Helping others or improving the situation in the country - key factors when choosing health studies during Covid-19

The Covid-19 pandemic had an impact on the choice of bachelor's degree studies related to health. The most significant factors were the desire to help other people (33.2% of cases), enhance civic values (28.4%) and contribute to improving the situation in the country (27.5 %). Those results are apparent from the TEMPS research project led by the University of Vic - Central University of Catalonia (UVic-UCC), which aimed to study the impact of the pandemic on social-health and biomedical degree studies in Spain, and to examine the underlying factors that could contribute to this impact. Some of the results have recently been published in the journal BMC Medical Education, in an article entitled "The impact of the Covid-19 pandemic on enrolment in undergraduate health-related studies in Spain".

The cross-sectional study was conducted by means of an online survey of 2,344 Nursing, Physiotherapy, Medicine, Psychology and Podiatry students who began their health-related undergraduate studies in higher education institutions all over Spain after the outbreak of Covid-19. According to the research, women were influenced to a significantly greater extent in terms of the social value attached to the profession during the pandemic, while men and students taking the bachelor's degree in Podiatry were more influenced by the outlook in terms of salaries. The increase in the desire to help others was significantly greater among women and among Nursing and Medical students.

Podiatry and Psychology were the two study programmes most affected by Covid-19, as more students decided to study them, in contrast to before the pandemic. The pandemic further reinforced interest in studying the bachelor's degrees in Nursing, Psychology and Medicine. In addition, students who had been personally affected by Covid-19 said it was a major influence when they reconsidered their career path, and had reinforced their desire to pursue studies in higher education related to health.

The TEMPS project was organised by the MɜO (Methodology, Methods, Models and Outcomes of Health and Social Sciences) research group and the Grífols Foundation Bioethics Chair at UVic-UCC. The University of the Basque Country, the University of A Coruña, the University of Málaga, the University of La Rioja and the Complutense University of Madrid were also involved, as well as the Rioja Salud Foundation through the Bioethics and Medical Education Platform.

Changes in demand

Another branch of the TEMPS project was an analysis of the change in demand - the number of applications for enrolment divided by the number of places available - for bachelor's degree studies at university related to health in Spain between 2015 and 2021. It also aimed to compare the changes that took place in each region between the pre-pandemic (2015-2019) and pandemic (2020-2021) periods. In this ecological observational study, time series analyses were performed using data for public higher education institutions taken from the Spanish Integrated University Information System.

There was greater demand for qualifications in Biomedicine (85%), Medicine (29%), Nursing (26%), Dentistry (27%) and Pharmacy (15%) after the outbreak of the pandemic. However, this pattern did not apply to qualifications in Physiotherapy, Occupational Therapy, Podiatry, Psychology, Social Work, or Nutrition and Dietetics. A significant increase in the demand for bachelor's degree studies related to health, of over 27%, was observed in all regions of Spain during the pandemic. Navarre (203%), Asturias (83%) and La Rioja (77%) are the autonomous communities that experienced the most dramatic changes. The changes were more limited in regions with more universities, such as Catalonia, Andalusia and Madrid. 

Despite the fact that the database analysed does not include data on demand at private universities, the information provided by this study "may be useful for higher education institutions when planning for trends," according to Javier Jerez, the principal investigator of the project and the coordinator of the MɜO research group at UVic-UCC. He says that "this analysis could also help institutions in the health sector with their planning in terms of the workforce they need."

Qualitative results

The TEMPS project also included a qualitative aspect. One of the aspects that were addressed in the interviews with students was their experience of the pandemic, which was shown to have had a significant emotional dimension. Feelings such as confidence and peace of mind were replaced by disbelief, uncertainty, panic and fear. The pandemic has had an impact in employment, economic and social terms, and a common determining factor observed was the type of home where the interviewees lived. The thoughts of the interviewees concerning the consequences of the pandemic for society focus on the hope that this health crisis will trigger social change, but there is also some degree of resignation that nothing will ultimately happen.

As for how they had obtained their professional vocation, some of the interviewees found their vocation outside the health field, in more socially common professions for each generation - while other people were clearly focused on the field of health from the beginning. Reasons such as experience as a patient, being able to provide care or the usefulness to society that healthcare professionals are believed to have are very important factors when choosing health-related studies. Some of the reasons why the students had not started studying health-related fields earlier were of a financial nature, or related to difficulties with balancing study and family life. The interviewees did not begin their studies earlier due to the fact that the studies were only on-site, or because of the working conditions in these professions. Close acquaintances played a major role in all cases, which was sometimes negative (in the form of warnings about the working conditions) and sometimes positive (rating the contribution to society in a positive light).

As for the pandemic's influence on the choice of bachelor's degree course, the study shows that in some cases it had no influence (the student would have chosen it anyway), while in others it reinforced their decision and in others it created an opportunity, either in terms of the point in time they started or an opportunity to change profession to begin health studies.