Treatment of medical students during clerkships based on their stated career interests

Background: Clerkship students often face questions from teachers about their career interests and may perceive that their responses change their clerkship experiences significantly. Purpose: To explore student experiences with "career interest" inquiries and how responses may influence clerkship experiences. Methods: A qualitative study of 4th-year medical students by use of focus groups, whose experienced facilitators used a structured interview protocol. Purposeful sampling identified a representative group of participants. Transcribed focus group proceedings were analyzed with a predetermined theme matrix. Results: Participants reported frequently facing career interest inquiries, feeling comfortable with some, and feeling threatened by others. The tone of inquiries ranged from casual to confrontational. Participants perceived that their responses could significantly influence the-quality of teaching relationships, access to clinical opportunities, and grades. Students often responded vaguely or deceptively for self-protection. Conclusions: For clerkship students, career interest inquiries and how students respond can be high-stakes issues, potentially compromising teaching quality, equitable treatment, and fair evaluations. Further quantitative study is essential.