What reasons do final-year medical students give for choosing the hospitals for their clinical training phases? A quantitative content analysis

Aim: In the final (practical) year (PY), students have the opportunity to become familiar with their potential future place of work. At the same time, university hospitals and teaching hospitals compete to recruit the best junior staff from this pool. The aim of this study is to present students' selection criteria for the location of the final year in detail. Methods: On the formal evaluation of the final year at the Mannheim Medical Faculty, students were asked after each training period which reasons led to the selection of the location. Thirty-one subcategories were formed from the free-text responses, sorted according to their controllability and then grouped into 11 main categories. The Mannheim University Hospital introduced an expense allowance in November 2015. The data from the period before and after its introduction, the reasons given for choosing the location for the compulsory and elective subjects, and the reasons given for choosing a teaching hospital or university hospital were evaluated and compared separately. Results: A total of 1,164 questionnaires were evaluated from the period before the introduction of the expense allowance, and 1,120 questionnaires were evaluated from the period after the introduction. Overall, Proximity (19%), Financial incentives (18%) and Subject (18%) were the most frequently cited reasons. The Financial incentives subcategory was the most frequent in period 1 (32%), but lost relevance in period 2 (6%). In contrast, Recommendation gained in importance (from 8% to 15%). A comparison of the lead categories shows that teaching hospitals benefit more from their public image and university hospitals more from the subjects they offer. Conclusion: Students primarily choose the location for their final year for pragmatic reasons, such as Incentives and Living environment, but the Public image of the hospitals also plays a significant role. The frequency of the reasons given differs between compulsory and elective subjects, as well as between university hospitals and teaching hospitals. The results can help to improve the attractiveness of the location in a targeted manner and to present a specific image to the public.