Parental Pressure Linked to Medical School Uncertainty, Potential Burnout

Familial pressure to become a doctor may actually be burdening students.

Medical students who are coerced by parents to pursue a medical profession because of family or cultural values are more likely to express uncertainty or signs of burnout in pursuit of their degree. A new study from a team of Australia investigators assessed parents’ career expectations, support, and their corresponding child’s career values through medical school.

The team—led by Barbara Griffin, of the Department of Psychology at Macquarie University in Sydney, and Wendy Hu, of Western Sydney University School of Medicine in Campbelltown—observed that pursuing a physician career commonly comes from the individual’s own interests.

“However, it is not uncommon, particularly amongst those from collectivist cultures, for career choice to be motivated by a desire or need to fulfill parent expectations,” they noted. Their study sought to understand whether the latter motivation has any long-term effects on prospective doctors’ career satisfaction and performance in school.

They distributed 3 waves of surveys to 370 medical school applicants pertaining to their perspective on their parents’ career expectations and support for them, and their own career values.

Among the surveyed applicants, 90 (24.3%) gained a study place, and reported on attitudes to their career at the end of their first year of medical school. Among them, 81 (90%) provided feedback on burnout symptoms and their intentions of practicing medicine in their fifth and final year of school.

Griffin and Wu also assessed examination grades in surveyed students’ first and last years of school to report their academic performance.

Study results showed that, though parents with a greater level of education more frequently showed support to their student children, parental support had no association to neither student academic success nor attitudes to their own career. Greater parental expectations were associated with more negative student attitudes towards their career after their first year of school. It also was found to have a significant—though indirect—effect on students’ burnout in their final year of school.

Though greater parent expectation was also associated with lower student grades in their final year of school, the relationship was dismissed as insignificant when researchers accounted for first-year grades as well.

Investigators reported that parent career expectations were greater among younger applicants, as well as those from a non-Western background. Though small, expectations were positive correlated with student applicants’ value of school prestige, and a negative correlation with their value of school service.

Investigators concluded that medical students who believe their parents have expectations for them to choose a career in medicine due to family or cultural values may be more susceptible to ambivalence surrounding their career choice.

Issues with guardian pressure may also be coupled by similar negativity from young physician educators. A study from the Mayo Clinic late last year reported that at least 14% of resident physicians expressed regret for their career choice, and another 7.1% regretted their medical specialty. At least 1 weekly symptom of burnout was reported in 45.2% of surveyed resident physicians.

Among specific specialties, rates of resident physician burnout were very similar to practicing physician burnout, investigators noted. This implies that the unique makeup of individual specialties could be attributing to consistent burnout—or perhaps the personnel.

“Alternatively, the high prevalence of burnout symptoms among supervising physicians in these specialties may adversely affect the learning environment, or these supervising physicians may model burnout to resident physicians, placing the resident physicians who are training in these specialties at greater risk,” investigators wrote at the time.

The career fatigue may be beginning, Griffin and Hu suggested, before they even reach medical school. Physician burnout could possibly come from the expectation of becoming a physician.

The study, "Parental career expectations: effect on medical students’ career attitudes over time," was published online in the journal Medical Education.