Specialty choices among new generation of doctors – insights from a Polish survey study

In this study, we present the most crucial factors considered by representatives of Generation Z when choosing their specialty. We determined that doctors pursuing a career in surgical fields are driven by other factors than those who chose a non-surgical specialty. Work-related aspects were more significant for surgical-focused doctors, while more personal and life-related aspects were more typical for those pursuing non-surgical interests.

Overall, the factors considered when choosing a future specialty are mostly work-related. Doctors are willing to continue their careers in line with their interests and skills. They expect to maintain a proper balance between work and personal life and be adequately paid for their work. Young doctors seem to be aware of their limitations in terms of possessed communication skills, as they consider the type of patients interactions significant. Little attention is paid to more external factors, like family or peer pressure, prestige, or duration of training. Surprisingly, the experience gained during medical school does not influence their choices.

Non-surgical specialties have been more popular among doctors recently. The national authorities and representatives of the surgical association have highlighted the crisis in surgery²⁰. The data from past qualifications (held in previous years) objectivized those statements. In the latest qualifications, many posts in surgical specialties (mostly general surgery) remained unmatched. On the other hand, some surgical programmes (e.g. urology or obstetrics and gynaecology) received significant interest from candidates²¹.

The ability to maintain a healthy work-life balance is becoming one of the most meaningful aspects taken into consideration by young people in their occupational life. They do not want to devote their personal life to their work and employer. As presented by Spooner at al. ²², young doctors find exploring their non-medical interests, spending time with friends and family more significant than spending long hours at work, even though it may mean having to abandon their initial career choices. Nowadays, doctors present a more holistic and long-term perspective on life. In the study, the respondents underlined that the attitude of life of those aged 25 is different from one may have when they are 45.

Surgical specialties are said to be more time-consuming and physically demanding. The training requires mentoring, long hours of practice, and persistence. Moreover, very little is said about support for young parents. What was not shown in our study, but has been proven by Dason et al.²³ is that students are concerned about developing families and how it would affect their occupational activities and relationships with colleagues and subsequently, their specialty choice.

New technologies, including artificial intelligence (AI) will undoubtedly become a significant part of the education and daily work of health professionals. So far, little research has been conducted exploring the impact of AI and new technologies on specialty choices. Gong et al.²⁴ presented that Canadian medical students had been discouraged from choosing radiology as a specialty, in contrast to the results of Pawelczyk et al. with regards to orthopaedic surgery²⁵. Atalay et al.²⁶ presented their results from 2017 to 2021 questionnaires indicating that medical students believe that emerging technologies would reduce job prospects in some specialties, including diagnostic radiology, pathology, and anesthesiology. Despite the studies conducted on the topic so far, further research is needed to understand the potential impact of new technologies on medical specialties.

This study reflects new insights and key factors taken into consideration by doctors of the younger generation while considering their careers. To our knowledge, it was the first nationwide quantitative study on this topic in Poland. The findings presented in the study are consistent with international research conducted on this topic^{27,28,29,30,31}. Therefore, the results may apply not only to Poland, but also to other countries. In a Brazilian study³² the authors presented that students reject and choose their preferred specialty in different periods, including controllable lifestyle specialties (e.g. neurology, ophthalomology, pathology) being chosen mainly during the last two years of education. The UK cohort study presented that socioeconomic background plays a crucial role when choosing a specialty³³.

The study provided a valuable source of information for policymakers and authorities to mitigate the crisis in the healthcare workforce. One challenge facing healthcare systems around the world is the education crisis^34,35, which refers to the inadequacy of educational institutions to properly train and prepare new generations of healthcare professionals¹. The results of an international study provide a clear mandate for healthcare managers to address the concerns of the younger generation of healthcare professionals. It emphasizes three critical areas that require urgent attention: education and training, technology, and work culture⁸. Educational institutions need to update their curricula and training programs to equip medical students with the necessary skills and competencies to meet the current and future demands of the healthcare system. Consequently, there is a gap between the education health workers receive and the practical needs of the health sector, leading to the health workforce that is not fully prepared to address the growing challenges in healthcare^1,2,7,8. In light of the aforementioned findings and the existing literature, it is evident that there is a pressing need for further international research on the topic of specialty choices among young doctors. A more comprehensive study on a larger scale is required to gain a deeper understanding of the preferences of Gen Z doctors. Nevertheless, the presented factors are beneficial to stakeholders and policymakers. These aspects should be acknowledged while planning reforms in medical education and capacity in human resources, which would be resilient against the challenges posed by the changing health needs of populations.

Our study is not free of limitations. The data collected were obtained from doctors whose medical school experience was conducted partially during the COVID-19 pandemic, having much of the teaching held online, limiting their access to clinical experiences. Secondly, we included a specific cohort of Polish doctors that may vary from older trainees, still, we aimed to reach those who have not had much work experience yet. The next limitation is the potential bias in responses, as an online survey may have resulted in different interpretations of the questions by respondents. While an online, self-administered survey has some limitations, benefits include accessing nationally geographically distributed respondents that would be difficult for an in-person questionnaire.

This research highlights the need for further investigation into the topic. The respondents, even though they have not been part of the system for a long time, will become the majority soon, changing the landscape of the health workforce. Policymakers should be able to communicate and answer their expectations and perspectives.