engleski

Are there any future public health professionals among medical students in Croatia?

In Croatia, Public Health (PH) had traditionally been directed by medical doctors, mainly Social Medicine specialists. Even though this field has lately become more and more interdisciplinary, medical doctors still play the main role. In the country of economical and social transition along with the privatization of the healthcare system, it is questionable whether future medical doctors will still have interest to work in this field. Research aim was to identify medical students’ motivation for professional work in PH. Research objectives were: (1) to examine students' interest to work professionally in PH, (2) to compare medical students' interest for PH with their attitudes regarding the social reputation of certain specialties (3) to determine the relationship of desired future specialization and importance of medical study subjects and (4) to determine the socio-economical characteristics of students who are looking for career in PH. Methods: Participants were final year students from Zagreb University School of Medicine during a 10 years follow up period (from 2000/01 to 2010/11), N=1423 (response rate around 90%). The instrument was an anonymous questionnaire which students completed during regular class. The questionnaire contained questions regarding (a) desired future specialization (b) motivation to enter medical school (c) opinion on the reputation of several medical specializations, (d) relevance of medical school curriculum subjects for future work in the healthcare sector and (e) students’ socio-demographic characteristics. Results: 28 or 1.97% final year medical students see themselves in future as PH professionals. Only 11 among them (0.77%) indicate it as their first and only choice. For medical students who want to work in PH in comparison to those who want other (mostly clinical) specializations, entrance to medical school was more a concurrence of events, and not the wish from ever (p<0.0001). Regarding external and internal motives to study medicine no significant difference was found between two groups. Pertaining to particular medical specialty reputation and social status perception, future PH professionals consider cardiologists as the most socially respectable in comparison to others for whom it is a surgeon. Nevertheless the „preventive workers“ are on the last place to both groups. Assessing the importance of medical school curriculum subjects, students likely to work in PH signed higher for Social Medicine (p=0, 0001), Medical Psychology (p=0.02), Medical Ethics (p=0.04) and Health Economics (p=0.003). According to logistic regression, future PH professionals evaluate Medical Ethics more important than others. Even there is no significant difference, those who see their future in PH, predominantly derive from smaller towns. Conclusion: Regardless medical profession choice, future medical doctors need to understand the PH and to know its tasks. Even though Zagreb University School of Medicine has a long tradition and a very high (10% of the core curriculum) representation of PH contents, special attention sholud be dedicated to the teaching process with the main aim to develop future medical doctors’ positive attitudes on this field.

medical education; public health

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