What influenced medical students to undertake paid work during the COVID-19 pandemic?

Problem

Universities were forced to close as part of the national lockdown in March 2020 to prevent the spread of COVID-19, which led to disruption of teaching and clinical placements for medical students. Many medical students undertook paid clinical roles during this period, but there is limited research available to understand why. As students are already being recruited to deliver COVID-19 vaccinations in hospitals and GP practices, it is important to understand the motivating factors which drive them to consider paid work during the pandemic.

Approach

Students were recruited through personal contact, snowball recruitment and social media. In-depth semi-structured interviews were conducted with students (n=20) who had undertaken paid work during the pandemic, and transcribed verbatim. Thematic analysis was conducted with a combination of inductive and deductive approaches and 7/20 transcripts were double coded to enable triangulation of results and increase consistency. Codes and themes were agreed between all investigators.

Findings

Three main themes were found to have influenced students’ decisions to work: duty to help, balancing their use of time, and personal gain.Participants had a strong sense of moral duty, particularly linked to the skillset they might be able to provide and to their sense of altruism which some linked to their reasons for studying medicine in the first place.The majority of participants found that they had more free time since formal teaching and exams at medical school were cancelled, which caused them to consider working as a better use of their time than staying at home. However, some felt conflict in balancing their time with ongoing exam preparation and felt that they would be disadvantaged by not spending as much time studying as their peers.Personal gain included educational opportunities and financial gain. Some students’ usual work had ceased due to the pandemic and they were looking for other ways to stay financially afloat. However, for other participants, educational opportunities to make up for missed placement time or the social aspect of work in a national lockdown were more potent motivators. Participants also had to balance personal gain with their sense of moral duty.

Consequences

With the roll-out of COVID-19 vaccinations, GP practices may want to recruit medical students to paid roles, some for the first time. It is important for them to consider the factors which drive students to take up these roles so that they can effectively recruit students, and meet students’ expectations and enhance their experience, for example by providing educational opportunities and being flexible around their course workload as they prepare for exams and attend placements.Further research could seek to understand the views of those students who did not choose to work in the pandemic or compare paid workers with volunteers.