Title : Determinants of public health career choice among medical students: Cross-sectional study at the training and research unit of medical sciences of Abidjan
Abstract:
Introduction: Public health, because it enables prevention, health promotion and the management of health challenges, appears as an essential discipline for developing countries. In sub-Saharan Africa, only 5.8% of medical students choose public health as their future specialty, despite critical needs for personnel trained in this discipline. This situation could reflect various factors including perception and knowledge that influence the career preferences of future physicians. This study aimed to identify the determinants of public health career choice among final-year students at the Training and Research Unit of Medical Sciences (UFR SMA) of Abidjan.
Methods: This was an analytical cross-sectional study conducted between September and December 2024. The study included 350 students enrolled in Master 2 (M2) and Doctorate 1 (D1). Data were collected via a self-administered questionnaire assessing sociodemographic characteristics, knowledge and perceptions of public health, and career choice factors. Multivariate logistic regression was conducted with a significance threshold of 5%.
Results: The response rate was 70% (350/500). The mean age was 23.4 years (±2.1), with 58% men. The majority of students surveyed (57%) had a moderate level of knowledge in public health, and 77% recognized the importance of this specialty for the country's health development. However, only 39% consider choosing public health as a career. The main positive perceptions included recognition of public health as a specialty of the future (57%) and a necessary discipline for the country (78%). The perception of public health practitioners as leaders and interest in health promotion were positively associated with the choice of public health. The perception of the CES as difficult, as well as the perception of public health practice opportunities as being limited, were negatively associated with the choice of this discipline. Multivariate analysis identified four significant determinants of public health choice: perception of practitioners as leaders (OR=2.14; 95% CI: 1.15-4.06; p=0.017), disagreement with the idea that practice opportunities are limited (OR=2.03; 95% CI: 1.02-4.16; p=0.048) as well as specialization being difficult (OR=2.14; CI=1.15-4.06) and interest in health promotion (OR=2.30; 95% CI: 1.11-4.91; p=0.028).
Conclusion: Despite correct knowledge of the definition of public health, less than 40% of medical students consider this specialty. Perceptions of professional leadership, career opportunities, and interest in health promotion are key determinants that could guide attraction strategies toward this essential discipline.
Key words: Career choice; Public health; Medical students; Côte d'Ivoire; Medical specialization.
