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Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study
  1. Anouk Wouters1,2,
  2. Gerda Croiset1,2,
  3. Ulviye Isik1,2,
  4. Rashmi A Kusurkar1,2
  1. 1 VUmc School of Medical Sciences, Research in Education, Amsterdam, The Netherlands
  2. 2 LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Anouk Wouters; a.wouters{at}


Objective To explore high school students’ motivation for applying to study medicine and the factors that influence this. To find explanations for under-representation of minority students in medical education, descriptions of motivation of students with different background characteristics were compared.

Design Qualitative phenomenological study using semistructured one-on-one interviews.

Setting One predominantly white and one mixed high school in a large multicultural city in the Netherlands. The study was conducted in March–December 2015.

Participants Twenty-four high school students, purposively sampled for demographic characteristics.

Methods The analysis consisted of the coding of data using a template based on the motivation types (autonomous and controlled motivation) described by self-determination theory and open coding for factors that influence motivation.

Results The main reasons for pursuing a medical career pertained to autonomous motivation (interest in science and helping people), but controlled motivation (eg, parental pressure, prestige) was also mentioned. Experiences with healthcare and patients positively influenced students’ autonomous motivation and served as a reality check for students’ expectations. Having to go through a selection process was an important demotivating factor, but did not prevent most students from applying. Having medical professionals in their network also sparked students’ interest, while facilitating easier access to healthcare experiences.

Conclusions The findings showed a complex interplay between healthcare experiences, growing up in a medical family, selection processes and motivation. Healthcare experiences, often one of the selection criteria, help students to form autonomous motivation for studying medicine. However, such experiences as well as support in the selection process seem unequally accessible to students. As a result, under-represented students’ motivation decreases. Medical schools should be aware of this and could create opportunities to acquire healthcare experiences. High schools could incorporate internships as part of their study counselling programmes and offer tailor-made guidance to each individual student.

  • School Admission Criteria
  • Motivation
  • Education, Medical, Undergraduate
  • Self-determination Theory

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  • Contributors All researchers contributed to the design of the study and interpretation of the data. AW and UI have completed courses on conducting qualitative research. AW conducted the interviews. AW and UI were responsible for the main data analysis. All researchers contributed to and approved the final manuscript.

  • Funding This work was partly funded by the Netherlands Federation of University Medical Centers (NFU).

  • Competing interests None declared.

  • Ethics approval This study has been approved by the Dutch Association for Medical Education Ethical Review Board (NVMO-ERB), dossier number 408.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Anonymised data set available from the main author upon request.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected theseerrors and the correct publishers have been inserted into the references.