Examining dimensions of career intentions: insights from medical and nursing students at a private not-for profit university in Vietnam | BMC Medical Education

Phase one: quantitative data

A total of 198 students participated, yielding a response rate of 77%. Results with p-values ≤ 0.05 were considered statistically significant. Descriptive statistics, including frequencies and percentages, were calculated to describe the specific attributes of the survey respondents. Table 1 summarizes the demographic characteristics of the survey respondents.

Participant demographics

Career intentions

Table 2 shows the current career intentions of respondents. A significant portion of participants (75.8%) plan to engage in clinical practice, specifically continuing residency training. Additionally, 60.1% plan to pursue clinical practice by applying for jobs in hospitals, while a smaller cohort (12.6%) favors non-clinical practice through entrepreneurship start-ups. Participants were allowed to choose multiple answers, resulting in a total frequency greater than 198.

Specialty preferences

In Table 3, among the 188 students interested in clinical practice, various medical specialties were identified. Surgery emerged as the most favored choice, with 30.9%, followed by those undecideds at 18.1%. Internal medicine and pediatrics each garnered notable interest at 10.1%, while psychiatry and family medicine followed closely with 6.4% and 4.3%, respectively. Less commonly chosen specialties included cardiology, forensics, geriatrics, oncology, anesthesiology, microbiology, radiology, each with percentages ranging from 0.5 to 1.1%.

Career intentions by demographic characteristics

Table 4 presents the career intentions of students by various demographic characteristics. The analysis revealed the following patterns.

Notable differences in career intentions between male and female students. A higher percentage of male students (83.3%) expressed interest in entering residency training compared to female students (71.4%), which is statistically significant (p = 0.049). Conversely, a larger proportion of female students (69.6%) preferred applying for hospital jobs compared to male students (47.6%), with this difference being significant (p < 0.001). Additionally, female students showed a greater inclination towards non-clinical roles in administration (27.7%) compared to their male counterparts (7.1%), also statistically significant (p < 0.001). These findings suggest gender-based differences in career intentions, with female students leaning more towards hospital-based roles and administrative positions, while male students show a stronger preference to continue residency training post-graduation.

The data indicates variations in career intentions across different cohorts. Students enrolled in 2020 demonstrated a higher interest in both residency training (73.7%) and hospital jobs (65.8%) compared to later cohorts. However, these differences were not statistically significant, suggesting that the enrollment year does not strongly influence career intentions. The slight variations observed might be attributed to individual cohort characteristics or evolving perspectives as students’ progress through their education.

The presence of scholarship support did not show statistically significant differences in career preferences. Both groups, those with and without scholarship support, had similar preferences for residency training, hospital jobs, and non-clinical roles. This suggests that financial support mechanisms may not heavily influence the career intentions of students at this stage, indicating more focus on other factors.

When examining nationality, Vietnamese students exhibited slightly higher preferences for clinical practice roles compared to their foreign counterparts, but these differences were not statistically significant. However, foreign students showed a higher preference for hospital jobs (78.6% vs. 58.7%, p = 0.003), indicating a potential difference in career planning and opportunities perceived by local versus international students. This highlights the need for tailored career guidance and support that considers the diverse backgrounds and intentions of both local and international students.

Factors influencing career intentions

Factors influencing the career interest of students

The stacked bar chart in Fig. 1 illustrates the importance of various factors influencing the career intentions of students. The data is categorized into five levels of importance: not important at all, slightly important, moderately important, important, and very important. The following analysis provides findings into how these factors are perceived by the students.

The influence of family and friends exhibits a diverse range of significance among students. While a substantial number of respondents (70) consider this factor moderately important, a notable proportion of students view it at the extremes—either not important at all (34 respondents) or very important (25 respondents).

Opportunities for research and academic involvement are predominantly regarded as crucial, with a combined total of 100 respondents rating this factor as important or very important. The practical consideration of job market demand is another significant factor, with 116 respondents rating it as important or very important. This highlights a pragmatic approach to career planning, where students seek fields with stable and promising employment prospects. Work-life balance is highly valued, with 121 respondents considering it important or very important. Financial stability and rewards are crucial for many students, with 136 respondents rating salary and financial considerations as important or very important.

Personal interest and passion stand out as the most critical factors influencing career intentions, with 115 respondents deeming it very important and 42 considering it important. This highlights the intrinsic motivation driving students’ choices, emphasizing that personal fulfillment and passion for the field are paramount.

Gender separates in factors influencing the career interest of student (Data labels less than 5% are hidden for better visibility)

Figure 2 shows the differences in factors influencing career interest between male and female students. The data reveals that female students are more focused on job market demand and financial considerations, reflecting a practical approach to career choice. Male students, while also considering these factors, place relatively higher importance on the influence of family and friends. Both genders equally value work-life balance and personal interest and passion, highlighting common concerns for wellness and intrinsic motivation.

Nationality separates in factors influencing the career intentions of student (Data labels less than 5% were hidden for better visibility)

Figure 3 shows the difference between nationality among all factors considered. There was a significant difference in the percentage of Vietnamese students and foreign students in “Influence of family and friends” and “Work-life balance.” Vietnamese students emphasize the influence of family and friends and opportunities for research and academic involvement more, reflecting cultural values and academic orientation. Foreign students place higher importance on job market demand, work-life balance, and financial considerations.

Career guidance and practice location preferences

Table 5 presents information on students’ response for career guidance and their envisioned practice locations. A significant majority of students, 140 individuals (70.7%), reported not yet receiving adequate career guidance.

Regarding their envisioned practice locations, the data shows diverse preferences. The largest group of students, 85 students (42.9%) envision practicing within their home country, emphasizing the importance of domestic career opportunities. Additionally, 45 students (22.7%) of the students aspire to work overseas, reflecting the global aspirations and mobility of the student body.

Interestingly, a small percentage of students (3.0%) are open to both domestic and international career opportunities, indicating flexibility in their career intentions. However, a significant portion (31.4%) remains undecided about their future practice location.

Phase two: qualitative data

To augment the quantitative data acquired from Phase one, an additional qualitative method involving in-depth individual interviews was undertaken. These interviews included 11 students currently enrolled in either medical or nursing programs at VinUniversity. Among the 11 respondents, nine were Vietnamese students, indicating a predominantly local representation within the sample. The participants encompassed both medical doctor and nursing programs. Utilizing a thematic analysis approach, five key themes emerged:

Career intentions

The students expressed diverse career intentions, with many aiming to pursue clinical practice roles. Nursing students often focused on patient care, aspiring to become pediatric nurses or nursing professors. Medical students aimed to become highly skilled professionals, considering various specialties or academic roles through advanced degrees. One nursing student articulated, “I want to become a pediatric nurse because I believe in the impact we can make on children’s lives. It’s a challenging field, but I feel it’s where I can make the most difference.” This aligns with the quantitative findings, where a significant portion of students (75.8%) expressed interest in clinical practice, particularly in surgical specialties (30.9%), internal medicine, and pediatrics (10.1% each). However, some students, especially those in their early years, expressed uncertainty about their career paths, highlighting the need for better career guidance. One student mentioned, “I am still exploring my options. There are so many specialties, and I want to make sure I choose the right one for me. I wish there was more guidance available.”

Factors influencing career intentions

Personal experiences and observations played a crucial role in shaping career intentions. Many students cited early childhood experiences, family health issues, and personal encounters with healthcare professionals as significant influences. One student shared, “Growing up, I watched my mother struggle with her health, and the compassion shown by her doctors inspired me to pursue medicine. I want to be that source of comfort and care for others.”

The COVID-19 pandemic also had a notable impact on career decisions. Some students were driven towards healthcare fields due to the increased visibility and importance of healthcare roles during the crisis. A student reflected, “The pandemic made me realize how crucial healthcare workers are. Seeing their dedication and impact made me sure that this is the path I want to take.”

Attitudes and perceptions

Students’ perceptions of the healthcare profession were mixed, with many recognizing its noble nature and the opportunities for personal and professional growth. One student noted, “Being in healthcare is not just a job; it’s a calling. The ability to help others and contribute to their well-being is incredibly fulfilling.” However, they also acknowledged the challenges, such as the high demands, emotional and physical stress, and the difficulty of balancing work and personal life. Another student mentioned, “Healthcare is demanding, both physically and emotionally. Balancing work with personal life is tough, but knowing I’m making a difference keeps me going.”

The quantitative data showed that personal interest and passion (58.1%), salary and financial considerations (63%), and work-life balance (49%) were significant factors influencing career choices. These themes were echoed in the qualitative interviews, where students discussed the rewarding aspects of the profession, such as making a positive impact on society, as well as the challenges, including the high demands and the difficulty of balancing work and personal life.

Social influences

Family, friends, and mentors emerged as pivotal influences in shaping career intentions. Many students highlighted the support and encouragement they received from their families. One participant said, “My family has always supported my dreams of becoming a doctor. Their belief in me has been a constant source of motivation.” Family members often served as role models, inspiring students through their own experiences and values. This finding aligns with the quantitative data, where the influence of family and friends was a significant factor for many students.

Mentorship from faculty members and healthcare professionals also played a critical role. A student shared, “My mentor has been instrumental in my journey. Her guidance has helped me navigate the challenges and stay focused on my goals.”

Perceived control and future plans

Students generally expressed confidence in their career paths, citing clear goals and strong support systems as key contributors. One student remarked, “I feel confident about my career choice. Having a clear plan and support from my mentors has made a big difference.” However, they also discussed the proactive steps they are taking to achieve their goals, such as gaining experience, seeking mentorship, and pursuing further education. Another student emphasized, “I am actively seeking out internships and volunteer opportunities to build my experience and network.”

Financial issues, work-life balance, and adapting to the demands of the profession were identified as potential challenges. A student expressed concern, “Balancing work and personal life is a major concern. I am trying to prepare myself for the challenges ahead.” These insights align with the quantitative finding that 70.7% of students did not receive adequate career guidance, highlighting the need for enhanced support systems.