Contributing factors to the choice of medical specialty in Brazil: An integrative review
DOI:
https://doi.org/10.33448/rsd-v14i12.50434Keywords:
Career Choice, Specialization, Medical Students.Abstract
Introduction: Choosing a medical specialty is a key step in physicians’ professional trajectories and has important implications for health workforce planning. In Brazil, this process takes place in a context of regional inequalities, structural challenges within the health system, and changes in medical students’ profiles. Objective: To evaluate the contributing factors to the choice of medical specialty in Brazil. Methods: An integrative literature review was conducted in April and May 2024 using the Virtual Health Library (VHL). DeCS/MeSH descriptors related to career choice, specialization, medical students, and Brazil were combined using the Boolean operator AND. Study selection followed the PRISMA 2020 guidelines, resulting in a final sample of 14 studies. Results: The findings indicate that medical specialty choice is influenced by multiple interrelated factors, including affinity with the specialty, personal satisfaction, lifestyle and quality of life, income expectations, professional prestige, clinical experiences during undergraduate training, extracurricular activities, family influence, and role models. Low interest in Family and Community Medicine was associated with perceptions of lower professional recognition. Conclusion: Medical specialty choice in Brazil is a complex process shaped by individual, academic, and institutional factors. Educational strategies and public policies aimed at improving professional valuation and training experiences are essential to promote a balanced medical workforce.
References
Borges, N. J., Navarro, A. M., Grover, A. C., & Hoban, J. D. (2017). How, when, and why do physicians choose careers in academic medicine? Academic Medicine, 85(4), 680–686.
Cruz, M. M., Ferreira, J. R., & Silva, R. C. (2019). Fatores associados à escolha da especialidade médica no Brasil. Revista Brasileira de Educação Médica, 43(1), 123–131.
Dorsey, E. R., Jarjoura, D., & Rutecki, G. W. (2013). Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA, 290(9), 1173–1178.
Dyrbye, L. N., Shanafelt, T. D., Balch, C. M., Satele, D., Sloan, J., & Freischlag, J. (2012). Relationship between work-home conflicts and burnout among American surgeons. Archives of Surgery, 146(2), 211–217.
Figueiredo, A. M., Santos, L. S., & Silva, R. A. (2019). Ensino da cirurgia plástica na graduação médica: desafios e perspectivas. Revista Brasileira de Cirurgia Plástica, 34(2), 234–241.
Fnais, N., Soobiah, C., Chen, M. H., Lillie, E., Perrier, L., Tashkhandi, M., & Straus, S. E. (2014). Harassment and discrimination in medical training: A systematic review and meta-analysis. Academic Medicine, 89(5), 817–827.
Heikkilä, T. J., Hyppölä, H., Kumpusalo, E., Halila, H., Vänskä, J., Kujala, S., & Virjo, I. (2015). Choosing a medical specialty—Study of factors influencing Finnish medical students. Medical Teacher, 37(8), 1–7.
Newton, D. A., Grayson, M. S., & Thompson, L. F. (2018). The variable influence of lifestyle and income on medical students’ career specialty choices. Academic Medicine, 80(9), 809–814.
Querido, S. J., van den Broek, S., de Rond, M. E. J., Wigersma, L., Ten Cate, O. T. J., & Croiset, G. (2018). Factors affecting senior medical students’ career choice. BMC Medical Education, 18, 123.
Scheffer, M., Cassenote, A., Guilloux, A. G. A., Biancarelli, A., Miotto, B. A., & Mainardi, G. M. (2020). Demografia Médica no Brasil 2020. Faculdade de Medicina da USP / Conselho Federal de Medicina.
Silva, A. R., Oliveira, M. S., & Pereira, J. R. (2018). Impacto das ligas acadêmicas na escolha da carreira cirúrgica. Revista do Colégio Brasileiro de Cirurgiões, 45(3), e1875.
Wright, S., Wong, A., & Newill, C. (2014). The impact of role models on medical students. Journal of General Internal Medicine, 12(1), 53–56.
World Health Organization. (2016). Global strategy on human resources for health: Workforce 2030. WHO.
Brasil. Ministério da Saúde. (2017). Política Nacional de Atenção Básica. Ministério da Saúde.
Starfield, B. (2012). Primary care: An increasingly important contributor to effectiveness, equity, and efficiency of health services. Health Services Research, 45(2), 457–465.
Bland, C. J., Meurer, L. N., & Maldonado, G. (1995). Determinants of primary care specialty choice: A non-statistical meta-analysis of the literature. Academic Medicine, 70(7), 620–641.
Lambert, T. W., Goldacre, M. J., & Turner, G. (2006). Career choices of United Kingdom medical graduates. Medical Education, 40(5), 465–472.
Reed, V. A., Jernstedt, G. C., & Reber, E. S. (2001). Understanding and improving medical student specialty choice. Academic Medicine, 76(2), 125–133.
Crossetti, MGO. Revisão integrativa de pesquisa na enfermagem o rigor cientifico que lhe é exigido. Rev Gaúcha Enferm., Porto Alegre (RS) 2012 jun;33(2):8-9.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, Elsevier. 104(C), 333-9. Doi: 10.1016/j.jbusres.2019.07.039.
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Copyright (c) 2025 Thiago Vaz de Andrade, Ana Clara Oliveira Lima, Beatriz Vitória Carvalho Lordêlo, Hanna Vitória da Cruz Correia, Isabelle Christine Melo Correia de Oliveira, João Pedro Rodrigues Pinto, Luys Antônyo Vasconcelos Caetano, Luma Teles de Resende, Maria Clara Ferreira Santos Nascimento, Maria Eduarda Fonseca de Melo, Maria Fernanda Targino Hora, Mariana de Oliveira Matos, Marina Loeser de Carvalho Lima, Náthalie Vitória Raimundo Nogueira, Luana Teles de Resende
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