Ian Scott

University of British Columbia - Vancouver, Vancouver, British Columbia, Canada

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Publications (20)44.29 Total impact

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    ABSTRACT: To examine the stability and switching patterns of student career interests over the course of medical school. From 2001 through 2004, during the first two weeks of classes, a survey on career interest was distributed to first-year students in 15 classes at eight Canadian medical schools. Students indicated interest in eight broad career paths (emergency medicine, family medicine, internal medicine, obstetrics-gynecology, pediatrics, psychiatry, surgery, and "other") and ranked their top three. Following these students' residency match three to four years later, student residency career choice was linked to their career interest at medical school entry. For students whose career interests switched be-tween medical school entry and exit, switching patterns were examined in terms of careers' matching difficulty scores (MDSs). Of 1,941 eligible students, 1,542 contributed to the final analysis. Family medicine, internal medicine, and surgery had the greatest student interest at both the beginning and end of medical school. Family medicine, surgery, obstetrics-gynecology, psychiatry, and "other" careers showed a net gain of student interest during medical school with the remaining careers showing a loss of interest. The most stable careers were family medicine, surgery, and internal medicine. The least stable were pediatrics and obstetrics-gynecology. Students tended to switch between careers with similar MDSs. Student career choice is relatively stable with a number of careers showing approximately 50% of stability from the entrance to the exit of medical school. Students tend to switch to careers with similar MDS, but some specific switching patterns exist.
    Academic medicine: journal of the Association of American Medical Colleges 07/2012; 87(9):1260-7. · 2.34 Impact Factor
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    ABSTRACT: In Canada, availability of and access to mental health professionals is limited. Only 6.6% of practising physicians are psychiatrists, a situation unlikely to improve in the foreseeable future. Identifying student characteristics present at medical school entry that predict a subsequent psychiatry residency choice could allow targeted recruiting or support to students early on in their careers, in turn creating a supply of psychiatry-oriented residency applicants. Between 2002 and 2004, data were collected from students in 15 Canadian medical school classes within 2 weeks of commencement of their medical studies. Surveys included questions on career preferences, attitudes, and demographics. Students were followed through to graduation and entry data linked anonymously with residency choice data. Logistic regression was used to identify early predictors of a psychiatry residency choice. Students (n = 1502) (77.4% of those eligible) contributed to the final analysis, with 5.3% naming psychiatry as their preferred residency career. When stated career interest in psychiatry at medical school entry was not included in a regression model, an exit career choice in psychiatry was predicted by a student's desire for prestige, lesser interest in medical compared with social problems, low hospital orientation, and not volunteering in sports. When an entry career interest in psychiatry was included in the model, this variable became the only predictor of an exit career choice in psychiatry. While experience and attitudes at medical school entry can predict whether students will chose a psychiatry career, the strongest predictor is an early career interest in psychiatry.
    Canadian journal of psychiatry. Revue canadienne de psychiatrie 10/2011; 56(10):605-13. · 2.48 Impact Factor
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    ABSTRACT: Student choice is an important determinant of the specialty mix of practicing physicians in Canada. Understanding student characteristics at medical school entry that are associated with a student choosing a residency in surgery can assist surgical educators in supporting medical students interested in surgery and in serving health human resources needs. From 2002 to 2004, data was collected from entering students in 15 classes at eight of 16 Canadian medical schools. Surveys included questions on career choice, attitudes to practice, and socio-demographics. Students were followed prospectively with survey data linked to their residency choice. Multiple logistic regression analysis was used to identify entry characteristics that predicted a student's ultimate choice of a surgical career. Eight entry variables predicted whether a student named surgery (including obstetrics) as their top residency choice: having surgery as their top career choice, having a relative or friend in a surgical career, having undertaken volunteer work with sports teams, an interest in narrow scope of practice, greater interest in medical the social patient problems, an interest in urgent care, and younger age were identified as predictors of a surgical career choice. Surgical educators may wish to attend to the factors that we found that predicted students selecting a surgical residency as their top career choice at medical school exit in order to foster and support students interested in the surgical disciplines during medical school. In addition, these factors could be used to identify students interested in a surgical career at medical school entry.
    Medical Teacher 07/2011; 33(12):1011-7. · 1.82 Impact Factor
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    ABSTRACT: to describe the characteristics of medical students interested in obstetrics and gynaecology and to build a model that predicts which of these students will choose obstetrics and gynaecology as their career. students were surveyed in 2002, 2003, and 2004 at the commencement of their medical studies. Data were collected on career choice, attitudes to practice, and demographics at medical school entry and on career choice at medical school exit. three items present at entry to medical school were predictive of students ultimately choosing a career in obstetrics and gynaecology: having this career as one of their first three career choices at entry (having it as their first choice was the strongest predictor), being female, and desiring a narrow scope of practice. students choosing a career in obstetrics and gynaecology have attributes at medical school entry that differentiate them from students interested in other specialties. Identifying these attributes may guide education in and recruitment to obstetrics and gynaecology.
    Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC 11/2010; 32(11):1063-9.
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    ABSTRACT: Student choice is an important determinant of the distribution of specialties of practising physicians in many countries. Understanding characteristics at entry into medical school that are associated with the choice of residency in family medicine can assist medical schools in admitting an appropriate mix of students to serve the health care needs of their regions. From 2002 to 2004, we collected data from students in 15 classes at 8 of 16 Canadian medical schools at entry. Surveys included questions on career choice, attitudes to practice and socio-demographic characteristics. We followed students prospectively with these data linked to their residency choice. We used multiple logistic regression analysis to identify entry characteristics that predicted a student's ultimate career choice in family medicine. Of 1941 eligible students in the participating classes, 1542 (79.4%) contributed data to the final analyses. The following 11 entry variables predicted whether a student named family medicine as his or her top residency choice: being older, being engaged or in a long-term relationship, not having parents with postgraduate university education nor having family or close friends practicing medicine, having undertaken voluntary work in a developing nation, not volunteering with elderly people, desire for varied scope of practice, a societal orientation, a lower interest in research, desire for short postgraduate training, and lower preference for medical versus social problems. Demographic and attitudinal characteristics at entry into medical school predicted whether students chose a career in family medicine.
    Canadian Medical Association Journal 10/2010; 183(1):E1-8. · 6.47 Impact Factor
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    ABSTRACT: To investigate what role family physicians currently play in the management of patients with nutrition-related issues and whether implementation of current nutrition counseling guidelines is feasible in primary care practices. Mailed survey. Family practice offices in British Columbia. A total of 451 Canadian-trained family physicians practising in British Columbia. Respondents' demographic characteristics; respondents' attitudes about and perceived barriers to nutrition counseling, as well as their current practices and training in this area. Among the 757 physicians surveyed, the response rate was 59.6%. Overall, respondents had positive attitudes about the role of nutrition in patient health, and most physicians (58.1%) believed that more than 60% of their patients would benefit from nutrition counseling. However, there was a considerable gap between the proportion of patients who respondents thought would benefit from nutrition counseling and the proportion of patients who received such counseling either in the family physicians' offices or through referral to dietitians. Rural physicians referred patients to dietitian services more frequently than urban physicians did (41.7% vs 21.7% made more than 20 referrals to dietitians each year). Nearly all physicians identified lack of time and compensation as the strongest barriers to providing nutrition guidance. Training was not considered to be as strong a barrier to counseling, even though 82.3% of family physicians reported their formal nutrition training in medical school to be inadequate, and only 30% of family physicians reported currently using any nutrition-related resources. For family physicians, successful implementation of the 2006 Canadian Clinical Practice Guidelines on the Management and Prevention of Obesity requires access to adequate training, compensation, and evidence-based interventions related to nutrition. This study highlights current nutrition counseling practices in family medicine and identifies several obstacles to integrating the current guidelines in primary care settings.
    Canadian family physician Medecin de famille canadien 03/2010; 56(3):e109-16. · 1.19 Impact Factor
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    ABSTRACT: Background: Medical student Pediatric rotations in Community Settings (CS) are increasingly common. The purpose of this paper is to assess the impact of setting (CS vs. exposure to an Academic Health Sciences Center (AHSC)) on the following: Clinical Performance, Examination Performance, Written Assignment Performance, and Successful Matching to a Canadian Pediatric Residency Program. Method: 340 medical students from the University of Toronto, Canada were studied. Rotation performance and acceptance into a Canadian pediatric residency program were assessed in relation to pediatric clerkship rotation site, while controlling for pre-clerkship career preference and pre-rotation site preference. Results: 172 medical students completed rotations that included exposure to an AHSC, while 168 medical students had exclusive exposure to a CS. Community based students received slightly higher clinical evaluations (p < 0.01), but not exam marks (p = 0.81) nor written assignment marks (p = 0.09). Students who had expressed career interest in pediatrics prior to clerkship performed better regardless of site (p < 0.001) and were more likely to choose an AHSC (p = 0.05). Clerkship setting had no demonstrated impact on successful matching to a Canadian pediatric residency program (p = 0.17). Conclusions: These results help validate the community setting for clerkship training in pediatrics and the shift toward distributed medical education.
    Canadian Medical Education Journal Canadian Medical Education Journal. 01/2010; 1(1).
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    ABSTRACT: Given the looming shortage of physicians in Canada, we wished to determine how closely the career preference of students entering Canadian medical schools was aligned with the current physician mix in Canada. Career choice information was collected from a survey of 2,896 Canadian medical students upon their entry to medical school. The distribution of career choices of survey respondents was compared to the current physician specialty mix in Canada. We show that there is a clear mismatch between student career choice at medical school entry and the current specialty mix of physicians in Canada. This mismatch is greatest in Urban Family Medicine with far fewer students interested in this career at medical school entry compared to the current proportion of practicing physicians. There are also fewer students interested in Psychiatry than the current proportion of practicing physicians. This mismatch between the student interest and the current proportion of practicing physicians in the various specialties in Canada is particularly disturbing in the face of the current sub-optimal distribution of physicians. If nothing is done to correct this mismatch of student interest in certain specialties, shortages and misdistributions of physicians will be further amplified. Studies such as this can give a window into the future health human resources challenges for a nation.
    BMC Medical Education 10/2009; 9:57. · 1.41 Impact Factor
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    ABSTRACT: To report the proportion of Canadian medical students interested in a career in psychiatry at medical school entry and to describe the unique demographics and career influences associated with this early interest. From 2001 to 2004, during the first 2 weeks of medical school, a 41-item survey of career choice, demographics, and attitudes toward various aspects of medical practice was distributed to all students in 18 classes at 8 Canadian medical schools. Associations between early career interest, demographics, and career influences were explored. Of the 2096 completed surveys, 3.2% of students named psychiatry as their first career choice. While 34% of students considered psychiatry a possible career option, 54.9% stated that they had not considered this option. Students interested in psychiatry were more likely than other students to have an undergraduate education in the arts, to have close family or friends practicing medicine, and to have worked voluntarily with people with mental illness. Students interested in psychiatry had a lesser social orientation than students interested in family medicine but had a greater social orientation and lesser hospital orientation than students interested in other specialties. Enhanced psychiatric care may be aided by the selective recruitment into medical school of students with a demonstrated empathy toward people with mental illness, an educational background in the arts, and a strong social orientation. As career influences change throughout medical school, participants in this study will be re-surveyed at graduation to better understand the evolution of career choice decision-making throughout medical school.
    Canadian journal of psychiatry. Revue canadienne de psychiatrie 09/2009; 54(8):557-64. · 2.48 Impact Factor
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    ABSTRACT: Studies indicate that a student's career interest at medical school entry is related to his or her ultimate career. We sought to determine the level of interest in emergency medicine among students at the time of medical school entry, and to describe characteristics associated with students primarily interested in emergency medicine. We surveyed students in 18 medical school classes from 8 Canadian universities between 2001 and 2004 at the commencement of their studies. Participants listed their top career choice and the degree to which a series of variables influenced their choices. We also collected demographic data. Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 6.1% (95% confidence interval 5.1%-7.1%) of respondents cited emergency medicine as their first career choice. When compared with students primarily interested in family medicine, those primarily interested in emergency medicine reported a greater influence of hospital orientation and a lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical specialties, those primarily interested in emergency medicine were more likely to report medical lifestyle and varied scope of practice as important influences. When compared with students primarily interested in the medical specialties, those who reported interest in emergency medicine were more likely to report that a hospital orientation and varied scope of practice were important influences, and less likely to report that social orientation was important. Students primarily interested in emergency medicine at medical school entry have attributes that differentiate them from students primarily interested in family medicine, the surgical specialties or the medical specialties. These findings may help guide future initiatives regarding emergency medicine education.
    Canadian Journal of Emergency Medicine 06/2009; 11(3):196-206. · 1.05 Impact Factor
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    ABSTRACT: Interest in both general surgery and surgical subspecialties has been declining among Canadian medical students. Studies have shown that a student's desire to practise surgery is largely determined before entry into medical school. As part of a larger study of students' career preferences throughout medical school, we sought to identify the level of interest in surgical careers and the factors that influence a student's interest in pursuing a surgical career. We surveyed students from 18 different classes at Canadian medical schools at the commencement of their studies between 2001 and 2004. We asked the students to list their top career choices and the degree to which a series of variables influenced their choices. We also collected demographic data. We performed a factor analysis on the variables. Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 21.0% of respondents named a surgical specialty as their first choice of career. We found that male students were more likely to express interest in a surgical specialty than female students, who were more likely to express interest in either family medicine or a medical specialty. Compared with students interested in a career in family medicine, those interested in a surgical or medical specialty were younger, more likely to be single and more likely to be influenced by prestige when making their career choices. Students interested in a career in surgery were less influenced by medical lifestyle and a varied scope of practice, less likely to demonstrate a social orientation and more likely to be hospital-oriented than students interested in either family medicine or a medical specialty. Male students interested in a career in surgery were more hospital-oriented and less likely to demonstrate a social orientation than female students interested in surgical careers. We identified 5 factors and a number of demographic variables associated with a student's interest in a surgical career.
    Canadian journal of surgery. Journal canadien de chirurgie 11/2008; 51(5):371-7. · 1.63 Impact Factor
  • Medical Teacher 07/2008; 30(5):543. · 1.82 Impact Factor
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    ABSTRACT: To determine how first-year medical students interested in rural family medicine in Canada differ from their peers. From 2002 to 2004, first-year students (n = 2189) from 16 classes in 8 Canadian medical schools ranked intended career choices and indicated influences on their choices using Likert scales. We used t tests and chi2 tests to determine demographic influences and factor analysis, and we used analysis of variance to examine associated attitudes. Of the 1978 surveys returned (90.3%), 1905 were used in the analysis. Rural family medicine was ranked first by 11.1%, varying from 4.7% to 20.2% among schools. Students interested in rural family medicine were more likely to have grown up rurally, graduated from a rural high school and have family in a rural location than others (p < 0.001). They were more likely to be older, in a relationship, to have volunteered in a developing nation and less likely to have university-educated parents than those interested in a specialty (p < 0.008). Attitudes of students choosing family medicine, rural or urban, include social orientation, preference for a varied scope of practice and less of a hospital orientation or interest in prestige, compared with students interested in specialties (p < 0.001). Medical schools may address the rural physician shortages by considering student demographic factors and attitudes at admission.
    Canadian journal of rural medicine: the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale: le journal officiel de la Societe de medecine rurale du Canada 02/2008; 13(2):73-9.
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    ABSTRACT: To describe the factors that medical students report influence them to pursue careers in family medicine. Qualitative study using focus groups and interviews and the results of surveys conducted at 3 different points in medical education. Three medical schools in western Canada: the University of British Columbia in Vancouver, the University of Calgary in Alberta, and the University of Alberta in Edmonton. A total of 33 medical students. Students were surveyed during the first 2 weeks of their programs, at the end of their preclinical training, and again at the end of their clinical training on their interest in family medicine or other specialty areas. Focus groups and interviews were conducted to explore the reasons students gave for an emerging or final interest in family medicine as a career choice. A small cohort of students who stayed with another specialty choice or switched to another specialty from family medicine were also interviewed. Thematic content analysis was carried out. Students identified several important influences that were subdivided into pre-medical school, medical school, postgraduate training, and life-in-medicine influences. Many positive and negative aspects of family medicine were reported during the preclinical period. Clinical exposure was critical for demonstrating the positive aspects of family medicine. Postgraduate training, future practice, and nonpractice life considerations also influenced students' career choices. This study provides a qualitative understanding of why students choose careers in family medicine. Medical schools should offer high-quality family medicine clinical experiences, consider the potentially positive influence of rural settings, and provide early and accurate information on family medicine training and career opportunities. These interventions might help students make more informed career decisions and increase the likelihood that they will consider careers in family medicine.
    Canadian family physician Medecin de famille canadien 12/2007; 53(11):1956-7. · 1.19 Impact Factor
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    ABSTRACT: To determine why students switch their career choices during the preclinical years of medical school. Two questionnaires were administered: the first at the beginning of medical school and the second about 3 years later just before students entered clinical clerkship. University of British Columbia, University of Alberta, University of Toronto, University of Ottawa, Queen's University, University of Western Ontario, University of Calgary, and McMaster University. Entering cohorts from 10 medical school classes at 8 Canadian medical schools. Proportion of students who switched career choices and factors that influenced students to switch. Among the 845 eligible respondents to the second survey, 19.6% (166 students) had switched between categories of family medicine and specialties, with a net increase of 1.2% (10 students) to family medicine. Most students who switched career choices had already considered their new careers as options when they entered medical school. Seven factors influenced switching career choices; 6 of these (medical lifestyle, encouragement, positive clinical exposure, economics or politics, competence or skills, and ease of residency entry) had significantly different effects on students who switched to family medicine than on students who switched out of family medicine. The seventh factor was discouragement by a physician. Seven factors appear to affect students who switch careers. Two of these factors, economics or politics and ease of residency entry, have not been previously described in the literature. This study provides specific information on why students change their minds about careers before they get to the clinical years of medical training.
    Canadian family physician Medecin de famille canadien 02/2007; 53(1):95, 95:e.1-5, 94. · 1.19 Impact Factor
  • Ian Scott
    Medical Education 01/2007; 40(12):1156-8. · 3.55 Impact Factor
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    Australian Journal of Rural Health 11/2006; 14(5):229-30. · 1.55 Impact Factor
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    ABSTRACT: Over the last 10 years the number of medical students choosing family medicine as a career has steadily declined. Studies have demonstrated that career preference at the time that students begin medical school may be significantly associated with their ultimate career choice. We sought to identify the career preferences students have at entry to medical school and the factors related to family medicine as a first-choice career option. A questionnaire was administered to students entering medical school programs at the time of entry at the University of Calgary (programs beginning in 2001 and 2002), University of British Columbia (2001 and 2002) and University of Alberta (2002). Students were asked to indicate their top 3 career choices and to rank the importance of 25 variables with respect to their career choice. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choice were also calculated. A logistic regression was performed using career choice (family v. other) as the criterion variable and the factors plus demographic characteristics as predictor variables. Of 583 students, 519 (89%) completed the questionnaire. Only 20% of the respondents identified family medicine as their first career option, and about half ranked family medicine in their top 3 choices. Factor analysis produced 5 factors (medical lifestyle, societal orientation, prestige, hospital orientation and varied scope of practice) that explained 52% of the variance in responses. The 5 factors demonstrated acceptable internal consistency and correlated in the expected direction with the choice of family medicine. Logistic regression revealed that students who identified family medicine as their first choice tended to be older, to be concerned about medical lifestyle and to have lived in smaller communities at the time of completing high school; they were also less likely to be hospital oriented. Moreover, students who chose family medicine were much more likely to demonstrate a societal orientation and to desire a varied scope of practice. Several factors appear to drive students toward family medicine, most notably having a societal orientation and a desire for a varied scope of practice. If the factors that influence medical students to choose family medicine can be identified accurately, then it may be possible to use such a model to change medical school admission policies so that the number of students choosing to enter family medicine can be increased.
    Canadian Medical Association Journal 07/2004; 170(13):1920-4. · 6.47 Impact Factor
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    Ian Scott, Cheryl Wilson
    Canadian Medical Association Journal 01/2004; 169(12):1297. · 6.47 Impact Factor
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    ABSTRACT: This study's objective was to evaluate the acceptability, effect, and use of handheld computers (also known as personal digital assistants or PDAs) as a reward for undergraduate rural community-based family medicine preceptors. All rural, undergraduate family physician teachers who accepted an undergraduate student for a 1-month placement were offered the choice between a PDA that carried medical software or a monetary payment of an equivalent value. Approximately 1 year later, different surveys were sent to both groups of preceptors to collect data on their use of PDAs and computer technology. The most commonly reported reason for choosing a PDA in lieu of payment was that it provided a good opportunity to learn about PDA technology. Of those who accepted a PDA, however, 10% had not yet used it, and another 44% of recipients had difficulty in getting started using the PDA. There were more reported problems with the software than the hardware. When surveyed 1 year later, those who received a PDA and were still using it reported satisfaction with the medical software, ranging from 31% for Epocrates qid to 71% for the 5-Minute Medical Consult. More than 90% of those using their PDA 1 year later reported that they used it in clinical settings, with 68% feeling their PDA had some or a significant effect on patient care. Rural family physicians appeared to find PDAs an acceptable reward for teaching, based on the reported use and utility of their PDA, but many had technical difficulties. Recipients of the PDA reported using their PDA primarily in the clinical setting, with the feeling that the PDA had a positive effect on their patient care. Many users had difficulty with technical aspects of PDA use. To support PDA recipients, technical assistance should be provided.
    Family medicine 37(10):727-33. · 1.20 Impact Factor