VOCATIONAL PREFERENCES FOR HEALTH SCIENCES CAREERS

IN PERUVIAN SECONDARY SCHOOL STUDENTS:

SOCIODEMOGRAPHIC PROFILES AND MOTIVATIONS FOR CHOICE
Iván Montes-Iturrizaga1, Eduardo Franco-Chalco2, David Montes-Iturrizaga3,
Aldo Bazán Ramírez4, Yajaira Licet Pamplona-Ciro5
1
Universidad César Vallejo - Trujillo (PERU)
2
Pontificia Universidad Católica del Perú (PERÚ)
3
Universidad Ricardo Palma (PERÚ)
4
Universidad César Vallejo - Piura (PERÚ)
5
Fundación Universitaria Católica del Norte (COLOMBIA)

Abstract
This study explores vocational preferences in 1159 students (764 males and 392 females) who are
completing their secondary education in the province of Arequipa (Peru). In this sense, a questionnaire
was applied under informed consent and authorization of the parents. Specifically, this research focuses
on the distribution of young people in this representative sample in the different health science careers
such as human medicine, nursing, psychology and physiotherapy, among others. The latter was
indicated according to variables such as sex, parents' occupation and type of school (public, private and
ssubsidized).
Specifically, we found that of the total sample (1159) 221 (19.1%) students wish to study a career in the
field of health sciences; of this total 108 (9.3%) are male and 113 (9.8%) are female. Also, and in general
terms, we found that the preferences for health science careers (221 young people) are distributed as
follows: 146 in medicine (12.6%), 8 in nursing (0.7%), 3 in obstetrics (0.3%), 50 in psychology (4.3%), 6
in dentistry (0.5%), 2 in pharmacology and biochemistry (0.2) and nutrition (0.5%). In terms of
motivations we apply to short four-item questionnaire was designed that explores: the assessment of
the profitability of a career over the vocation; the assessment of following the wishes of the parents over
the vocation; the belief that there are careers more valuable than others, and; the belief in the existence
of careers for people more intelligent than others. The items were measured on a 5-point Likert scale
(completely agree - completely disagree) and applied with informed consent. Statistical analyses were
based on those who expressed a preference for health careers (221). For this purpose, we used the Chi
Squared statistics and ANOVAS depending on the type of variables that were tested. All data was
analyzed in R v.4.0.1. In this context, we find that medicine is the most preferred career for men, while
women have a greater preference for other vocational training alternatives (X2 = 26.76, df = 6, p < 0.001).
We also found significant associations that tell us that preferences for health careers are mostly located
in private and subsidized schools. However, for nursery, pharmaceutics, medicine, obstetrics and
psychology most of the students are from public schools; while for nutrition and odontology most of them
come from subsidized schools.
In the family dimension, the results indicate that students with parents with a higher level of education
are more inclined to study medicine, while students with parents with a lower level of education show
interest in other types of health careers. On the other hand, students with mothers with higher
educational level declared themselves more likely to dream of studying medicine, nutrition and dentistry.
Finally, we observed that fathers are more likely to disapprove of their children's preferences for careers
in the following areas nursery, nutrition and psychology. Mothers, on the other hand, are more inclined
to disapprove of nursing, dentistry and psychology.
We found no differences in vocational attitudes among students according to the type of health career.
Keywords: vocational preferences, health careers, demand for health careers, vocational motivation.

1 INTRODUCTION
Adolescents at the end of secondary school must decide - in most cases - on a choice of studies at a
university or technological institute [1], [2]. This process is more noticeable in urban areas, where more
than 65% access higher education in Peru, and where the rest enter the world of work or are supported
by their families for a longer period of time [3].

Proceedings of ICERI2021 Conference ISBN: 978-84-09-34549-6

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8th-9th November 2021
However, the process of vocational choice is not an easy task and, in addition to one's own preferences,
the influence of parents, teachers and the social circles in which young people participate [4], [5], [6]. To
this we could add the concerns associated with the ease or difficulty of finding a job afterwards [7]. This,
in a complex process where it is difficult to know how autonomous are these decisions to apply for a
certain professional career [8]. However, what is known in more detail are parental influences, gender
stereotypes [9], [10] and the effect that salary expectations (rate of return) may have on career choices
[11]. But also, preferences may be affected by the very evidence emanating from the universities
themselves regarding the existence of careers where men or women would be more concentrated (or
perhaps that they are present in the same proportion) [12]. But also, the cost of careers is an important
variable in engineering and health sciences to a large extent. For this reason, it could be said that
choosing or considering an option as the career of one's dreams is a complete process that, although it
materialises at the end of secondary education, obeys many years under the interaction of multiple
factors [1], [2]. Against this background, it could be said that the aforementioned influences shape
diverse attitudes (expressed at times in the form of motivations) capable of predictively explaining
vocational preferences [3].
In the case of the health sciences, we find that these careers enjoy a high degree of respectability, status
and employment. In this context, medicine constitutes the most legitimised paradigm that offers (for
almost all careers) the maximum characteristics that distinguish a university profession, such as
prestige, years of training, autonomy and low intrusiveness. Perhaps, this last aspect is the one that is
most shared among the different health careers; motivated to a large extent by the action of the
professional associations, the fact that the actions are related to health-illness (life) and the laws that
protect its practice in the public and private sectors, among others.
However, not all health careers share the same characteristics [9] and gender stereotypes (for example,
in the professional group of nurses), costs (medicine being the most expensive career) and different
motivations may be at work to justify preferences. The latter leads us to think that the choice of a career
could possibly be driven by vocation, parental pressure or by the salaries it could offer once one finishes
one's studies [6], [13], [5], [6], [14]. For example, a number of studies report motivations behind the
choice of medical careers such as social interest and inclinations towards science [10]. Others estimate
that in the spectrum of health careers, family influence is more likely to be at work in medicine than in
other careers [9]. But recent findings seem to place particular importance on personal experiences
related to one's own or relevant people's health [9]. However, other motivations and conditioning factors
may also play a role in career choice, such as the influence of friends, the proximity of the university to
one's place of residence or the ease of study, personality and the desire to repay one's parents, among
others [2], [15]. And it is precisely in this area that qualitative studies stand out as approaches capable
of delving deeper into these phenomena [15], [9].
Scientists are also interested in knowing how vocational preferences can help us to plan the
development of certain careers in a country or group of countries [7], [15]. All this within a logic of
prospective analysis of professional careers that are usually estimated with respect to social demands,
new situations (such as the one proposed by COVID-19), professional turnover (in terms of retirement
and death) and the usual ratios according to the population. Here, we should consider that although
these aspects are not new, the agreements are not so frequent and it is common to find differences
between the criteria proposed by international organisations and the countries' own governmental
expectations. If we do not address these aspects, which are becoming more and more accentuated in
the global context, we run the risk of showing a real shortage of professionals in areas relevant to the
health system.
As mentioned above, and in health careers, the Pan American Health Organisation (PAHO) frequently
mentions that health teams need more nurses than doctors. But it does not clearly indicate the need for
specialities in the different careers, nor does it mention the number of psychologists, dentists or
obstetricians needed to guarantee adequate care in the health services. These and other aspects are
the object of attention in major statistical research in the United States, Canada, France, England,
Australia, Japan and South Korea. In Peru, these analyses are very scarce and there is no observatory
or public office interested in these issues.
It should be made clear that we consider that the genuine preferences of adolescents for a given career
are legitimate and should therefore be respected, since they speak of expectations to achieve personal
self-fulfilment thanks to the competition [2], [9], [16]. This rightful claim is also associated with making a
low-risk choice, which means being able to get a job once the respective qualification has been obtained
[7].

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On the other hand, and in view of what was mentioned in the previous paragraph, it could be said that
the study of vocational preferences and actual application could offer us important scopes for decision-
making [17]. Of concern are for example careers that could offer important inputs for estimating future
needs. For example, the fact that some careers are less preferred (and underpopulated) than others
that are very popular (and therefore overpopulated) should lead us to think about incentives to study
some careers [1]. To this should be added adequate career information from government agencies,
universities and from schools themselves, which is apparently insufficient [15], [9]. Finally, and at least
in Peru, we do not have a set of standards or criteria that help psychologists or school counsellors to
develop a vocational guidance process that is based on an adequate assessment and that respects the
informed preferences of young people at the end of their secondary education [18].
In the aforementioned scenario, the present study analyses preferences for health science careers in a
large sample of adolescents from the city of Arequipa (Peru) who are about to finish school. Likewise,
some sociodemographic factors and the stated motivations associated with the different careers in this
field of university education are studied.

2 METHODOLOGY
A sample of 1159 students from the fourth (49.91%) and fifth (50.09%) grades attending 11 secondary
schools was collected. All the sample was from the city of Arequipa (Peru). 66.09% of the students were
male and were 15.52 years old on average. Regarding the school type, 50.35% of the students were
registered in public schools, 31.95% in subsidized private schools, and 17.70% in private schools.
Father instruction levels were: 33.57% with university education, 24.65% with technical education,
35.57% with secondary education, and 5.21% with primary education. Finally, mother instruction levels
were: 30.76% with university education, 21.91% with technical education, 35.23% with secondary
education, and 12.09% with primary education.
All the students gave their consent before the survey was administered. The authors of the present
research designed the survey, and its modality was self-administered and anonymous. The instrument’s
question was about the dreamed major (e.g., “If you had complete freedom to choose, which would your
dream major of study be?”), with this question vocational preferences for health sciences careers were
identified resulting in eight careers: medicine, nursery, obstetrics, psychology, odontology,
pharmaceutics, medical technology, nutrition. Also, parental approval of the dreamed carreer was
explored with a two questions: “Does your father/mother approves the career you dream to study?”.
Finally, a short four-item self-administrated questionnaire was designed to explore the attitudes towards
the choice of a professional career, assessing: (1) the preference of the profitability of a career over
vocation; (2) the choice of a career based on the wishes of the parents over vocation; (3) the belief that
there are careers more valuable than others; and (4) the belief in the existence of careers for people
more intelligent than others. These four items were averaged to obtain an attitudes towards vocation
scale [19].
Regarding the statistical analyses, data was explored in two moments. In a first moment we compared
the differences in frequencies and percentages of students that dreamed to study a health sciences
career versus other careers by demographic variables and attitudes towards vocation. And in a second
moment we selected only the students that dreamed a health science career studied their demographic
characteristics and attitudes towards vocation. These analyses were performed using Chi Squared
statistics and ANOVAS depending on the type of variables that were tested. All data was analyzed in R
v.4.0.1.

3 RESULTS
Table 1 shows the frequencies and percentages of dreamed career chose by student’s gender. First, in
general 19.07% of the students dream to study a career in health sciences, within this percentage
51.13% of them are females and 48.87% males. This shows those women are slightly more inclined to
study something related to health than males. However, the difference in gender preferences can be
more widely observed in the other careers where females only represent nearly a third of the population
(29.84%), these differences are statistically significant according to the chi squared statistic (X2 = 35.21,
df = 1, p < 0.001). More specifically, when studying only the 221 students that dreamed to study a health
science career a clear preference towards majors in medicine (66.06%) and psychology (22.62%) could
be observed. In terms of gender, there were more males (60.96%) that dreamed to study medicine
compared to females (39.04%); however, in nursery, pharmaceutics, nutrition, obstetrics, odontology

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and psychology more than two thirds of students that dreamed to study them were females. These
differences were statistically significant (X2 = 26.76, df = 6, p < 0.001).

Table 1. Frequencies and percentages for dreamed careers by gender

Males Females Total

Sex
f % f % f %
Health sciences career 108 48.87 113 51.13 221 100
Other careers 656 70.16 279 29.84 938 100
Dreamed career
Nursery 2 25.00 6 75.00 8 100
Pharmaceutics 0 0.00 2 100.00 2 100
Medicine 89 60.96 57 39.04 146 100
Nutrition 2 33.33 4 66.67 6 100
Obstetrics 0 0.00 3 100.00 3 100
Odontology 2 33.33 4 66.67 6 100
Psychology 13 26.00 37 74.00 50 100

In Table 2, the frequencies and percentages of dreamed career chose by school type. In general, most
of the students that say that dream to study a health science career come from private (23.41%) and
subsidized schools (22.16%). While only 15.61% of the students from public schools declare to be
interested in these types of careers. This association of variables was statistically significant (X2= 9.32,
df = 2, p = 0.009). Furthermore, there are slight differences in the percentage of students that dream to
study medicine in terms of school type, most of them coming from public and subsidized schools.
However, for nursery, pharmaceutics, medicine, obstetrics and psychology most of the students are
from public schools; while for nutrition and odontology most of them come from subsidized schools.
These differences were statistically significant (X2 = 22.29, df = 12, p = 0.034).

Table 2. Frequencies and percentages for dreamed careers by school type

Public Private Subsidized

School type
f % f % f %
Health sciences career 91 15.61 48 23.41 82 22.16
Other careers 492 84.39 157 76.59 288 77.84
Dreamed career
Nursery 7 87.50 0 0.00 1 12.50
Pharmaceutics 2 100 0 0.00 0 0.00
Medicine 55 37.67 35 23.97 56 35.36
Nutrition 0 0.00 2 3.33 4 6.67
Obstetrics 3 100 0 0.00 0 0.00
Odontology 1 16.67 1 16.67 4 66.67
Psychology 23 46.00 10 20.00 17 34.00

In Table 3, the frequencies and percentages of dreamed career that the student declares by father’s
educational level. In general, there are no differences in the father’s educational level and the type of
career their children choose (X2= 5.81, df = 3, p = 0.12). However, when analysing the specific careers
statistically significant differences could be observed (X2 = 37.24, df =18, p = 0.005). Students with
fathers with higher educational level are more inclined to study medicine, while students with fathers
with lower educational levels show interest towards the other type of health careers. A similar pattern of
results can be observed in Table 4, related to mother’s educational level; no statistical differences could
be observed for type of career and mother’s education (X2 = 16.29, df = 3, p < 0.001); however, some

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differences could be observed when analysing the specific careers (X2 = 32.42, df =18, p=0.02).
Specifically, students with mothers with higher educational level were declared more that dreamed to
study a career in medicine, nutrition and odontology; nevertheless, the other careers didn’t show a
specific pattern.

Table 3. Frequencies and percentages for dreamed careers by father’s educational level

Primary Secondary Technical University

Father’s educational level
f % f % f % f %
Health sciences career 11 18.64 66 15.94 56 20.07 86 22.63
Other careers 48 81.36 348 84.06 223 79.93 294 77.37
Dreamed career
Nursery 1 12.50 6 75.00 0 0.00 1 12.5
Pharmaceutics 1 50.00 1 50.00 0 0.00 0 0.0
Medicine 4 2.76 36 24.83 37 25.52 68 46.9
Nutrition 0 0.00 2 33.33 2 33.33 2 33.3
Obstetrics 1 33.33 1 33.33 1 33.33 0 0.0
Odontology 0 0.00 1 16.67 3 50.00 2 33.3
Psychology 4 8.16 19 38.78 13 26.53 13 26.5

Table 4. Frequencies and percentages for dreamed careers by mother’s educational level

Primary Secondary Technical University

Mother’s educational level
f % f % f % f %
Health sciences career 25 18.12 58 14.43 46 18.4 91 25.93
Other careers 113 81.88 344 85.57 204 81.6 260 74.07
Dreamed career
Nursery 3 37.50 3 37.50 1 12.50 1 12.50
Pharmaceutics 1 50.00 0 0.00 1 50.00 0 0.00
Medicine 13 8.90 32 21.92 30 20.55 71 48.63
Nutrition 0 0.00 1 16.67 1 16.67 4 66.67
Obstetrics 0 0.00 3 100.00 0 0.00 0 0.00
Odontology 1 16.67 1 16.67 1 16.67 3 50.00
Psychology 7 14.29 18 36.73 12 24.49 12 24.49

Regarding parental approval of the dreamed career, table 5 shows the father’s and mother’s approval
of the dreamed career by type of dreamed career. In general, no statistical differences could be observed
in mother’s (X2= 0.54, df = 1, p = 0.50) and father’s (X2= 1.73, df = 1, p = 0.19) approval of careers in
health sciences and other careers, in both cases most of them supported the dreamed career. However,
when observing specific career data, fathers are more inclined to disapprove nursery, nutrition and
psychology (X2 = 14.23, df = 6, p = 0.03). In the same line, mothers are more inclined to disapprove
nursery, odontology and psychology (X2 = 14.23, df = 6, p = 0.03). For both cases the most approved
careers were pharmaceutics, medicine, and obstetrics.

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 Table 5. Frequencies and percentages for dreamed careers by parental approval

Father Mother
Parental approval Disapproves Approves Disapproves Approves
f % f % f % f %
Health sciences career 25 30.12 58 69.88 46 33.57 91 66.42
Other careers 113 24.73 344 75.27 204 43.97 260 56.03
Dreamed career
Nursery 2 25.00 6 75.00 1 12.50 7 87.50
Pharmaceutics 0 0.00 2 100.00 0 0.00 2 100.00
Medicine 5 3.68 131 96.32 5 3.50 138 96.50
Nutrition 1 16.67 5 83.33 0 0.00 6 100.00
Obstetrics 0 0.00 3 100.00 0 0.00 3 100.00
Odontology 0 0.00 5 100.00 2 33.33 4 66.67
Psychology 8 17.78 37 82.22 7 14.00 43 86.00

Finally, regarding vocational attitudes, the means and standard deviations by career type can be
observed in table 6. No differences could be observed when comparing health sciences career versus
other careers (F (1,1133) = 0.55, p = 0.46). Also, when comparing the specific dreamed career in health
sciences no differences could be observed according to ANOVA (F (6,210) = 0.47, p = 0.83).

Table 6. Vocational attitude’s means and standard deviations for career type

Vocational Attitudes
M SD
Health sciences career 9.42 2.8
Other careers 9.58 2.85
Dreamed career
Nursery 10 2.45
Pharmaceutics 11.5 2.12
Medicine 9.51 2.9
Nutrition 8.83 2.93
Obstetrics 9.5 0.71
Odontology 9.5 3.51
Psychology 9.02 2.51

4 CONCLUSIONS
The career of medicine is the most preferred alternative for young people of both sexes who have
participated in the study, and men are the most inclined to choose this option. This finding corresponds
to what has been found in other studies, where men express this predilection to a greater extent. The
opposite is true for psychology (the second most preferred career according to gender), where women
prefer it more, which indicates that this profession continues to be a typically female alternative. It is
worth mentioning that gender stereotypes are also at work in some health science careers [4], [5], [6];
where the main problem is said to lie in the exclusion of women from certain professional fields.
However, it is striking that the other careers in the field of health are scarcely preferred by the subjects.
This is where there are some results that are not in line with the internationally registered trends, as is
the case of the nursing career, which does not enjoy any preferences. With regard to this last finding, it
is important to mention that this career (nursing) always stands out in the estimates as the profession
that is most needed in the health systems above the number of doctors.

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In allusion to the above, it is likely that a significant proportion of young people will decide to apply for
nursing on the basis of resources to enrol in alternatives such as medicine. Others, on the other hand,
and unable to gain admission to medicine through the entrance exam, would see professional nursing
as the closest alternative. In any case, this career has been going through a crisis due to the lack of
vocations throughout the continent [8].
As for the type of schools, the significant associations suggest that preferences are more concentrated
in private and subsidised schools. This would indicate the participation of the economic factor in
vocational inclinations; due to the fact that these careers (and despite the fact that they are studied in
public universities, which are free of charge) require greater economic investment, much more time and
a delay in incorporation into the economically active population. However, in public schools, preferences
for medicine were concentrated. Here, it should be noted that this study analyses preferences and that
these will not necessarily materialise in a formal incorporation into these studies. Therefore, longitudinal
research is needed to follow the behaviour of a cohort from the last year of secondary education and
over a period of 5 or 6 years. Similarly, qualitative studies would deserve to be developed to deepen the
results that we report here [9], [10].
Finally, one should consider the effects of the Covid-19 pandemic on vocational preferences and the
unprecedented exposure to health information that young students (and society as a whole) have had
in recent months [11], [20]. In this field, interest in these issues and a deeper understanding of health is
beginning to be reported [12]. In this way, the extension of these efforts could be projected to new
studies to be developed in Peru, as information (even more so when it has been painful) would not
necessarily be associated with interest.

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