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Journal of Immigrant and Minority Health

, Volume 18, Issue 5, pp 1148–1158 | Cite as

“It’s Every Family’s Dream”: Choice of a Medical Career Among the Arab Minority in Israel

  • Ariela Popper-Giveon
  • Yael Keshet
Original Paper

Abstract

Application to medical studies and the choice of medicine as a career are influenced by many factors, some internal (academic ability, intellectual curiosity, interests) and some external (parental pressure, peer pressure, teacher and school expectations). Ethnicity plays a role in motivational orientation and belonging to an ethnic minority group may influence both internal and external motives and priorities in choosing medicine as a career. In this article, we present a qualitative study of the motives that impel Arab physicians in Israel to choose a medical career. As a theoretical framework, we apply self-determination theory (SDT) (Ryan and Deci in Am Psychol 55:68–78, 2000), consisting of three principal categories situated along a continuum: Amotivation, extrinsic motivation and intrinsic motivation. We show that extrinsic motivation is dominant among Arab physicians in Israel, demonstrating specifically the unique political context and cultural characteristics of Arab society in Israel. These findings, and the attention to the unique motivations of people from different ethnic minority groups who choose medical career, may increase the number of physicians from minority groups, a step known to decrease health gaps in multi-cultural contexts.

Keywords

Arabs Israel Medical education Physicians Motivation 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no financial relationship with the organization that sponsored the research. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

References

  1. 1.
    Abraham Fund. Information File: Arab society in Israel [Hebrew]. http://www.abrahamfund.org/5544 (2013). Retrieved 1 Nov 2013.
  2. 2.
    Adelbi N, Barhana M, Melman U, Carel R. Diabetes and cancer: various manifestations among Arabs and Jews in Israel. Harefua. 2012;151(5):626–8 [Hebrew].Google Scholar
  3. 3.
    Ali N. The unpredictable status of Palestinian woman in Israel: actual versus desirable. Paper presented at Religion, Gender and Politics: An International Dialogue. Jerusalem: Van Leer Institute; 2006.Google Scholar
  4. 4.
    Annett D. The experiential journey of Korean mothers of international students living in Delta, Canada. Thesis submitted in partial fulfilment of the requirements for the degree of doctor of education. Canada: Simon Fraser University; 2012.Google Scholar
  5. 5.
    Averbuch E (ed). Inequality in health and how to cope with it. Jerusalem: Ministry of Health, Economics and Health Insurance Division; 2010. [Hebrew].Google Scholar
  6. 6.
    Babbott D, Weaver SO, Baldwin DC. Primary care by desire or default? Specialty choices of minority graduates of U.S. medical schools in 1983. J Natl Med Assoc. 1994;86:509–15.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Baron-Epel O, Garty N, Green MS. Inequalities in use of health services among Jews and Arabs in Israel. Health Serv Res. 2007;42(3):1008–19.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Betancourt RJ, Alexander GR, Carrillo EJ, Ananeh-Firempong O. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health. 2003;118(4):293–302.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Brotherton SE, Stoddard JJ, Tang SS. Minority and nonminority pediatricians’ care of minority and poor children. Arch Pediatr Adolesc Med. 2000;154:912–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Carr PL, Palepu A, Szalcha L, Caswell C, Inui T. “Flying below the radar”: a qualitative study of minority experience and management of discrimination in academic medicine. Med Educ. 2007;41:601–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Central Bureau of Statistics. The population, by population groups. http://www.cbs.gov.il/shnaton64/st02_01.pdf (2013). Retrieved 27 April 2014. [Hebrew].
  12. 12.
    Cohen JJ, Gabriel BA, Terrell C. The case for diversity in the health care workforce. Health Affairs (Millwood). 2002;21(5):90–102.CrossRefGoogle Scholar
  13. 13.
    Daoud N, Soskolne V, Manor O. Examining cultural, psychosocial, community and behavioural factors in relationship to socioeconomic inequalities in limiting longstanding illness among the Arab minority in Israel. J Epidemiol Commu Health. 2009;63:351–8.CrossRefGoogle Scholar
  14. 14.
    Deci EL, Ryan RM. Handbook of self-determination research. Rochester (NY): University of Rochester Press; 2002.Google Scholar
  15. 15.
    Dorsey ER, Jarjoura D, Rutecki GW. The influence of controllable lifestyle and sex on the specialty choices of graduating U.S. medical students, 1996–2003. Acad Med. 2005;13(9):791–6.CrossRefGoogle Scholar
  16. 16.
    Erwin D, Henry-Tillman R, Thomas BR. A qualitative study of the experiences of one group of African Americans in pursuit of a career in academic medicine. J Natl Med Assoc. 2002;94(9):802–12.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Ferguson E, James D, Yates J, Lawrence C. Predicting who applies to study medicine: implication for diversity in UK medical schools. Med Teach. 2012;34:382–91.CrossRefPubMedGoogle Scholar
  18. 18.
    Ginat J. Illicit sexual relationships and family honor in Arab society. Isr Stud Criminol. 1979;10:179–202.Google Scholar
  19. 19.
    Gofin R, Avitzor M, Haklai Z, Jellin N. Injury inequalities: morbidity and mortality of 0–17 year olds in Israel. Int J Epidemiol. 2002;31(3):593–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Hollow D, Patterson G, Laura-Maebaldwin O. American Indians and Alaska Natives: How do they find their path to medical school? J Assoc Am Med Coll. 2006;81(10):S65–9.CrossRefGoogle Scholar
  21. 21.
    Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMedGoogle Scholar
  22. 22.
    Israel Center for Disease Control. The state of health of the Arab population of Israel. Publication No. 226. Jerusalem: Ministry of Health; (2005). [Hebrew].Google Scholar
  23. 23.
    Khater-Menassa B, Major S. Factors influencing the choice of specialty among medical students in Lebanon. Leban Med J. 2005;53(1):16–20.Google Scholar
  24. 24.
    Kusurkar RA, Tencate J, Van Aspern M, Croiset G. Motivation as an independent and a dependent variable in medical education: a review of the literature. Med Teach. 2011;33:242–62.CrossRefGoogle Scholar
  25. 25.
    Lind DS, Cendan JC. Two decades of student career choice at the University of Florida: Increasingly a lifestyle decision. Am J Surg. 2003;13(1):53–5.Google Scholar
  26. 26.
    Luvetzky H, Friger M, Washarwsky-Livne L, Shvarts S. Distance and socio-economic status as a health service predictor on the periphery of the southern region in Israel. Health Policy. 2011;100:310–26.CrossRefGoogle Scholar
  27. 27.
    MacLachlan AJ. Minority undergraduate programs intended to increase participation in biomedical careers. Mt Sinai J Med. 2012;79:769–81.CrossRefPubMedGoogle Scholar
  28. 28.
    McGee R, Saran S, Krulwich T. Diversity in the biomedical research workforce: developing talent. Mt Sinai J Med. 2012;79:397–411.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    McGee V, Fraher E. The state of racial/ethnic diversity in North Carolina’s Health Workforce. N C Med J. 2012;73(5):337–45.PubMedGoogle Scholar
  30. 30.
    McManus IC, Livingston G, Katona C. The attractions of medicine: the generic motivations of medical school applicants in relation to demography, personality and achievement. BMC Med Educ. 2006;6:11.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Millan LR, Azevedo RS, Rossi E, de Marco O, Millan MPB, de Arruda P. What is behind a student’s choice for becoming a doctor? Clinics. 2005;60(2):143–50.CrossRefPubMedGoogle Scholar
  32. 32.
    Moulton P, Amundson M. Medical student and resident Preliminary survey results. Grand Forks: Center for Rural Health, School of Medicine and Health Services, University of North Dakota; 2005.Google Scholar
  33. 33.
    Newton DA, Grayson MS, Thompson LF. The variable influence of lifestyle and income on medical students’ career specialty choices: data from two U.S. medical schools, 1998–2004. Acad Med. 2005;13(9):809–14.CrossRefGoogle Scholar
  34. 34.
    Pagnin D, De Queiroz V, De Oliveira Filho MA, Gonzalez NV, Salgado AE, Cordeiro e Oliveira B, Lodi CS, Melo RM. Burnout and career choice motivation in medical students. Med Teach. 2013;35(5):388–94.CrossRefPubMedGoogle Scholar
  35. 35.
    Popper-Giveon A, Liberman I, Keshet Y. Workforce ethnic diversity and culturally competent health care: the case of Arab physicians in Israel. Ethnic Health 2014;19(6):645–58.CrossRefGoogle Scholar
  36. 36.
    Pruthi S, Pandey R, Singh S, Aggarwal A, Ramavat A, Goel A. Why does an undergraduate student choose medicine as a career? Nat Med J India. 2013;26(3):147–9.Google Scholar
  37. 37.
    Radda HT, Iwamoto D, Patrick C. Collaboration research and change: motivational influences on American Indian students. J Am Indian Educ. 1998;37(4):2–20.Google Scholar
  38. 38.
    Rao V, Flores G. Why aren’t there more African-American physicians? A qualitative study and exploratory inquiry of African-American students’ perspectives on careers in medicine. J Nat Med Assoc. 2007;99:986–93.Google Scholar
  39. 39.
    Rolfe IE, Ringland C, Pearson SA. Graduate entry to medical school? Testing some assumptions. Med Educ. 2004;38:778–86.CrossRefPubMedGoogle Scholar
  40. 40.
    Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development and wellbeing. Am Psychol. 2000;55:68–78.CrossRefPubMedGoogle Scholar
  41. 41.
    Shemesh A, Rotem N, Haklai Z, Georgi M, Horev T. Employment characteristics of physicians in Israel. Jerusalem: Ministry of Health; 2012. [Hebrew].Google Scholar
  42. 42.
    Smooha S. Arab–Jewish relations in Israel: alienation and rapprochement. Washington, DC: United States Institute of Peace; 2010.Google Scholar
  43. 43.
    Tucker CR, Winsor D. Where extrinsic meets intrinsic motivations: an investigation of black student persistence in pre-health careers. Negro Educ Re. 2013;64:37–57.Google Scholar
  44. 44.
    U.S. Department of Health and Human Services. The rationale for diversity in the health professions: a review of the evidence. Washington, DC: U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions; 2006. http://bhpr.hrsa.gov/healthworkforce/reports/diversityreviewevidence.pdf. Accessed 6 Sept 2012.
  45. 45.
    Vaglum P, Wiers-Jenssen J, Elkeberg O. Motivation for medical school: The relationship to gender and specialty preferences in a nationwide sample. Med Educ. 1999;33:236–42.CrossRefPubMedGoogle Scholar
  46. 46.
    Wagoner NE, Bridwell SD. High school students’ motivations for a career as a physician. Acad Med. 1989;64:325–7.CrossRefPubMedGoogle Scholar
  47. 47.
    Wierenga AR, Branday JM, Simeon DT, Pottinger A, Brathwaite B. Motivation for and concern about entering a medical programme. West Indian Med J. 2003;52(4):304–10.PubMedGoogle Scholar
  48. 48.
    Willeto AA. Navajo culture and family influences on academic success: traditionalism is not a significant predictor of achievement among Navajo youth. J Am Ind Educ. 1999;38(2):1–24.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.David Yellin Academic CollegeJerusalemIsrael
  2. 2.Sociology and Anthropology DepartmentWestern Galilee Academic CollegeAkkoIsrael

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