Exploring how longitudinal integrated clerkships at Stellenbosch University influence the career journeys of medical graduates

Background. Longitudinal integrated clerkships (LICs) are increasingly being implemented across the globe for their educational benefits and the recruitment of rural medical practitioners. As new LICs are established, it is important to explore the extent to which these benefits manifest, and the influence of LICs on the career journeys of graduates. Stellenbosch University's LIC has been running for 11 years, and to date the career outcomes of graduates have not been described. Objectives. To explore factors that influence the career journeys of graduates from Stellenbosch University's LIC. Methods. An interpretivist, qualitative study was performed. Semi-structured interviews that were recorded and transcribed were conducted (8 graduates, =5 years after graduation). Inductive thematic analysis was done. Participants were asked to depict their career journeys. These pictures and an interview guide were used as prompts during the interviews. Results. Three themes were generated from the data: (i) feeling prepared for the career journey; (ii) acquiring a new motivation and career goals; and (iii) unexpected influences on career journeys. The availability of posts and transformative influences are important factors in the career journeys of LIC graduates. These graduates were enabled by their undergraduate training to explore non-traditional career options and preferred working in rural environments. Although individual priorities caused many participants to work in urban settings, they indicated a desire to return to rural environments. Conclusions. The LIC training at Stellenbosch University acts as a significant influence on the early career journeys of such graduates, which are possibly achieved in two ways. Firstly, LIC supports the development of professional identities among its graduates. Secondly, LIC supports transformative learning within a safe learning environment that leads to changes in perspectives regarding the graduates' responsibility towards patients and communities.