Parental career expectations: effect on medical students’ career attitudes over time

Background: Motivation to become a doctor has typically been conceived as arising from personal interests. However, it is not uncommon, particularly amongst those from collectivist cultures, for career choice to be motivated by a desire or need to fulfil parent expectations. Whether or not this motivation has longer term effects on the career satisfaction and performance of medical students is unknown. Methods: Using three waves of survey data collection, applicants to medical school (n = 370) reported parent career expectations, parent career support and physician career values. Those who gained a student place (n = 90) reported attitudes to their career at the end of their first year of study. Burnout and intentions regarding practice location were assessed during the fifth and final year of study (n = 81). Examination marks in Years 1 and 5 assessed academic performance. Results: Those with more highly educated parents reported more support, but parent support had no relationship with students’ academic performance or attitudes to their career. Perceived parent career expectation was higher amongst younger applicants and those from a non-Western background. Expectations had a small positive correlation with applicants’ valuing of prestige and a small negative correlation with valuing service. Medical students with high parent expectation at selection had, a year later, more negative attitudes to medicine as a career. Parent expectation had a significant indirect effect on Year-5 burnout. Higher parent expectation was related to lower Year-5 academic grades, but after Year-1 grades were accounted for, this relationship was no longer significant. Conclusions: Medical students who perceive that their parents expect them to choose a prestigious career in line with family or cultural values may be more ambivalent about their career choice once in medical school. They may also be more likely to experience longer term burnout but there was little evidence that they might have lower academic performance.