Perceptions on gender awareness and considerations in career choices of medical students in a medical school in Taiwan.

The trend of medical career choice in the younger generation has resulted in deficiency of manpower in the four major disciplines of internal medicine, surgery, obstetrics/gynecology, and pediatrics, which will threaten people's health care in Taiwan. However, perceptions of gender awareness and factors affecting the career choices of medical students have not been investigated systemically in Taiwan. To explore the perceptions on gender awareness and considerations in career choices, we recruited 280 1(st)- and 7(th)-year male and female medical students at a Medical University for the study. A modified Nijmegen questionnaire using a 5-point Likert scale containing medical curricula (18 items), gender awareness (13 items), and career inclination (9 items) was adopted as the investigation tool in our study. The response rate was 75% (224/280). With regard to gender, the 1(st)-year male students had greater confidence in being a physician than the female students (p < 0.05), and female students subjectively suggested an advantage to communicate with patients or colleagues (p < 0.05). Faculty attitude in treating students differently by gender was more prominent in the 7(th)-year than in the 1(st)-year students (p < 0.001), and they felt male preceptors typically were more enthusiastic to teach and to rank higher grades to female than to male students; however, this was not observed among female preceptors. Both male and female students showed a low level of agreement that clinical skills and performance of a physician were significantly different by gender and "female physicians are more empathetic and provide more communications than male physicians". Factors influencing career choices of medical students, including "personal interests/talents" and "academic achievement of the specialty," were not significantly different by gender. Factors included "training and learning environments of the specialty", "risk of lawsuit", and "economic incentive" were more appreciated by the senior than the junior students (p < 0.05). Effect of "family" or "spouse" did not differ significantly regardless of gender or seniority. The 7(th)-year students had experiences in clinical medicine and had different considerations in career choice in comparison to the 1(st)-year students, and gender played a role in senior students. In addition, the senior rather than the junior students regarded "training and learning environments", "risk of lawsuit", and "economic incentive" as more important factors affecting the career choices, and male students paid more attention to these issues. Other factors such as fixed hours of duty with no emergency, easier lifestyle, and more time to take care his/her families were also important factors affecting career choice in medical students regardless of their gender; however, the junior students disclosed lower concern on the issues. In addition, four major misperceptions of gender and health issues were prevalent in the 7(th)-year students; therefore, we recognized the importance of integrating gender issues into medical curriculum to diminish gender misunderstanding and prejudice, and to provide gender-specific health care is mandatory in Taiwan.