Mapping medical careers: Questionnaire assessment of career preferences in medical school applicants and final-year students

BACKGROUND: The medical specialities chosen by doctors for their careers play an important part in the workforce planning of health-care services. However, there is little theoretical understanding of how different medical specialities are perceived or how choices are made, despite there being much work in general on this topic in occupational psychology, which is influenced by Holland's RIASEC (Realistic-Investigative-Artistic-Social-Enterprising-Conventional) typology of careers, and Gottfredson's model of circumscription and compromise. In this study, we use three large-scale cohorts of medical students to produce maps of medical careers. METHODS: Information on between 24 and 28 specialities was collected in three UK cohorts of medical students (1981, 1986 and 1991 entry), in applicants (1981 and 1986 cohorts, N = 1135 and 2032) or entrants (1991 cohort, N = 2973) and in final-year students (N = 330, 376, and 1437). Mapping used Individual Differences Scaling (INDSCAL) on sub-groups broken down by age and sex. The method was validated in a population sample using a full range of careers, and demonstrating that the RIASEC structure could be extracted. RESULTS: Medical specialities in each cohort, at application and in the final-year, were well represented by a two-dimensional space. The representations showed a close similarity to Holland's RIASEC typology, with the main orthogonal dimensions appearing similar to Prediger's derived orthogonal dimensions of 'Things-People' and 'Data-Ideas'. CONCLUSIONS: There are close parallels between Holland's general typology of careers, and the structure we have found in medical careers. Medical specialities typical of Holland's six RIASEC categories are Surgery (Realistic), Hospital Medicine (Investigative), Psychiatry (Artistic), Public Health (Social), Administrative Medicine (Enterprising), and Laboratory Medicine (Conventional). The homology between medical careers and RIASEC may mean that the map can be used as the basis for understanding career choice, and for providing career counselling

The 'feminisation of poverty' and the 'feminisation' of anti-poverty programmes: room for revision?

The construct of the 'feminisation of poverty' has helped to give gender an increasingly prominent place within international discourses on poverty and poverty reduction. Yet the way in which gender has been incorporated pragmatically�-�predominantly through the 'feminisation' of anti-poverty programmes�-�has rarely relieved women of the onus of coping with poverty in their households, and has sometimes exacerbated their burdens. In order to explore how and why this is the case, as well as to sharpen the methodological and conceptual parameters of the 'feminisation of poverty' thesis, this paper examines four main questions. First, what are the common understandings of the 'feminisation of poverty'? Second, what purposes have been served by the popularisation and adoption of this term? Third, what problems are there with the 'feminisation of poverty' analytically, and in respect of how the construct has been taken up and responded to in policy circles? Fourth, how do we make the 'feminisation of poverty' more relevant to women's lives�-�and empowerment�-�at the grassroots? Foremost among my conclusions is that since the main indications of feminisation relate to women's mounting responsibilities and obligations in household survival we need to re-orient the 'feminisation of poverty' thesis so that it better reflects inputs as well as incomes, and emphasises not only women's level or share of poverty but the burden of dealing with it. Another, related, conclusion is that just as much as women are often recruited into rank-and-file labour in anti-poverty programmes, 'co-responsibility' should not be a one-way process. This requires, inter alia, the more active support of men, employers and public institutions in domestic labour and unpaid care work.

Reversing the paradigm: quantification, participatory methods and pro-poor impact assessment

Recent debates about integrated impact assessment have tended to treat participatory approaches and methods as a fashionable frill added on to more 'expert' quantitative and qualitative investigation. This paper argues that, far from being an optional add-on, participatory approaches, methods and behaviours are essential for the new agendas of pro-poor development and 'improving practice'. Recent evidence shows that participatory methods can generate accurate quantitative data as well as capturing local priorities, different experiences of poor people and potential for innovation in relation to causality and attribution. They can also be cost-effective for focusing quantitative and qualitative investigation. The main challenge is ensuring that mainstreaming them does not compromise their role in giving poor women and men more voice in development priorities, policies and practice. Copyright © 2005 John Wiley & Sons, Ltd.