A mandatory Emergency Medicine clerkship influences students' career choices in a developing system

Background: Attracting medical students for a front-line specialty, Emergency Medicine, is challenging in many countries. The available literature is scarce and bounded to the mature emergency care and education systems. In the countries where emergency medicine is a new specialty and has different contextual needs, the perception of the students and their career interest in emergency medicine specialty is an unanswered question. Objective: We aimed to study the effects of a mandatory Emergency Medicine (EM) clerkship on students' perceptions and their future career choice to be emergency physicians. Methods: A voluntary de-identified survey was prospectively collected before and after the EM clerkship to capture students' perceptions in four domains (EM clerkship, EM physicians, EM patients, and EM specialty as a career choice). The survey included 24 statements having five-point Likert scale for each statement. Non-parametric Wilcoxon signed rank test was used for statistical analysis. Results: Sixty-seven students responded to both surveys (response rate of 85%). Students' perceptions have significantly improved on the EM physicians, and their job after attending the clerkship (p < 0.001). They found EM a respected (p = 0.038), flexible (p < 0.001), secure (p < 0.001), satisfying, and prestigious (p = 0.006) job. They found EM physicians compassionate (p < 0.011), have adequate patient contact (p < 0.045) and control on their time (0.004). Choosing EM as a future career has significantly increased after clerkship (p < 0.001). Conclusions: Our mandatory EM clerkship significantly improved students' perceptions on EM specialty as a future career choice. A well-structured and mandatory EM clerkship can attract more students to be trained in the EM.