The early determinants of career choices for medical students following an obstetrics and gynaecology placement: Mixed methods study.

OBJECTIVE: To explore the impact of attending a clinical placement in considering a career in obstetrics and gynaecology. DESIGN: Mixed methods study. SETTING: London Medical School. POPULATION: Fifth year medical students attending a clinical placement in obstetrics and gynaecology. METHODS: Between January 2021 and January 2022, questionnaires were used and semi-structured focus groups conducted, which were audio-recorded. Descriptive statistics were conducted and a framework analysis on transcribed focus groups. MAIN OUTCOME MEASURE: The impact of the clinical placement on career choice. RESULTS: Six main themes were identified from the analysis; three contributing to considering a career in obstetrics and gynaecology; pregnancy is not an illness, extraordinary experience of observing childbirth and variable specialty and three themes emerged contributing to not considering a career; lack of work-life balance, high stakes specialty and the emotional toll. Even at an undergraduate level, medical students exhibited concerns about the long-term feasibility of achieving work-life balance and avoiding professional burnout, which was partly attributed to the responsibility of looking after both the woman and their baby. CONCLUSIONS: Obstetrics and gynaecology is perceived as an exciting and variable speciality by medical students. Students' experiences on the labour ward during a clinical placement appear to contribute to the consideration of a career in obstetrics and gynaecology. Students should be given opportunities to discuss their concerns about obstetrics, particularly over the potential psychological impact of adverse/traumatic birth events. It is crucial to provide a realistic introduction to obstetrics, to recruit enthusiastic junior doctors who will be resilient to the pressures of the speciality, to avoid burnout and minimise attrition rates.

Patients, clients, users or customers: what should we call people attending sexual health services?

BACKGROUND AND METHODOLOGY: In sexual health clinics there is debate on whether to call service users 'patients' or 'clients' and this mirrors an ongoing dialogue in the medical literature. The authors undertook a questionnaire survey in five UK centres of clinic attendees and staff to assess their preference. RESULTS: A total of 1428 clinic attendees and 250 staff members completed questionnaires. 61% of attendees who responded preferred 'patient', with 23% expressing no preference. Only 9% of respondents preferred the term 'client'. 148 (59%) of all staff groups preferred the term 'patient' followed by 82 (33%) selecting 'client'. No staff member opted for 'customer' or 'user' as the preferred term. The difference between preference for 'patient' between doctors and nurses was statistically significant, with most doctors preferring the term 'patient'. Out of a total of 84 nurses, there was equal preference for 'patient' and 'client' (38 nurses in each group). Comments from attendees and staff who responded generally emphasised the concept of the 'caring' role of the health professional towards people attending the services. DISCUSSION AND CONCLUSIONS: The majority of people attending sexual health clinics and medical and clerical staff working in these services expressed a preference to retain the title of 'patient'. The main justification for this appeared to relate to the concept of caring for people. The authors therefore conclude that the terminology in sexual health services should revert to predominantly using the term 'patient'.