Medical specialty choice as a situated social practice
A systematized literature review of its academic, sociocultural, and institutional configuration
DOI:
https://doi.org/10.66778/CS.v14n40.13Keywords:
Medical specialty choice, physicians in training, situated social practice, medical education, complex thinking, health workforceAbstract
The decision about which medical specialty to pursue is often presented as a matter of vocation, individual preference, or clinical affinity. However, it takes shape day by day within training scenarios, such as classrooms, clinical rotations, and healthcare services, and is related to professional hierarchies, discourses of prestige, mentorship received, family expectations, working conditions, and institutional opportunities. Objective: To understand, from a socio-complex perspective, how academic, sociocultural, and institutional conditions are articulated in medical specialty choice among physicians in training. Methodology: A systematized review with narrative synthesis was conducted using searches in PubMed and LILACS for publications from 2020 to 2025, in Spanish, English, or Portuguese. Results: Twenty articles were included. The synthesis organized the evidence into five analytical entry points related to medical training, sociocultural expectations, professional hierarchies, institutional conditions, and future biographical projects. Discussion: The synthesis shows that these entry points do not act as separate components, but as relationships that guide aspirations, enable or restrict possibilities, and participate in the production of professional preferences. Conclusions: Understanding medical specialty choice as a situated social practice makes it possible to discuss specialist workforce planning beyond the expansion of residency positions, incorporating the discourses, hierarchies, and institutional conditions that organize medical training
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