Abstract
Mismatches between the needs of public health systems and student interests have led to renewed study on the factors predicting career specializations among medical students. While most work examines career and lifestyle values, emotional proclivities may be important; disgust sensitivity may help explain preferences for careers with greater and lesser degrees of procedural content. In the study, 294 students completed measures assessing: (1) demographics, (2) career interest or intention regarding emergency medicine, internal medicine, obstetrics/gynecology, and pediatric medicine, (3) traditional determinants of career intention/interest, and (4) core/bodily product, animal reminder, contamination, and sexual/moral disgust sensitivity. As predicted, logistic regressions controlling for demographics and traditional career predictors, showed that greater animal reminder disgust predicted reduced interest in emergency medicine but greater interest in pediatric medicine. Conversely, greater core/bodily product disgust predicted lower interest in obstetrics/gynecology and pediatric medicine; greater contamination and sexual/moral disgust both predicted increased odds of interest in internal medicine. Overall, specific disgust sensitivities were the best predictors of specialization intention in multivariate models. Specific disgust sensitivities appear to differentially deter and/or predispose self-selection into specific trajectories varying in procedural content. Such findings may permit the early identification of specialty fit and provide guidance in career counseling.
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Babbott, D., Levey, G. S., Weaver, S. O., & Killian, C. D. (1991). Medical student attitudes about internal medicine: A study of United States medical school seniors in 1988. Annals of Internal Medicine, 114, 16–22.
Bixler, R. D., & Floyd, M. F. (1997). Nature is scary, disgusting, and uncomfortable. Environment and Behavior, 29, 443–467.
Borges, N. J., & Savickas, M. L. (2002). Personality and medical specialty choice: a literature review and integration. Journal of Career Assessment, 10, 362–380.
Boyd, J. S., Clyne, B., Reinert, S. E., & Zink, B. J. (2009). Emergency medicine career choice: a profile of factors and influence from the Association of American Medical Colleges (AAMC) Graduation Questionnaires. Academic Emergency Medicine, 16, 544–549.
Buddeberg-Fischer, B., Klaghofer, R., Abel, T., & Buddeberg, C. (2006). Swiss residents’ speciality choices: Impact of gender, personality traits, career motivation and life goals. BMC Health Services Research, 6, art. no. 137.
Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavior Research Methods, 1, 245–276.
Chapman, H. A., Kim, D. A., Susskind, J. M., & Anderson, A. K. (2009). In bad taste: evidence for the oral origins of moral disgust. Science, 323, 1222–1226.
Compton, M. T., Frank, E., Elon, L., & Carrera, J. (2008). Changes in US medical students’ specialty interests over the course of medical school. Journal of General Internal Medicine, 23, 1095–1100.
Consedine, N. S., Adjei, B. A., Ramirez, P. M., & McKiernan, J. (2008). An object lesson: Differences in source determine the relations that trait anxiety, prostate cancer worry, and fear of screening hold with prostate screening frequency. Cancer Epidemiology, Biomarkers and Prevention, 17, 1631–1639.
Consedine, N. S., Krivoshekova, Y. S., & Harris, C. R. (2007). Bodily embarrassment and judgment concern as separable factors in the measurement of medical embarrassment: Psychometric development and links to treatment-seeking outcomes. British Journal of Health Psychology, 12, 439–462.
Consedine, N. S., & Moskowitz, J. T. (2007). The role of discrete emotions in health outcomes: a critical review. Journal of Applied and Preventive Psychology, 12, 59–75.
Consedine, N. S., Yu, T.-C., & Windsor, J. A. (2013). Nursing, pharmacy, or medicine? Disgust sensitivity predicts career interest among trainee health professionals. Advances in Health Sciences Education.
Council, N. Z. M. (2010). Scopes of practice and prescribed qualifications for the practice of medicine in New Zealand. In New Zealand Gazette (Vol. 8, pp. 253–267). Wellington, New Zealand: New Zealand Medical Council.
Curtis, V., Aunger, R., & Rabie, T. (2004). Evidence that disgust evolved to protect from risk of disease. Proceedings of the Royal Society Biological Sciences: Series B, 271, S131–S133.
Darwin, C. E. (1872/1965). The expression of the emotions in man and animals. Chicago: University of Chicago Press.
Davey, G. C. L., & Bond, N. (2006). Using controlled comparisons in disgust psychopathology research: The case of disgust, hypochondriasis and health anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 37, 4–15.
Dial, T. H., & Lindley, D. W. (1987). Predictive validity of specialty choice data from AAMC graduation questionnaire. Journal of Medical Education, 62, 955–958.
Ekman, P. (1992). An argument for basic emotions. Cognition and Emotion, 6, 169–200.
Erzurum, V. Z., Obermeyer, R. J., Fecher, A., Thyagarajan, P., Tan, P., Koler, A. K., et al. (2000). What influences medical students’ choice of surgical careers. Surgery, 128, 253–256.
Fessler, D. M. T., Eng, S. J., & Navarrete, C. D. (2005). Elevated disgust sensitivity in the first trimester of pregnancy: Evidence supporting prophylaxis the compensatory hypothesis. Evolution and Human Behavior, 26, 344–351.
Fincher, R.-M. E., Lewis, L. A., & Rogers, L. Q. (1992). Classification model that predicts medical students’ choices of primary care or non-primary care specialties. Academic Medicine, 67, 324–327.
Fischer, J. E. (2007). The impending disappearance of the general surgeon. Journal of the American Medical Association, 298, 2191–2193.
Freed, G. L., Dunham, K. M., Balistreri, W. F., Boat, T. F., Lister, G., McMillan, J. A., et al. (2010). All primary care trainees are not the same: The role of economic factors and career choice. Pediatrics, 125, 574–577.
Fukuda, Y., & Harada, T. (2010). Gender differences in specialty preference and mismatch with real needs in Japanese medical students. BMC Medical Education, 10.
Goldacre, M. J., Laxton, L., & Lambert, T. W. (2010). Medical graduates’ early career choices of specialty and their eventual specialty destinations: UK prospective cohort studies. British Medical Journal, 341.
Green, S. M. (2009). Trauma surgery: Discipline in crisis. Annals of Emergency Medicine, 53, 198–207.
Haidt, J., McCauley, C., & Rozin, P. (1994). Individual differences in sensitivity to disgust: A scale sampling seven domains of disgust elicitors. Personality and Individual Differences, 16, 701–713.
Hardigan, P. C., & Cohen, S. R. (1998). Comparison of personality styles between students enrolled in osteopathic, medical, pharmacy, physical therapy, physician assistant, and occupational therapy programs. Journal of the American Osteopathic Association, 98, 637–641.
Harris, M. C., Marx, J., Gallagher, P. R., & Ludwig, S. (2005). Improving comprehensive surgical resident training through use of the NEO Five-Factor Personality Inventory: Results from a cohort-based trial. Archives of Pediatrics and Adolescent Medicine, 159, 212–216.
Hauer, K. E., Durning, S. J., Kernan, W. N., Fagan, M. J., Mintz, M., O’Sullivan, P. S., et al. (2008). Factors associated with medical students’ career choices regarding internal medicine. Journal of the American Medical Association, 300, 1154–1164.
Horwitz, I. B., Horwitz, S. K., Brunicardi, F. C., & Awad, S. S. (2011). Improving comprehensive surgical resident training through use of the NEO Five-Factor Personality Inventory: Results from a cohort-based trial. American Journal of Surgery, 201, 828–834.
Inbar, Y., Pizarro, D. A., & Bloom, P. (2009). Conservatives are more easily disgusted than liberals. Cognition and Emotion, 23, 714–725.
Jeffe, D. B., Andriole, D. A., Hageman, H. L., & Whelan, A. J. (2007). The changing paradigm of contemporary US allopathic medical school graduates’ career paths: Analysis of the 1997–2004 national AAMC graduation questionnaire database. Academic Medicine, 82, 888–894.
Kassebaum, D. G., & Szenas, P. L. (1994). Factors influencing the speciality choice of 1993 medical school graduates. Academic Medicine, 69, 164–170.
Kassler, W. J., Wartman, S. A., & Silliman, R. A. (1991). Why medical students choose primary care careers. Academic Medicine, 66, 41–43.
Knudson, M. M. (2010). Trauma/critical care surgery. American Journal of Surgery, 199, 266–268.
Martini, C. J., Veloski, J. J., Barzansky, B., Xu, G., & Fields, S. K. (1994). Medical school and student characteristics that influence choosing a generalist career. Journal of the American Medical Association, 272, 661–668.
McAlister, R. P., Andriole, D. A., Rowland, P. A., & Jeffe, D. B. (2007). Have predictors of obstetrics and gynecology career choice among contemporary US medical graduates changed over time? American Journal of Obstetrics and Gynecology, 196, 275–277.
McGreevy, J., & Wiebe, D. (2002). A preliminary measurement of the surgical personality. American Journal of Surgery, 184, 121–125.
Newton, D. A., & Grayson, A. S. (2003). Trends in career choice by US medical school graduates. Journal of the American Medical Association, 290, 1179–1182.
Newton, D. A., Grayson, M. S., & Foster Thompson, L. (2010). Money, lifestyle, or values? Why medical students choose subspecialty versus general pediatric careers. Clinical Pediatrics, 49, 116–122.
Olatunji, B. O., Cisler, J. M., Deacon, B. J., Connolly, K., & Lohr, J. M. (2007a). The Disgust Propensity and Sensitivity Scale-Revised: Psychometric properties and specificity in relation to anxiety disorder symptoms. Journal of Anxiety Disorders, 21, 918–930.
Olatunji, B. O., Haidt, J., McKay, D., & David, B. (2008). Core, animal reminder, and contamination disgust: Three kinds of disgust with distinct personality, behavioral, physiological, and clinical correlates. Journal of Research in Personality, 42, 1243–1259.
Olatunji, B. O., & Sawchuk, C. N. (2005). Disgust: characteristic features, social manifestations, and clinical implications. Journal of Social and Clinical Psychology, 24, 932–962.
Olatunji, B. O., Sawchuk, C. N., de Jong, P. J., & Lohr, J. M. (2007b). Disgust sensitivity and anxiety disorder symptoms: Psychometric properties of the disgust emotion scale. Journal of Psychopathology and Behavioral Assessment, 29, 115–124.
Pelaccia, T., Delplanq, H., Triby, E., Bartier, J.-C., Leman, C., Hadef, H., et al. (2010). Gender stereotypes: An explanation to the underrepresentation of women in emergency medicine. Academic Emergency Medicine, 17, 775–779.
Polk, H. C. (1999). The declining interest in surgical careers, the primary care mirage, and concerns about contemporary undergraduate surgical education. American Journal of Surgery, 178, 177–179.
Ravindra, P., & Fitzgerald, J. E. F. (2011). Defining surgical role models and their influence on career choice. World Journal of Surgery, 35, 704–709.
Reynolds, L., Consedine, N. S., Pizarro, D. A., & Bissett, I. (2013). Disgust and behavioral avoidance in colorectal cancer screening and treatment: a systematic review and research agenda. Cancer Nursing.
Rozin, P. (2008). Hedonic “adaptation”: Specific habituation to disgust/death elicitors as a result of dissecting a cadaver. Judgment and Decision Making Journal, 3, 191–194.
Rozin, P., Haidt, J., McCauley, C., Dunlop, L., & Ashmore, M. (1999). Individual differences in disgust sensitivity: Comparisons and evaluations of paper-and-pencil versus behavioral measures. Journal of Research in Personality, 33, 330–351.
Scott, I. M., Wright, B. J., Brenneis, F. R., & Gowans, M. C. (2009). Whether or wither some specialties: A survey of Canadian medical student career interest. BMC Medical Education, 9, art. no. 57.
Sherman, N. C., & Sherman, M. F. (1998). Sensitivity to disgust among college women by major. Psychological Reports, 83, 1192–1194.
Tabachinick, B. G., & Fidell, L. S. (2001). Using multivariate statistics. Boston, MA: Allyn & Bacon.
Thomas, J. H. (1997). The surgical personality: Fact or fiction? American Journal of Surgery, 174, 6.
Tokar, D. M., Fischer, A. R., & Mezydlo Subich, L. (1998). Personality and vocational behavior: a selective review of the literature, 1993–1997. Journal of Vocational Behavior, 53, 115–153.
Wright, S., Wong, A., & Newill, C. (1997). The impact of role models on medical students. Journal of General Internal Medicine, 12, 53–56.
Zeldow, P. B., & Daugherty, S. R. (1991). Personality profiles and specialty choices of students from two medical school classes. Academic Medicine, 66, 283–287.
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Consedine, N.S., Windsor, J.A. Specific disgust sensitivities differentially predict interest in careers of varying procedural-intensity among medical students. Adv in Health Sci Educ 19, 183–201 (2014). https://doi.org/10.1007/s10459-013-9469-1
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DOI: https://doi.org/10.1007/s10459-013-9469-1