nature of clerkship influenced specialty choice[xiv][14]. A sub-medicine internship did not affect students’ application to join internal medicine[xv][15]. Clinical exposure was an important factor in choosing family medicine[xvi][16]. Preceptors have an impact on student career choices the impact being larger the longer the duration of contact[xvii][17]. Students from small colleges had more hands on experience and felt more confident at internship[xviii][18].

Professional success: Selection of an appropriate career, based on existing student attributes, ensures professional success and career satisfaction. A 10-year longitudinal study identified academic achievement as a predictor of professional competence, copying styles predicted career satisfaction, and levels of anxiety and depression predicted future quality of life. Professional stress was not predictable[xix][19].

Career guidance: Career choice is neither easy nor straightforward and a lot if career guidance/counseling is needed. Medical students experience anxiety and depression due to external pressures to succeed in a medical career[xx][20]. This anxiety may be positive when it spurs them to work and succeed and may be negative when it paralyzes their effort out of fear of failing.  College based career advisory programs were more effective than one-to-one faculty advising about careers[xxi][21]. Fourth year medical students were satisfied with career advisory services at the college[xxii][22]. A UK study showed that students delayed career choices especially general practice however those from poorer areas has early career intentions[xxiii][23].

Other factors: A US study showed that postgraduate experience was more important than undergraduate clinical attachments in determining career choices[xxiv][24]. New Zealand data showed no relation between career choice and size if the secondary school or town of origin[xxv][25].

CHOICE OF PUBLIC AND PRIMARY HEALTH CARE DISCIPLINES

Public health: The proportion of students ending up in public health careers is higher than the proportion who expressed interest during medical school an indication that there are other factors operating in public health career choices[xxvi][26].

General practice: A national survey in France showed low interest in general practice and increasing feminization of the profession[xxvii][27]. Choice of general practice tracks were influenced by: 'Patient orientation'[xxviii][28]. Older students in New Zealand differed from direct entry from school in a higher proportion taking up general practice as a specialty[xxix][29].

Primary care: Financial pressures after graduation were a disincentive for choosing a career in primary care[xxx][30]. Factors of choice of primary care were: interest in underserved populations, relationships with patients, scope of practice, and role models important in their career choice. Salary and competitiveness were "not at all" important.[xxxi][31]. International health electives influenced choice of a career in primary health care and public health[xxxii][32].

Community medicine: Canadian students had poor understanding of community medicine and had several misconceptions: irrelevant to clinical practice, no exclusive specialty, poor understanding of its role [xxxiii][33]

Family medicine: Students know income by specialty quite early in their career and their knowledge that family medicine has low income acted as a disincentive[xxxiv][34].

Geriatrics: Positive attitude to the elderly and female gender determined choice of geriatrics in Singapore[xxxv][35] [xxxvi][36].

Rural practice: Factors that predicted rural practice for graduates of an American medical college were: growing up rural, planning rural practice, and planning family medicine [xxxvii][37]. A special program in Australia encouraged students to choose rural practice[xxxviii][38]. A longer rural clerkship increased choice of a rural career[xxxix][39]. Clinical attachments encouraged US students to choose rural careers[xl][40]. Medical students in Malawi from small towns and rural areas tended to work in rural areas[xli][41].

CHOICE OF SURGICAL DISCIPLINES

Surgery: An international study revealed variation by country in favoring a surgical career with males preferring surgery more than females[xlii][42]. Some countries experiencing a decline while others experienced an increase[xliii][43] in surgical interest. Greek students had a low interest for surgical[xliv][44]. Malawian students preferred surgical disciplines over others with choice of specific surgical sub disciplines depending on the influence of the mentor[xlv][45]. Surgical demonstrations encouraged choice of surgical careers[xlvi][46]. Canadian students choosing careers in surgery were: male, younger age, single, influenced by prestige, and hospital oriented[xlvii][47]. Exposure was the most important factor making medical students choose a career in plastic surgery[xlviii][48]. Brief exposure to a hand surgeon influenced student career preferences[xlix][49]. A study in Ireland showed that males preferred surgical disciplines while females preferred care disciplines of pediatrics and geriatrics[l][50]. An Irish study showed that three factors determined specialty choice among students: Future employment, career opportunities and intellectual challenge. Job prestige was addition factor for those interested in a surgical career. Lifestyle factors made surgery unpopular among women.[li][51]. Student choice of an orthopedic career was made prior to medical school, contact with faculty, clinical rotations, and anticipated income played a small role[lii][52]. Exposure of students to endovascular surgery simulation increased student interest in this career path[liii][53] [liv][54]. Medical school and residency experiences determined choice of an academic neuro surgery career[lv][55] [lvi][56]. Clerkship in surgery and a mentor predicted choice of a career in general surgery[lvii][57]. Being female and desiring a narrow scope of practice were factors favoring choice of an obstetric career[lviii][58].

CHOICE OF MEDICAL DISCIPLINES

Pediatrics: Support of medical students to undertake pediatric research motivated them to choose a career in pediatrics and especially in academic pediatrics[lix][59]. Students in pediatric clerkships needed advice about career choice in addition to the clerkship experience[lx][60].

Internal medicine (IM): Factors that influenced student choice of internal medicine were: educational experiences in IM, the nature of patient care in IM, and lifestyle. Students were more likely to pursue careers in IM if they were of male gender, attended a private school, had favorable impression with their educational experience in IM, had favorable feelings about caring for IM patients or reported a favorable impression of internists' lifestyle[lxi][61].

Psychiatry: Student choice of psychiatry as a career choice was affected by an undergraduate education in the arts, having close family or friends practicing medicine, having worked voluntarily with people with mental illness, and lower hospital orientation[lxii][62] A promotional DVD increased students’ interest in psychiatry[lxiii][63]. A study in Serbia found mixed reactions to psychiatry as a career among medical students: Those who liked psychiatry considered it an interesting and challenging job (especially intellectually) and were less interested in its prestige and financial reward. Those who did not like psychiatry saw it as lacking a scientific foundation, clinically inefficient, intense emotional involvement, and stressful.[lxiv][64]. Despite a small number of practicing psychiatrists few Pakistani students showed interest in the discipline[lxv][65].

OTHER DISCIPLINES

Emergency medicine: Students interested in emergency medicine had some attributes: hospital orientation, medical lifestyle, and less social orientation[lxvi][66]. Lifestyle and length of residency were found to be factors of students choosing emergency medicine[lxvii][67] [lxviii][68].

Radiology: Use of medical students to triage images after hours influenced their career choices[lxix][69].

Anatomy: Nigerian students showed low preference for anatomy as a career choice[lxx][70].

REFERENCES

---

[1] Soethout MB, Ten Cate OT, van der Wal G. Correlations of knowledge and preference of medical students for a specialty career: a case-study of youth health care. BMC Public Health. 2008 Jan 14;8:14.

[2] Gillies RA, Warren PR, Messias E, Salazar WH, Wagner PJ, Huff TA.. Why a medical career and what makes a good doctor? Beliefs of incoming United States medical students. Educ Health (Abingdon). 2009 Dec;22(3):331. Epub 2009 Dec 1. 

[3] Park SJ, McGhee CN, Sherwin T. Medical students' attitudes towards research and a career in research: an Auckland, New Zealand study. N Z Med J. 2010 Sep 24;123(1323):34-42. 

[4] Kumar R, Dhaliwal U. Career choices of undergraduate medical students. Natl Med J India. 2011 May-Jun;24(3):166-9. 

[5] Goldacre MJ, Laxton L, Lambert TW.

Medical graduates' early career choices of specialty and their eventual specialty destinations: UK prospective cohort studies. BMJ. 2010 Jul 6;341:c3199. doi: 10.1136/bmj.c3199. 

[6] Pai SA. Career preferences of medical students who joined Grant Medical College, Bombay in 1957 and 1982. Natl Med J India. 2009 May-Jun;22(3):121-3.

      

[7]  Burch VC, McKinley D, van Wyk J, Kiguli-Walube S, Cameron D, Cilliers FJ, Longombe AO, Mkony C, Okoromah C, Otieno-Nyunya B, Morahan PS. Career intentions of medical students trained in six sub-Saharan African countries. Educ Health (Abingdon). 2011 Dec;24(3):614. Epub 2011 Dec 16.

[8] Scott IM, Wright BJ, Brenneis FR, Gowans MC. Whether or wither some specialties: a survey of Canadian medical student career interest. BMC Med Educ. 2009 Sep 4;9:57. 

[9] Coleman MM, Richard GV. Faculty career tracks at U.S. medical schools. Acad Med. 2011 Aug;86(8):932-7. 

[10] Jeffe DB, Andriole DA, Hageman HL, Whelan AJ. The changing paradigm of contemporary U.S. allopathic medical school graduates' career paths: analysis of the 1997-2004 national AAMC Graduation Questionnaire database. Acad Med. 2007 Sep;82(9):888-94

[11]   Haviland MG, Yamagata H, Werner LS, Zhang K, Dial TH, Sonne JL.  Student mistreatment in medical school and planning a career in academic medicine. Teach Learn Med. 2011 Jul-Sep;23(3):231-7.

[12] Horn L, Koehler E, Gilbert J, Johnson DH. Factors associated with the career choices of hematology and medical oncology fellows trained at academic institutions in the United States. J Clin Oncol. 2011 Oct 10;29(29):3932-8. Epub 2011 Sep 12. 

[13] Rings EH, Escher JC, Büller HA, Heymans HS.. 20 years of scientific training of Dutch medical students in an American academic division for pediatric gastroenterology and nutrition: impact on career development. J Pediatr Gastroenterol Nutr. 2008 Apr;46(4):419-22.

[14] Coffeng LE, Visscher AJ, Ten Cate OT.  The influence of early clinical experiences on career preference of male and female medical students. Med Teach. 2009 Jul;31(7):e323-6.

[15] Kogan JR, Shea JA, O'Grady E, Bellini LM, Ciminiello F. The impact of the internal medicine sub-internship on medical student career choice. J Gen Intern Med. 2010 May;25(5):403-7. Epub 2010 Mar 13. 

[16] Scott I, Wright B, Brenneis F, Brett-Maclean P, McCaffrey L.. Why would I choose a career in family medicine?: Reflections of medical students at 3 universities. Can Fam Physician. 2007 Nov;53(11):1956-7.

[17] Stagg P, Prideaux D, Greenhill J, Sweet L Are medical students influenced by preceptors in making career choices, and if so how? A systematic review. Rural Remote Health. 2012;12:1832. Epub 2012 Jan 24. 

[18] Eley DS. Postgraduates' perceptions of preparedness for work as a doctor and making future career decisions: support for rural, non-traditional medical schools. Educ Health (Abingdon). 2010 Aug;23(2):374. Epub 2010 Jul 17.

[19] Tartas M, Walkiewicz M, Majkowicz M, Budzinski W. Psychological factors determining success in a medical career: a 10-year longitudinal study. Med Teach. 2011;33(3):e163-72.

[20] Karaoglu N, Seker M. Anxiety and depression in medical students related to desire for and expectations from a medical career. West Indian Med J. 2010 Mar;59(2):196-202. 

[21]  Sastre EA, Burke EE, Silverstein E, Kupperman A, Rymer JA, Davidson MA, Rodgers SM, Fleming AE..

Improvements in medical school wellness and career counseling: A comparison of one-on-one advising to an Advisory College Program. Med Teach. 2010;32(10):e429-35.

[22] Coates WC, Crooks K, Slavin SJ, Guiton G, Wilkerson L. Medical school curricular reform: fourth-year colleges improve access to career mentoring and overall satisfaction. Acad Med. 2008 Aug;83(8):754-60.

[23] Maudsley G, Williams L, Taylor D. Medical students' and prospective medical students' uncertainties about career intentions: cross-sectional and longitudinal studies. Med Teach. 2010;32(3):e143-51. 

[24] Watmough S, Taylor D, Ryland I.. Using questionnaires to determine whether medical graduates' career choice is determined by undergraduate or postgraduate experiences. Med Teach. 2007 Oct;29(8):830-2.

[25] Mitchell CJ, Shulruf B, Poole PJ. Relationship between decile score of secondary school, the size of town of origin and career intentions of New Zealand medical students. J Prim Health Care. 2010 Sep 1;2(3):183-9.

[26] Soethout MB, Ten Cate OJ, van der Wal G. Development of an interest in a career in public health during medical school. Public Health. 2008 Apr;122(4):361-6. Epub 2007 Nov 5.

[27] Lefevre JH, Roupret M, Kerneis S, Karila L. Career choices of medical students: a national survey of 1780 students. Med Educ. 2010 Jun;44(6):603-12.

[28] Kiolbassa K, Miksch A, Hermann K, Loh A, Szecsenyi J, Joos S, Goetz K. Becoming a general practitioner--which factors have most impact on career choice of medical students? BMC Fam Pract. 2011 May 9;12:25. 

[29] Shelker W, Belton A, Glue P. Academic performance and career choices of older medical students at the University of Otago. N Z Med J. 2011 Nov 25;124(1346):63-8.

[30] Palmeri M, Pipas C, Wadsworth E, Zubkoff M.  Economic impact of a primary care career: a harsh reality for medical students and the nation. Acad Med. 2010 Nov;85(11):1692-7.

[31] Knox KE, Getzin A, Bergum A, McBride P, Rieselbach R, Friedsam DShort report: factors that affect specialty choice and career plans of Wisconsin's medical students. WMJ. 2008 Dec;107(8):369-73.

[32] Jeffrey J, Dumont RA, Kim GY, Kuo T

Effects of international health electives on medical student learning and career choice: results of a systematic literature review. Fam Med. 2011 Jan;43(1):21-8.   

[33] Hau MM, Tyler IV, Buxton JA, Elliott LJ, Harvey BJ, Hockin JC, Mowat DL.

Assessing Canadian medical students' familiarity with and interest in pursuing a career in community medicine. Can J Public Health. 2009 May-Jun;100(3):194-8.

[34] Morra DJ, Regehr G, Ginsburg S. Medical students, money, and career selection: students' perception of financial factors and remuneration in family medicine. Fam Med. 2009 Feb;41(2):105-10.

[35] Chua MP, Tan CH, Merchant R, Soiza RL. Attitudes of first-year medical students in Singapore towards older people and willingness to consider a career in geriatric medicine. Ann Acad Med Singapore. 2008 Nov;37(11):947-51. 

[36] Hughes NJ, Soiza RL, Chua M, Hoyle GE, MacDonald A, Primrose WR, Seymour DG. Medical student attitudes toward older people and willingness to consider a career in geriatric medicine. J Am Geriatr Soc. 2008 Feb;56(2):334-8. Epub 2007 Dec 26. 

 [37]  Rabinowitz HK, Diamond JJ, Markham FW, Santana AJ. The relationship between entering medical students' backgrounds and career plans and their rural practice outcomes three decades later. Acad Med. 2012 Apr;87(4):493-7.

[38] Stagg P, Greenhill J, Worley PS. A new model to understand the career choice and practice location decisions of medical graduates. Rural Remote Health. 2009 Oct-Dec;9(4):1245. Epub 2009 Nov 28. 

[39] Eley D, Baker P, Chater B. The Rural Clinical School Tracking Project: more IS better--confirming factors that influence early career entry into the rural medical workforce. Med Teach. 2009 Oct;31(10):e454-9. 

[40] Worley P, Martin A, Prideaux D, Woodman R, Worley E, Lowe M.. Vocational career paths of graduate entry medical students at Flinders University: a comparison of rural, remote and tertiary tracks. Med J Aust. 2008 Feb 4;188(3):177-8.

[41]  Yeganeh-Arani E, Chandratilake M, Muula AS. Factors affecting career preferences of medical students at the College of Medicine, Malawi. S Afr Med J. 2012 Mar 7;102(4):249-51.

[42]  Are C, Stoddard HA, Prete F, Tianqiang S, Northam LM, Chan S, Lee J, Jani P, Protic M, Venkateshwarulu S, Sarela A, Thompson JS. An international perspective on interest in a general surgery career among final-year medical students. Am J Surg. 2011 Sep;202(3):352-6. Epub 2011 Apr 1. 

[43] Deedar-Ali-Khawaja R, Khan SM.  .

Trends of surgical career selection among medical students and graduates: a global perspective. J Surg Educ. 2010 Jul-Aug;67(4):237-48. 

[44] Pikoulis E, Avgerinos ED, Pedeli X, Karavokyros I, Bassios N, Anagnostopoulou SMedical students' perceptions on factors influencing a surgical career: the fate of general surgery in Greece. Surgery. 2010 Sep;148(3):510-5. Epub 2010 Mar 11. 

[45] Kollias C, Banza L, Mkandawire N.  Factors involved in selection of a career in surgery and orthopedics for medical students in Malawi.. Malawi Med J. 2010 Mar;22(1):20-3. 

      

[46] Are C, Stoddard HA, Thompson JS, Todd GL. The influence of surgical demonstrations during an anatomy course on the perceptions of first-year medical students toward surgeons and a surgical career. J Surg Educ. 2010 Sep-Oct;67(5):320-4. 

[47] Scott IM, Matejcek AN, Gowans MC, Wright BJ, Brenneis FR. Choosing a career in surgery: factors that influence Canadian medical students' interest in pursuing a surgical career.  Can J Surg. 2008 Oct;51(5):371-7.

[48] Greene AK, May JW Jr.. Applying to plastic surgery residency: factors associated with medical student career choice. Plast Reconstr Surg. 2008 Mar;121(3):1049-53; discussion 1054.

[49] Smith AA, Duncan SF, Esparra BC.. Can brief interventions by hand surgeons influence medical students toward a career in hand surgery?

J Hand Surg Am. 2007 Oct;32(8):1267-70.

[50] O'Donnnell ME, Noad R, Boohan M, Carragher A. The effect of modernising medical careers on foundation doctor career orientation in the Northern Ireland Foundation School. Ulster Med J. 2010 May;79(2):62-9. 

[51] Glynn RW, Kerin MJ. Factors influencing medical students and junior doctors in choosing a career in surgery. Surgeon. 2010 Aug;8(4):187-91. Epub 2010 Mar 12. 

[52] Johnson AL, Sharma J, Chinchilli VM, Emery SE, McCollister Evarts C, Floyd MW, Kaeding CC, Lavelle WF, Marsh JL, Pellegrini VD Jr, Van Heest AE, Black KP. Why do medical students choose orthopaedics as a career? J Bone Joint Surg Am. 2012 Jun 6;94(11):e78

[53] Markovic J, Peyser C, Cavoores T, Fletcher E, Peterson D, Shortell C. Impact of endovascular simulator training on vascular surgery as a career choice in medical students. J Vasc Surg. 2012 May;55(5):1515-21. Epub 2012 Mar 29. 

[54]  Lee JT, Son JH, Chandra V, Lilo E, Dalman RL Long-term impact of a preclinical endovascular skills course on medical student career choices. J Vasc Surg. 2011 Oct;54(4):1193-200. Epub 2011 Jul 1. 

[55]  Campbell PG, Awe OO, Maltenfort MG, Moshfeghi DM, Leng T, Moshfeghi AA, Ratliff JK. Medical school and residency influence on choice of an academic career and academic productivity among neurosurgery faculty in the United States. Clinical article. J Neurosurg. 2011 Aug;115(2):380-6. Epub 2011 Apr 15. 

[56] Campbell PG, Lee YH, Bell RD, Maltenfort MG, Moshfeghi DM, Leng T, Moshfeghi AA, Ratliff JK. Medical school and residency influence on choice of an academic career and academic productivity among US neurology faculty. Arch Neurol. 2011 Aug;68(8):999-1004. Epub 2011 Apr 11. 

[57] Makama JG, Ameh EA. Does general surgery clerkship make a future career in surgery more appealing to medical students? Afr Health Sci. 2010 Sep;10(3):292-6. 

[58] J Obstet Gynaecol Can. 2010 Nov;32(11):1063-9.  Obstetrics and gynaecology as a career choice: a cohort study of canadian medical students. Scott IM, Nasmith T, Gowans MC, Wright BJ, Brenneis FR.

[lix][59] Smith WH, Rogers JG, Hansen TN, Smith CV. Early career development in academic pediatrics of participants in the APS-SPR Medical Student Research Program.

Pediatr Res. 2009 Apr;65(4):474-7. 

[60] Bindal T, Wall D, Goodyear HM. Medical students' views on selecting paediatrics as a career choice.  Eur J Pediatr. 2011 Sep;170(9):1193-9. Epub 2011 Apr 13. 

[61] Hauer KE, Durning SJ, Kernan WN, Fagan MJ, Mintz M, O'Sullivan PS, Battistone M, DeFer T, Elnicki M, Harrell H, Reddy S, Boscardin CK, Schwartz MD. Factors associated with medical students' career choices regarding internal medicine. JAMA. 2008 Sep 10;300(10):1154-64.

[62]  Gowans MC, Glazier L, Wright BJ, Brenneis FR, Scott IM.. Choosing a career in psychiatry: factors associated with a career interest in psychiatry among Canadian students on entry to medical school. Can J Psychiatry. 2009 Aug;54(8):557-64.

[63] Robertson T, Walter G, Soh N, Hunt G, Cleary M, Malhi G.  Medical students' attitudes towards a career in psychiatry before and after viewing a promotional DVD. Australas Psychiatry. 2009 Aug;17(4):311-7.

[64]   Marić NP, Stojiljković DJ, Milekić B, Milanov M, Stevanović D, Jasović-Gasić M. How medical students in their pre-clinical year perceive psychiatry as a career: the study from Belgrade. Psychiatr Danub. 2009 Jun;21(2):206-12.

[65] Syed EU, Siddiqi MN, Dogar I, Hamrani MM, Yousafzai AW, Zuberi S. Attitudes of pakistani medical students towards psychiatry as a prospective career: a survey. Acad Psychiatry. 2008 Mar-Apr;32(2):160-4.

[66] Scott IM, Abu-Laban RB, Gowans MC, Wright BJ, Brenneis FR. Emergency medicine as a career choice: a descriptive study of Canadian medical students. CJEM. 2009 May;11(3):196-206. 

[67] Boyd JS, Clyne B, Reinert SE, Zink BJ. Emergency medicine career choice: a profile of factors and influences from the Association of American Medical Colleges (AAMC) graduation questionnaires. Acad Emerg Med. 2009 Jun;16(6):544-9. Epub 2009 Mar 26.

[68] Boyd JS, Clyne B, Reinert SE, Zink BJ. Emergency medicine career choice: a profile of factors and influences from the Association of American Medical Colleges (AAMC) graduation questionnaires. Acad Emerg Med. 2009 Jun;16(6):544-9. Epub 2009 Mar 26.

[69] Kennedy S, Knibutat DB, DelBasso SL, Bokhari SA, Forman HP.  The educational and career impact of using medical students for triaging off-hour diagnostic imaging requests at a major academic medical center.. AJR Am J Roentgenol. 2010 Apr;194(4):1027-33. 

[70] Onakpoya OH, Onakpoya UU, Adereti GE. The prospect of anatomy as a career choice among clinical year medical students in Nigeria. Ann Afr Med. 2009 Apr-Jun;8(2):90-4.