RESEARCH PAPER
I am Becoming a Doctor: Mine or Someone Else’s Will? Or Does it Even Matter? A Qualitative Investigation
 
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Medical Education and Research Development Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, MALAYSIA
Online publish date: 2018-05-15
Publish date: 2018-05-15
 
EURASIA J. Math., Sci Tech. Ed 2018;14(7):3253–3267
KEYWORDS
ABSTRACT
This study explored the motivation of underperforming students at three points of time: applying the programme, studying in Year 1 and during their repeating year due to academic failure. Six underperforming Year 1 students were interviewed on their initial motivations for choosing the medical programme. Triangulation of analysts was applied in the narrative analysis. Later, these students completed the Academic Motivation Scale (AMS) questionnaire twice to reflect on their learning experience in Year 1 and their repeating year. Results showed that these students initially had a mix of amotivation, intrinsic motivation and extrinsic motivation upon applying the medical programme where the worst case scenario was that students genuinely “did not know why”. It was further shown that their motivation for studying medicine was unchanged, increased or decreased over a period of time. Although this study fails to support the notion that initial motivation matters in influencing academic success, the AMS results proved that student motivation could also change over time. Hence, more effort is needed to nurture intrinsic motivation after enrolling into medical schools.
 
REFERENCES (72)
1.
Abdullah, A., & Pederson, P. B. (2003). Understanding multicultural Malaysia delights, puzzles and irritations. Malaysia: Pearson Malaysia Sdn. Bhd.
 
2.
Al-Hemiary, N., Al-Nuaimi, A. S., Al-Saffar, H., & Randall, I. (2017). Why people apply to medical school in Iraq? Journal of Medical Education and Curricular Development, 4, 1-5. https://doi.org/10.1177/238212....
 
3.
Almeida, G. d. C., Souza, H. R. d., Almeida, P. C. d., Almeida, B. d. C., & Almeida, G. H. (2016). The prevalence of burnout syndrome in medical students. Archives of Clinical Psychiatry (São Paulo), 43(1), 6-10. https://doi.org/10.1590/0101-6....
 
4.
An, M., Kusurkar, R., Li, L., Xiao, Y., Zheng, C., Hu, J., & Chen, M. (2017). Measurement invariance of the strength of motivation for medical school: a multi-group confirmatory factor analysis. BMC Medical Education, 17(1), 116. https://doi.org/10.1186/s12909....
 
5.
Ayuob, N. N., Bahumdain, S. Z., AL-Najei, Z. A., Khobrani, F. M., & El Deek, B. S. (2015). Becoming a doctor, what is behind this decision? A comparative study between governmental and private medical school in Saudi Arabia. Journal of Contemporary Medical Education, 3(4), 155. https://doi.org/10.5455/jcme.2....
 
6.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191. https://doi.org/10.1037/0033-2....
 
7.
Bao, X. h., & Lam, S. f. (2008). Who makes the choice? Rethinking the role of autonomy and relatedness in Chinese children’s motivation. Child Development, 79(2), 269-283. https://doi.org/10.1111/j.1467....
 
8.
Cohen, D., Rollnick, S., Smail, S., Kinnersley, P., Houston, H., & Edwards, K. (2005). Communication, stress and distress: Evolution of an individual support programme for medical students and doctors. Medical Education, 39(5), 476-481. https://doi.org/10.1111/j.1365....
 
9.
Crossley, M. L., & Mubarik, A. (2002). A comparative investigation of dental and medical student’s motivation towards career choice. British Dental Journal, 193(8), 471-473. https://doi.org/10.1038/sj.bdj....
 
10.
Cruez, A. F. (7 September 2014). 20% Malaysian medical students lack qualification. The Sun Daily. Retrieved from http://www.thesundaily.my/news....
 
11.
Czarny, M. J., Faden, R. R., & Sugarman, J. (2010). Bioethics and professionalism in popular television medical dramas. Journal of Medical Ethics, 36(4), 203-206. https://doi.org/10.1136/jme.20....
 
12.
Deci, E. L., & Ryan, R. M. (2000). The” what” and” why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227-268. https://doi.org/10.1207/S15327....
 
13.
Deci, E. L., & Ryan, R. M. (2008). Self-determination theory: A macrotheory of human motivation, development, and health. Canadian Psychology, 49(3), 182-185. https://doi.org/10.1037/a00128....
 
14.
Del-Ben, C. M., Machado, V. F., Madisson, M. M., Resende, T. L., Valério, F. P., & Troncon, L. E. D. A. (2013). Relationship between academic performance and affective changes during the first year at medical school. Medical Teacher, 35(5), 404-410. https://doi.org/10.3109/014215....
 
15.
Diwan, V., Minj, C., Chhari, N., & De Costa, A. (2013). Indian medical students in public and private sector medical schools: are motivations and career aspirations different?–studies from Madhya Pradesh, India. BMC Medical Education, 13(1), 127. https://doi.org/10.1186/1472-6....
 
16.
Eva, K. W., Rosenfeld, J., Reiter, H. I., & Norman, G. R. (2004). An admissions OSCE: the multiple mini‐interview. Medical Education, 38(3), 314-326. https://doi.org/10.1046/j.1365....
 
17.
Feri, R., Soemantri, D., & Jusuf, A. (2016). The relationship between autonomous motivation and autonomy support in medical students’ academic achievement. International Journal of Medical Education, 7, 417. https://doi.org/10.5116/ijme.5....
 
18.
Gąsiorowski, J., Rudowicz, E., & Safranow, K. (2015). Motivation towards medical career choice and future career plans of Polish medical students. Advances in Health Sciences Education, 20(3), 709-725. https://doi.org/10.1007/s10459....
 
19.
Girasek, E., Molnár, R., Eke, E., & Szócska, M. (2011). The medical career choice motivations—Results from a Hungarian study. Open Medicine, 6(4), 502-509. https://doi.org/10.2478/s11536....
 
20.
Goel, S., Angeli, F., Dhirar, N., Singla, N., & Ruwaard, D. (2018). What motivates medical students to select medical studies: a systematic literature review. BMC Medical Education, 18(1), 16. https://doi.org/10.1186/s12909....
 
21.
Govindarajan, S., Vasanth, G., Kumar, P. A., Priyadarshini, C., Radhakrishnan, S. S., Kanagaraj, V. et al. (2017). Impact of a comprehensive early clinical exposure program for preclinical year medical students. Health Professions Education. Retrieved from https://doi.org/10.1016/j.hpe.....
 
22.
Győrffy, Z., Birkás, E., & Sándor, I. (2016). Career motivation and burnout among medical students in Hungary-could altruism be a protection factor? BMC Medical Education, 16(1), 182. https://doi.org/10.1186/s12909....
 
23.
Heikkilä, T. J., Hyppölä, H., Vänskä, J., Aine, T., Halila, H., Kujala, S. et al. (2015). Factors important in the choice of a medical career: a Finnish national study. BMC Medical Education, 15(1), 169. https://doi.org/10.1186/s12909....
 
24.
Hurst, S. A. (2014). Eroding students’ rural motivation: First do no harm. Swiss Medical Weekly, 144, w14020. https://doi.org/10.4414/smw.20....
 
25.
Hyppölä, H., Kumpusalo, E., Neittaanmäki, L., Mattila, K., Virjo, I., Kujala, S. et al. (1998). Becoming a doctor --Was it the wrong career choice? Social Science & Medicine, 47(9), 1383-1387. https://doi.org/10.1016/S0277-....
 
26.
Juma, F. Z., Abas, T., & Banu, S. (2016). The transition from high school to university: A medical student’s perspective. Advances in Medical Education and Practice, 7, 517. https://doi.org/10.2147/AMEP.S....
 
27.
Khami, M., Murtomaa, H., Jafarian, M., Vehkalahti, M., & Virtanen, J. (2008). Study motives and career choices of Iranian dental students. Medical Principles and Practice, 17(3), 221-226. https://doi.org/10.1159/000117....
 
28.
Kitayama, S., Markus, H. R., Matsumoto, H., & Norasakkunkit, V. (1997). Individual and collective processes in the construction of the self: self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology, 72(6), 1245. https://doi.org/10.1037/0022-3....
 
29.
Kusurkar, R. A., Croiset, G., Galindo-Garré, F., & Ten Cate, O. (2013). Motivational profiles of medical students: association with study effort, academic performance and exhaustion. BMC Medical Education, 13(1), 87. https://doi.org/10.1186/1472-6....
 
30.
Kusurkar, R. A., Ten Cate, T. J., van Asperen, M., & Croiset, G. (2011). Motivation as an independent and a dependent variable in medical education: A review of the literature. Medical Teacher, 33(5), 242-262. https://doi.org/10.3109/014215....
 
31.
Lee, S. S., Foong, C. C., Choon, S. K., & Jamuna, V. (in press). Language in medicine: a necessity or redundancy for medical undergraduates? International Medical Journal.
 
32.
Lyndon, M. P., Henning, M. A., Alyami, H., Krishna, S., Zeng, I., Yu, T.-C., & Hill, A. G. (2017). Burnout, quality of life, motivation, and academic achievement among medical students: A person-oriented approach. Perspectives on Medical Education, 6(2), 108-114. https://doi.org/10.1007/s40037....
 
33.
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2), 224. https://doi.org/10.1037/0033-2....
 
34.
McHarg, J., Mattick, K., & Knight, L. V. (2007). Why people apply to medical school: implications for widening participation activities. Medical Education, 41(8), 815-821. https://doi.org/10.1111/j.1365....
 
35.
McHugh, S., Corrigan, M., Sheikh, A., Lehane, E., Broe, P., & Hill, A. (2011). A study of the factors influencing school-going students considering medical careers. The Surgeon, 9(4), 191-194. https://doi.org/10.1016/j.surg....
 
36.
Merriam, S. (2009). Qualitative research: A guide to design and implementation San Fransisco: John Willey & Sons Inc.
 
37.
Millan, L. R., Azevedo, R. S., Rossi, E., De Marco, O. L. N., Millan, M. P. B., & Arruda, P. C. V. d. (2005). What is behind a student’s choice for becoming a doctor? Clinics, 60(2), 143-150. https://doi.org/10.1590/S1807-....
 
38.
Molnár, R., Nyári, T., Hazag, A., Csinády, A., & Molnár, P. (2008). Career choice motivations of medical students and some characteristics of the decision process in Hungary. Open Medicine, 3(4), 494-502. https://doi.org/10.2478/s11536....
 
39.
Nimkuntod, P., Kaewpitoon, S., Uengarporn, N., Ratanakeereepun, K., & Tongdee, P. (2015). Perceptions of medical students and facilitators of an early clinical exposure instructional program. Journal of the Medical Association of Thailand, 98(Suppl 4), S64-70.
 
40.
Nishimura, T., & Sakurai, S. (2017). Longitudinal changes in academic motivation in Japan: Self-determination theory and East Asian cultures. Journal of Applied Developmental Psychology, 48, 42-48. https://doi.org/10.1016/j.appd....
 
41.
Pagnin, D., De Queiroz, V., Oliveira Filho, M. A. D., Gonzalez, N. V. A., Salgado, A. E. T., Oliveira, B. C. E. et al. (2013). Burnout and career choice motivation in medical students. Medical Teacher, 35(5), 388-394. https://doi.org/10.3109/014215....
 
42.
Parameshvaradeva, M. (1981). Career choices of Malaysian medical students. Medical Journal of Malaysia, 36(3), 188-192.
 
43.
Park, J., Chung, S., An, H., Park, S., Lee, C., Kim, S. Y. et al. (2012). A structural model of stress, motivation, and academic performance in medical students. Psychiatry Investigation, 9(2), 143-149. https://doi.org/10.4306/pi.201....
 
44.
Pintrich, P. R., & De Groot, E. V. (1990). Motivational and self-regulated learning components of classroom academic performance. Journal of Educational Psychology, 82(1), 33. https://doi.org/10.1037/0022-0....
 
45.
Pruthi, S., Pandey, R., Singh, S., Aggarwal, A., Ramavat, A., & Goel, A. (2013). Why does an undergraduate student choose medicine as a career. The National Medical Journal of India, 26, 147-149.
 
46.
Puljak, L., Kraljevic, J. B., Latas, V. B., & Sapunar, D. (2007). Demographics and motives of medical school applicants in Croatia. Medical Teacher, 29(8), 227-234. https://doi.org/10.1080/014215....
 
47.
Razali, S. M. (1996). Medical school entrance and career plans of Malaysian medical students. Medical Education, 30(6), 418-423. https://doi.org/10.1111/j.1365....
 
48.
Riessman, C. K. (2005). Narrative analysis. Thousand Oaks, California: Sage Publications.
 
49.
Roff, S., McAleer, S., Harden, R. M., Al-Qahtani, M., Ahmed, A. U., Deza, H. et al. (1997). Development and validation of the Dundee ready education environment measure (DREEM). Medical Teacher, 19(4), 295-299. https://doi.org/10.3109/014215....
 
50.
Ryan, R. M., & Deci, E. L. (2000a). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 25(1), 54-67. https://doi.org/10.1006/ceps.1....
 
51.
Ryan, R. M., & Deci, E. L. (2000b). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68-78. https://doi.org/10.1037//0003-....
 
52.
Schutte, T., Tichelaar, J., Dekker, R. S., Thijs, A., de Vries, T. P., Kusurkar, R. A. et al. (2017). Motivation and competence of participants in a learner-centered student-run clinic: An exploratory pilot study. BMC Medical Education, 17(1), 23. https://doi.org/10.1186/s12909....
 
53.
Shahabuddin, S. H. (1986). Career choice of final-year female medical students at Universiti Kebangsaan Malaysia (UKM). Medical Journal of Malaysia, 41(4), 327-330.
 
54.
Shankar, N., Singh, S., Gautam, S., & Dhaliwal, U. (2013). Motivation and preparedness of first semester medical students for a career in medicine. Indial Journal of Physiology and Pharmacology, 57, 432-438.
 
55.
Shin, S., Lee, J.-K., & Ha, M. (2017). Influence of career motivation on science learning in Korean high-school students. EURASIA Journal of Mathematics Science and Technology Education, 13(5), 1517-1538. https://doi.org/10.12973/euras....
 
56.
Shrestha, L., & Pant, S. N. (2018). Motivational Profiles of Medical Students of Nepalese Army Institute of Health Sciences. Journal of Nepal Health Research Council, 15(3), 252-257. https://doi.org/10.3126/jnhrc.....
 
57.
Skatova, A., & Ferguson, E. (2014). Why do different people choose different university degrees? Motivation and the choice of degree. Frontiers in Psychology, 5, 1244. https://doi.org/10.3389/fpsyg.....
 
58.
Sobral, D. T. (2004). What kind of motivation drives medical students’ learning quests? Medical Education, 38(9), 950-957. https://doi.org/10.1111/j.1365....
 
59.
Strauman, E., & Goodier, B. C. (2008). Not your grandmother’s doctor show: A review of Grey’s Anatomy, House, and Nip/Tuck. Journal of Medical Humanities, 29(2), 127-131. https://doi.org/10.1007/s10912....
 
60.
ten Cate, O. T. J., Kusurkar, R. A., & Williams, G. C. (2011). How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59. Medical Teacher, 33(12), 961-973. https://doi.org/10.3109/014215....
 
61.
Turner, J. C., & Patrick, H. (2008). How does motivation develop and why does it change? Reframing motivation research. Educational Psychologist, 43(3), 119-131. https://doi.org/10.1080/004615....
 
62.
Vaglum, P., Wiers-Fenssen, F., & Ekeberg, Ø. (1999). Motivation for medical school: the relationship to gender and specialty preferences in a nationwide sample. Medical Education, 33, 236-242. https://doi.org/10.1046/j.1365....
 
63.
Vallerand, R. J., Pelletier, L. G., Blais, M. R., Briere, N. M., Senecal, C., & Vallieres, E. F. (1992). The Academic Motivation Scale: A measure of intrinsic, extrinsic, and amotivation in education. Educational and Psychological Measurement, 52(4), 1003-1017. https://doi.org/10.1177/001316....
 
64.
Vallerand, R. J., Pelletier, L. G., Blais, M. R., Brière, N. M., Senecal, C., & Vallieres, E. F. (1993). On the assessment of intrinsic, extrinsic, and amotivation in education: Evidence on the concurrent and construct validity of the Academic Motivation Scale. Educational and Psychological Measurement, 53(1), 159-172. https://doi.org/10.1177/001316....
 
65.
Wong, A., & Trollope‐Kumar, K. (2014). Reflections: an inquiry into medical students’ professional identity formation. Medical Education, 48(5), 489-501. https://doi.org/10.1111/medu.1....
 
66.
Woodward, A., Thomas, S., Jalloh, M. B., Rees, J., & Leather, A. (2017). Reasons to pursue a career in medicine: a qualitative study in Sierra Leone. Global Health Research and Policy, 2(1), 34. https://doi.org/10.1186/s41256....
 
67.
Wouters, A., Bakker, A. H., van Wijk, I. J., Croiset, G., & Kusurkar, R. A. (2014). A qualitative analysis of statements on motivation of applicants for medical school. BMC Medical Education, 14(1), 200. https://doi.org/10.1186/1472-6....
 
68.
Wouters, A., Croiset, G., Galindo-Garre, F., & Kusurkar, R. A. (2016). Motivation of medical students: selection by motivation or motivation by selection. BMC Medical Education, 16(1), 37. https://doi.org/10.1186/s12909....
 
69.
Wouters, A., Croiset, G., Isik, U., & Kusurkar, R. A. (2017). Motivation of Dutch high school students from various backgrounds for applying to study medicine: A qualitative study. British Medical Journal Open, 7(5), e014779. https://doi.org/10.1136/bmjope....
 
70.
Yin, R. K. (2003). Case study research: Design and methods (3rd ed.). Thousand Oaks, California: SAGE.
 
71.
Yousefy, A., Ghassemi, G., & Firouznia, S. (2012). Motivation and academic achievement in medical students. Journal of Education and Health Promotion, 1, 4. https://doi.org/10.4103/2277-9....
 
72.
Yusoff, M. S. B., Rahim, A. F. A., Baba, A. A., & Esa, A. R. (2011). Medical student selection process and its pre-admission scores association with the new students’ academic performance in Universiti Sains Malaysia. International Medical Journal, 18(4), 327-331.
 
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