29th November 2019, Volume 132 Number 1506

Sam Seleq, Emmanuel Jo, Phillippa Poole, Tim Wilkinson, Fiona Hyland, Joy Rudland, Antonia Verstappen, Warwick Bagg

Understanding when medical students and doctors make choices about their future medical career is of importance to universities, postgraduate colleges and for individual doctors. Choosing a career is influenced by…

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This paper aims to compare New Zealand medical students’ graduate intentions with the health workforce requirements in 2028, where medical graduates are anticipated to have completed training. At graduation, half of medical students were undecided on a career pathway. We found that the career intentions of medical students who had decided on a vocational pathway did not align with workforce requirements, with the main gap existing in general practice. The key limitation is the assumption that medical students career decisions and workforce requirements remain constant.



To determine the career decision intentions of graduating doctors, and the relationship between these intentions and the predicted medical workforce needs in New Zealand in 10 years’ time.


A workforce forecasting model developed by the Ministry of Health (MOH) has been used to predict the proportion of doctors required in each medical specialty in 2028 in New Zealand. The future work intentions of recently graduated doctors at the Universities of Auckland and Otago were collected from the Medical Student Outcomes Data (MSOD), and compared with these predicted needs.


Between 2013 and 2017, 2,292 doctors graduated in New Zealand, of whom 1,583 completed the MSOD preferences section (response rate 69%). Of these only 50.1% had decided on a future medical specialty. The most popular were surgical specialties (26.2%), general practice (20.7%), and internal medicine (11.0%). Compared to the MOH workforce forecast model there appears to be insufficient interest in general practice at the time of graduation.


To shape the medical workforce to meet forecast needs, multiple stakeholders will need to collaborate, with a special focus on the early postgraduate years, as many doctors have yet to decide on specialisation.

Author Information

Sam Seleq, Clinical Medicine Education Fellow, School of Medicine, University of Auckland, Auckland; Emmanuel Jo, Manager, Analytics and Modelling, Health Workforce New Zealand, Ministry of Health, Wellington; Phillippa Poole, Head, School of Medicine, University of Auckland, Auckland;
Tim Wilkinson, Director, MBChB Programme, Otago Medical School, University of Otago, Dunedin; Fiona Hyland, Assessment Manager, Otago Medical School, University of Otago, Dunedin;
Joy Rudland, Director, Faculty Education Unit, Otago Medical School, University of Otago, Dunedin; Antonia Verstappen, Research Fellow, School of Medicine, University of Auckland, Auckland;
Warwick Bagg, Department of Medicine, School of Medicine, University of Auckland, Auckland.


We would like to thank Health Workforce New Zealand, Ministry of Health and Medical Schools Outcomes Database project.


Dr Sam Seleq, Clinical Medicine Education Fellow, School of Medicine, University of Auckland, Auckland.

Correspondence Email


Competing Interests

Dr Bagg was Head of the Medical Programme at the University of Auckland until February 2019. Ms Verstappen and Dr Poole report grants from Health Workforce New Zealand during the conduct of the study.


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