Impact of longitudinal integrated clerkship programs on career path selection: A case study from Japan.

Introduction: To address the shortage of healthcare professionals in rural regions of Japan, Longitudinal Integrated Clerkship (LIC) programs were introduced with the objective of training community-oriented generalists. LIC provides students with a longitudinal approach to clinical education, fostering a commitment to primary care careers. Studies have shown that LIC graduates are more likely to work in rural settings, with a significant proportion pursuing primary care. The LIC model has recently garnered increased interest, leading several institutions in Japan to adopt this educational framework to enhance regional healthcare delivery. Methods: This study employed semi-structured interviews with three sixth-year medical students who completed the LIC program between 2014 and 2020. Interview transcripts were subjected to thematic analysis to identify factors influencing career choices. Results: The analysis revealed six key themes that influenced the career decisions of the LIC participants. The students' interactions with mentors and their involvement in long-term patient care emerged as pivotal experiences, reinforcing their dedication to community healthcare and primary care. The participants reported an enhancement of their clinical competencies and a growing confidence in their roles as generalists. Discussion: Despite the limited number of LIC participants, the findings indicate that the program effectively promotes interest in general practice careers. The study identified potential areas for program enhancement and elucidated the mechanisms by which LIC influences career decision-making. Additionally, the results highlight the importance of educational strategies based on established learning theories, which foster students' professional growth, adaptation to community healthcare, and reinforce their commitment to primary care.