This cross sectional study was conducted in two public (Dow Medical College and Sindh Medical College) and two private medical institutes (Aga Khan Medical College and Ziauddin Medical College) from June 2007 to August 2007 in Karachi. There are three public medical institutes in Karachi and Dow and Sindh Medical College are the two largest public institutes. Average number of student varied from 200 to 250 for each class in these public medical institutes. Aga Khan and Ziauddin medical college were selected out of six private medical institutes in Karachi. There is a significant difference between public and private medical institutions as to the technique of teaching. Some private medical institutions are following a problem based learning system (PBLS) (15
), whereas all the public medical institutions follow a conventional lecture based curriculum (LBL). In addition, there are certain postgraduate specialty training programs, like Family Medicine, which is only offered in private medical institutions (16
). In Pakistan, medical schools offer a five (5
) year program leading to an M.B.B.S (Bachelor of Medicine; Bachelor of Surgery) degree. Basic health sciences are the primary focus of instruction during the first two years, with gradually increasing exposure to clinical rotations over the next three years (15
). After graduation, there is one-year compulsory internship in a teaching hospital in order to obtain medical licensure. Fellowship training starts after completing an internship and passing a postgraduate medical exam (16
The authors developed a self-administered questionnaire in English as all of these medical institutes have English as an official teaching language. The questionnaire included demographics, undergraduate courses, satisfaction in medical profession, and first, second and third career choices of medical students (questions regarding a particular field of medicine will be reported separately). The questionnaire was kept anonymous to maintain confidentiality of the participants. Pre-testing of questionnaire was done on 30 participants from each of the four medical institutes to determine response rate and applicability of the tool; changes were made in the questionnaire accordingly (unpublished data). The same questionnaire was used for data collection from all four medical institutes.
Only third, fourth and final year medical students and house officers were included in this study. First and second year students were excluded because of little exposure to clinics in beginning years of medical studies and less number of students were able to report their commitment for any particular medical specialty. After seeking verbal consent, data collectors distributed self-administered anonymous questionnaires to medical students after lectures, tutorials and PBL (Problem based learning) in medical colleges and were recollected after few minutes. To target house officers, questionnaires were distributed and collected in different wards of the attached teaching hospitals within these four medical institutes. The department of Community Health Sciences, Sindh Medical College issued study approval. An information sheet was attached with each questionnaire to provide project details, rights of the participants and suggesting that filling the questionnaire implies informed consent.
Data were entered and analyzed in SPSS version 15 (17
); categorical variable of self-reporting interest in choosing Psychiatry as a career was the defined outcome. Interested in choosing Psychiatry is defined as “those who find the subject interesting to take as a career however may not actually be taking it as postgraduate specialization field”. Chi-square and t-test were applied for categorical and continuous variables respectively to test the statistical significance at 95% confidence level.