In this study, we analyzed a large-scale, nationally representative sample of 99,559 students from 90 medical schools in China. We illustrated the association between prosocial behavior of role models with medical students’ intention to pursue a medical career. We found that faculty’s prosocial behavior had a greater effect than parents on the medical students. This study contributes to the understanding of the effects on medical students of exposure to role models’ frontline involvement in the fight against COVID-19.
Existing studies have shown that prosocial modeling promote prosocial behavior. In one case, children who watched a cartoon about helping puppies were more likely to help others than those who had not watched the cartoon . Another study showed that after observing an example of active blood donation, the probability that college students would donate blood was higher than that of students without the blood donation model . Our study is based on the assumption that the doctor can offer a role model to medical students, and confirms the positive effect that the prosocial behavior of role models participating in the battle against the pandemic can have.
We found that during the COVID-19 pandemic, prosocial modeling has associated with medical students’ intention to pursue a medical career, and that the effect of faculty on medical students was greater than that of the students’ parents. Studies of adolescent students have demonstrated that they are more likely to leave their parents and seek help from teachers . From the perspective of the theory of the CoP, medical students are in a common community of learning/practice with their faculty. They share the same ideas, and their occupational expectations are influenced most by other members of the community. Medical students join this community as novices and obtain knowledge and skills, along with the identity conferred by their membership of the community . They share the same goal of preventing and treating human diseases . Medical students learn from faculty members what it is to be a doctor , and they may retain the faculty’s behavior, which then affects their motivations and occupational expectations. The role of parents is perhaps reflected more in the choice of medical major . Students are familiar with their parents but not necessarily with faculty. Thus, by combining the familiar and unfamiliar into one group, the influence of faculty could have been underestimated. This again highlights the power wielded by faculty as role models [24, 43], which is greater than the influence of family at this stage of learning. Doctors should be aware of the effect of role models, and that by being good role models they can attempt to avoid negative effects on medical students.
The willingness to become a doctor before the pandemic is significantly associated with medical students’ commitment. Students who wanted to become doctors before the pandemic, compared with those who did not, demonstrated a greater increase in the intention to pursue the medical career. Factors that can influence the career choices of medical students include the potentially high income, their status as perceived by their colleagues, and opportunities to benefit their families [44, 45]. Altruistic and scientific reasons have been found to be the main motivations for medical students’ career choices , but the primary motivation can differ between countries and depend on the level of income .
We found that during the COVID-19 pandemic, male students were more affected by role models than female students. A survey conducted in Japan found that women prefer disciplines such as pediatrics, gynecology, obstetrics, and psychology, while men prefer orthopedics and operating, suggesting that medical students of different gender have different motivations . A controllable lifestyle has been found to be an important factor in women’s choices , and women have been shown to attach more importance to family and lifestyle than men . The social definition of the male role is often as more independent, with a stronger sense of social responsibility. Masculine traits such as strength and tenacity can also be viewed as attracting especial respect . Thus, men may be more encouraged than women by others’ involvement in the fight against the pandemic and become more determined to pursue medical careers.
Those majoring in clinical medicine in China typically go through four phases. The first is general education, in which the main courses are chemistry, mathematics, sociology, biology, computer science, and English. The second phase is basic medical education, which includes anatomy, histology and embryology, biochemistry, and physiology. The third phase is clinical medical education, which includes basic clinical courses such as internal medicine, surgery, obstetrics, gynecology, pediatrics, and diagnostics. The fourth phase is that of clerkship rotation, in which students’ study with the clinical faculty of various departments in a hospital . Some studies have shown that before entering medical college, the mental health levels of medical students are the same or higher than those of their peers [51, 52], but after starting medical school their mental health can deteriorate [53–55]. Senior students are particularly likely to suffer from burnout [54, 56, 57], which is related to the level of stress they experience. Good support can, however, reduce the possibility of burnout , and good communication with faculty can have a positive impact on students’ learning perceptions . Our research suggests that faculty might have a positive effect on the intention of medical students to pursue a medical career when in the clerkship rotation phase, while parents do not. The rotation phase is when medical students have the closest contact with faculty, and it is also the key phase in which medical students imitate their role models. The experiences of medical students in the clinical phase thus significantly affect their choices, and so the positive guidance of faculty is extremely important. Our research confirms this. Although the pandemic affects the arrangement of rotation, students of this learning phase may be more sensitive than others.
We found a statistically significant association between the region and the increased intention to pursue medicine as a career. The central region, as the epicenter of the pandemic, was most sensitive to it, and thus the anti-pandemic behavior of medical staff in the central region was more extensive. Thus, the prosocial behavior of role models was more apparent. According to figures released by the National Health Commission of the PRC, the eastern region sent the most medical personnel of all regions of China . Half of the medical staff participating in anti-pandemic work were from affiliated hospitals of the university, and thus typically taught medical students as faculty. The more local medical faculty were involved in the fight against COVID-19, the greater students intended to become doctors. For the eastern and central regions, faculty played a significant role in increasing the students’ intention to practice medicine, while the parent group did not. This indicates that the prosocial behavior of faculty plays a greater role than that of parents in medical students’ intention to pursue a medical career in these regions. This is also consistent with our hypothesis.
This study has several limitations. First, we only measured the influence of parents in general, without distinguishing between the influences of fathers and mothers on their offspring. Some studies have reported that the influences of fathers and mothers on children differ . Second, this study was conducted during the pandemic, so we did not consider the effects of the key variables on medical students after the pandemic. It is unclear how long the effect may last. Finally, this survey was self-reported, and thus may have included reporting and selection bias. We intend to address these limitations in the future.