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Annals of African Medicine, Vol. 8, No. 2, April-June, 2009, pp. 90-94 Original Article The prospect of anatomy as a career choice among clinical year medical students in Nigeria Onakpoya Oluwatoyin H, Onakpoya UvieU, Adereti GraceE Department of Anatomy and Cell Biology and Surgery, Obafemi Awolowo University, Ile-Ife Code Number: am09021 PMID: 19805938 Abstract Background : Medical doctors are potential important source of anatomy teachers. The aim of this study was to determine the choice of anatomy as a career option among medical students in a Nigerian medical schoolMethod : Descriptive survey of second- and third-year medical students using a self-administered questionnaire to asses age, sex, perception of anatomy as a subject, anatomy training experience and choice of anatomy as a career among respondents. Analysis was conducted using the SPSS and statistical significance inferred at P<0.05. Results : Three hundred and fifty three (85.3% response rate) who completely filled questionnaire were returned and analyzed of which 195 (55.2%) were males and 158(44.8%) were females. Their ages ranged between 18 and 37 years with a mean of 22.4 ± 9.9 years. Although most students agreed that anatomy was an important subject in medical sciences 346 (98%), they had benefited from anatomy training in their clinical classes 320 (90.7%), and the knowledge of anatomy is useful in investigating patients with certain diseases 251 (71.1%), only 22 (6.2%) would choose anatomy as a career. Male students were more likely to choose anatomy as a career (P=0.026). Textbooks were the most common 334 (94.5%), while radiological means were the least 23 (6.5%) method employed in learning anatomy. Conclusion : Anatomy as a subject is perceived positively by clinical medical students, but the choice as a career option is low; attempt at increasing career interest is needful. Keywords: Anatomy, career choice, gender, medical education, medical students, Nigeria Résumé Arrière-plan: Médecins sont potentiel source importante d’anatomie enseignants. L’objectif de cette étude est de
déterminer le choix d’anatomie comme une option de carrière parmi les étudiants en médecine dans une école de
médecine nigériane Mots cles: l’éducation médicale Nigéria; anatomie; choix de carrière; étudiants en médecine; genre Introduction Anatomy is an important subject in medical sciences. [1] The knowledge of structure of the human body from the naked eye appearance (gross anatomy) down to molecular level is fundamental to understanding its function and how both structure and function are modified by disease processes. [2] A decline and dearth of anatomy lecturers to match the number of medical schools and increasing student populations has been reported in USA and India. [1],[2],[3] More medical schools are springing up in Nigeria. Medical doctors remain a potential and important source of anatomy teachers. [1],[3] Teaching of gross anatomy to preclinical students by surgeons in the USA provided clinical adjuncts and offered assistance to professional anatomists and anatomy course directors. [4] Medical doctors also serve as temporary anatomy lecturers to fill the gap of declining medically qualified anatomy lecturers in the UK. [3] Practical and clinical adjunct to lectures was considered by ~90% of medical students as having the potential of making learning more interesting and easier to remember. [5] The choice of career path by doctors is influenced by a number of factors. Career progression, on-call commitment, a teacher as a role model, love of anatomy, and interest in the subject were the top five factors influencing the choice of career among 169 medical students in Dundee. [6] In addition to personal interest and life style, income also influences the choice of career among medical students. [7],[8] Sanfeh et al, reported the influence of gender on career choice. [9] The interest in a specialty is aroused during training and has an important influence on career choice. [10] A previous study in Nigeria reported only 1.5% of preclinical medical students desirous of taking a career in teaching anatomy. [7] In India, although medical students understood and noted the usefulness of anatomy to their training, 30% indicated interest in anatomy as a career if options of research and job opportunities were made available. [6] The choice of career is affected by interest aroused during training and evolves during training; [10] nevertheless, doctors are now encouraged to choose a career path at an early stage in medical training. [11] Clinical year medical students who have successfully completed anatomy courses should have received maximal potential for arousal of interest in anatomy as career choice. Moreover, current exposure to clinical practice affords them the opportunity of a more objective comparison in contrast to their pre-clinical counterparts. This study was conducted to determine the choice of anatomy as a career option among clinical year medical students in a Nigerian medical school. Materials and Methods The survey was conducted among consenting second-year and third-year clinical medical students of the College of Medicine, Obafemi Awolowo University, Ile-Ife. This college runs a 3-year preclinical course for medical students; in the second and third year of which human anatomy is taught. Only students who had successfully completed the anatomy course along with other basic medical sciences can proceed to clinical course that runs for another 3 years. Second- and third-year clinical students had successfully completed human anatomy course and commenced clinical medicine training at least within the last 2 and 3 years, respectively, from the study period. They had been exposed to all preclinical basic medical sciences and most clinical sub-specialties. First-year clinical students were excluded from the study because they passed anatomy within 3 months of the study and were not deemed to have had enough clinical exposure to make informed choices about career options in the medical sub-specialties. A structured self-administered questionnaire was distributed to consenting second- and third-year clinical medical students to assess their age, sex, perception of importance of learning anatomy to clinical medicine, perception of preclinical training in anatomy, and the choice of anatomy as a career option. Previous failure necessitating a re-sit examination or repeat of anatomy class was used for gross assessment of performance in the human anatomy course. Identification through numbering or names was excluded from the questionnaire that was distributed to the students by a clinical II year medical student to ensure anonymity of the respondents. Data were imputed into SPSS version 13, analyzed, and presented in simple frequency. Variables were compared using the chi-squared test and statistical significance inferred at P< 0.05. Results A total of 353 second- and third-year clinical medical students returned filled questionnaire out of the total number of 414 students representing 85.3%% response rate. 195 (55.2%) were males while 158(44.8%) were females and their ages ranged between 18 and 37 years with a mean of 22.4 ± 9.9 years. Most students agreed that anatomy was an important subject in medical sciences 346 (98%), they had benefited from anatomy training in their clinical classes 320 (90.7%), that teaching anatomy gives as much satisfaction as treating patients 218(61.8%), and that the knowledge of anatomy is useful in investigating patients with certain diseases 251(71.1%). However, only 22 (6.2%) would choose anatomy as a career in post-graduation [Table - 1]. Male students were more likely to choose anatomy as a career than female clinical medical students (P=0.026). A majority of the students 297 (84.1%) had enjoyed their preclinical anatomy training, while 53(15%) did not. 91(25.2%) had a resit or repeat during their preclinical anatomy training while 262 (74.2%) did not. Comparison of students perception of anatomy in relation to gender showed more females agreeing that anatomy was a difficult subject to understand and retain (P< 0.001), did not enjoy the anatomy course (P=0.001), and more likely to have had a resit or repeat examinations in anatomy (P=0.012) when compared to their male counterparts [Table - 2]. A previous experience of resit or repeat examination in preclinical anatomy course did not significantly affect the choice of anatomy as a career option (P=0.446) [Table - 3]. Learning was mainly through textbooks and atlases in 94.5%, lectures in 42.8%, and rarely through audio-visual devices (22.1%) or radiologic studies (6.5%). [Table - 4] shows the commonly used method of learning anatomy during pre-clinical anatomy training among students by gender. A higher percentage of female medical students learned through reading textbooks/atlas (P=0.033) and during anatomy lectures (P=0.014) compared to their male counterparts. Discussion In the College of Health Sciences, Ile Ife, anatomy is taught in the first and second year out of the total required 5 years of medical training as gross anatomy, embryology, histology, and introduction to medical genetics. Anatomy is an important subject in the medical training curriculum. In this study, 98% of 353 clinical students agreed that anatomy was an important subject in medical sciences, and its immense contribution during their clinical rotations was attested to be 90.3% of the medical students. Similar high positive response rate was reported among Indian medical students. [1] Anatomy encompasses many aspects of the morphological basis of medicine and provides a structural framework for the development of clinical logic. [2],[12] The clinical relevance of anatomy remains highly rated among medical students globally; [1],[13] the same is noted in this study. In spite of the positive disposition to and understanding of the importance of anatomy in medical training, only 6.2% of students will consider anatomy as a career option after graduation from medical school. In the medical profession, non-clinical teaching specialties are opted for only by a very few students. [14] In a previous study among preclinical students in Nigeria, only 1.5% considered anatomy as a possible career option. [7] It is possible that the increase in percentage of student willing to take anatomy as a career is due to their exposure to clinical rotations that could have afforded them the opportunity of noting the importance and relevance of anatomy to clinical practice in comparison with the other study conducted on preclinical students. Moreover, the teaching of introduction to medical genetics in the preclinical anatomy curriculum may be contributory to the increasing number. Anand et al, recorded up to 30% of their students willing to take anatomy as a career option, which was considered low for the need among Indian medical schools. [1] Clinical specialties especially surgery and obstetrics and gynecology tended to be more attractive to interns in Lagos. [14] Students′ approaches to learning anatomy are driven by many factors and perceptions like the curriculum, assessment, previous educational experience, and the influence of staff and fellow students. [15] Textbook/atlas of anatomy and anatomy lectures were the most common mode of learning anatomy by students in this study, while radiology was the least common. While these traditional means of learning are age long and very useful, introduction of radiological and computer-assisted learning methods may arouse student interest in the subject and enhance performance. Our finding is similar to a study in Auckland, New Zealand, that reported traditional means of textbooks/atlas as the most commonly used method of learning and radiology being the least. [16] Moreover, with the recent advances in medical practice viz three-dimensional radiologic investigations and minimal access surgeries, the requirement for medical anatomists is likely to be on the increase. [1],[2] Teaching anatomy enables the medical doctor refresh his knowledge of anatomy, a subject that is indispensable in providing a basis for examination of patients, interpretation of imaging, and safe conduct of basic interventional procedures. Gender plays a role in choice of career after medical school; [7],[9],[16],[17] with the continuous increase in the percentage of women in the medical schools, the issue of gender cannot be overlooked . Significant differences existed in this study with more females finding anatomy difficult to understand and retain, not enjoying the course and having resit/repeat anatomy exams. The reason for this difference is not immediately clear but considering that females were also less likely to choose anatomy as a career, the issues are worthy of further investigation. Anatomy as a subject is perceived positively by clinical medical students, but the choice as a career option is low. Increasing the use of radiological methods and computer-assisted methods in learning anatomy may increase students′ interest in the subject. Further studies on the reasons for the noted differences in the perception and performance of females in anatomy course will enable modifications to effect a change. References
Copyright 2009 - Annals of African Medicine The following images related to this document are available:Photo images[am09021t2.jpg] [am09021t1.jpg] [am09021t4.jpg] [am09021a1.jpg] [am09021t3.jpg] |
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