What motivates the choice of specialty among medical doctors in Tanzania

Background: Studies have shown there is a low specialist workforce, coupled with wide range of disparity among different specialities in the country to cater for the needs of more than 54 million Tanzanians. The theories of motivation and development have shown many theories influencing choices made by people in life. Objectives: This study aims to assess the motivation for choice of specialty among medical doctors (including registrars, residents, and specialists) in Dar es Salaam, Tanzania. Methods: A descriptive cross-sectional study was conducted at Muhimbili University of Health and Allied Sciences, Muhimbili National hospital, and the Aga Khan University Hospital Dar es Salaam, enrolling medical doctors. Data was collected using a structured self-administered questionnaire to garner data on demographics, reasons for choice of specialty, specialty of choice and location of practice after consent has been given. Descriptive analysis was performed on the data. Results: Appraisal of own skills (85.4%), job opportunity and job security post-graduation (73.2%), perceived high income potential (67.3%) and prestige of the specialty (63.4%) were important motivations for choosing a specialty. Internal medicine was the most commonly chosen specialty (51/205; 24.9%) with academic medicine being the least preferred (0.5%, n=1). Majority of doctors were undecided on preference of area (urban/rural) of practice, but there was a high number of doctors preferring to practice in Tanzania rather than abroad after completion of specialty training. Conclusion: Two overarching themes influence/determine choices of specialization among doctors: personal and societal, and specialty characteristics. Both underlines the personal needs for safety, security and financial stability. There was a preference for more traditional core v specializations such as internal medicine, surgery, pediatrics and child health, and obstetrics and gynecology