Medicine As a Career Choice: A Comprehensive Study on Factors Influencing Sudanese Students to Opt in/out Medical Career
Authors: BASHIR MOEZ MOHAMMED IBRAHIM , ALRAYAH MOHMED AHMED FADELALLA , MUSTAFA MOHAMED ESAMELDIN ELSAYED , MAROOF MOHAMMED KHALID ABDULLA , HAMAD MOHAMED AWAD OMER , MOHAMEDOSMAN MOAID MOHAMEDOSMAN ALI 
Published: January 2023

Abstract
Background: The medical profession is one of the most highly respected and desired professions among students worldwide, most likely because it provides opportunities for both a financially and socially rewarding career. However, while it has been quite established that factors such as self-interest, family pressure, friend pressure, and socioeconomic status do influence the choice of medicine among students worldwide, the exact reasons for an individual to enter a medical school may actually vary worldwide.
An institutional based descriptive cross-sectional study was conducted at University of Khartoum in the year 2022 with a random sample of 330 students that was obtained from the medical students at the The University of Khartoum, Faculty of Medicine using stratified random sampling to comprehensively explore factors influencing medical students to opt in/out medical careers.
Results: Self-interest was the most common factor influencing opting in (choosing) medical profession (70.6%) (n= 233), followed by getting a very high score in high-school that qualifies into the faculty (55.5%) (n= 183). Better job opportunities in the future was the third factor for (45.5%) (n= 150) for our subjects. Regarding the factors affecting medical students’ choices, parental pressure was the main factor (37.0%) (n= 122), followed by other relatives' pressure (12.4%) (n= 41), and 4.2% (n= 14) chose Peer pressure. 59.7% (n= 197) of the participants stated that they were not affected by any of these factors. Regarding the general perception of the medical profession by society, most of our participants (65.8%) (n= 217) chose “With good career opportunities”, 62.4% (n= 206) chose “Prestigious”, 55.8% (n= 184) chose “Well-paid”, while 5.8% (n= 19) believed that it is “Not appreciated at all”, and statistically significant association was found between the type of admission & parent pressure (p value 0.01). out of 330 participants, (56.1%) (n=185) have opted out i.e.lost their interest or regretted their choice of medical career. Regarding the factors causing opting out, academic difficulties was the most common factor (37%) (n=122) followed by Multiple suspensions of education (35.2%) (n=116), Current political & security conflicts in Sudan (29.7%) (n=98), Poor quality of education (24.8%) (n=82), health-related conditions (7.3%) (n=24), Financial difficulties (6.4%) (n=21). Also (3.3%) (n=11) mentioned other options. The proportion of students having regrets for the medical profession was significantly higher among females. Over one third of the participants reported having depressive symptoms more than half days of the week .
Conclusions: This study has surprisingly found that the majority of current medical students at the University of Khartoum have already lost their interest or regretted their medical career choice. Academic difficulties, multiple suspension of education, and poor quality of education were the most common reasons that caused medical students to opt out of the medical career. Self-interest and getting high scores in high school were the most common reasons for opting in a medical career, and parents' pressure was the most common factor to influence the choice. Also surprisingly, more than one third of students were found to have symptoms of depression, a statistically significant correlation was found between opting out and having “little interest or pleasure in doing things” (anhedonia) over the last two weeks and also between opting out and feeling “down, depressed or hopeless” over the last two weeks, these two findings highly suggest that symptoms of depression can very well be one of the hidden factors that influence career choice regret, yet it is fair to say you can never tell which one comes first.