Impact of adverse clinical training experiences on the career development of medical and psychology student

Clinical training is an integral part of medical and health service psychology education. These experiences offer valuable opportunities for students to develop applied skills and evaluate their interest in various specialty and practice areas; however, the power differential between trainees and supervisors also puts students at risk for harm. While prior research has explored the effects of adverse clinical training experiences on students' mental health, little is known about how negative training events affect students' career development.;Two hundred twenty-seven fourth-year MD students and 129 advanced doctoral students in clinical and counseling psychology participated in an anonymous online survey assessing the frequency with which students changed their career plans during school, the prevalence of adverse clinical training experiences during clerkship and practicum experiences, and the impact of these adverse events on students' (1) clinical self-efficacy, (2) perceived fit with specialty/setting, (3) perceived fit with profession, and (4) ultimate career choice. Seventy percent of medical students and 78% of psychology students entered their programs with a specific specialty or work setting in mind, and more than half of these participants changed their career plans during school. Both populations identified clinical training experiences as influential in their career-decision making.;Receiving inadequate supervision and being denied timely feedback were the most prevalent adverse training event among health service psychology students, while being subjected to counterproductive teaching methods and being denied timely feedback were the most frequently cited adverse clinical experience among medical students. Adverse clinical training events were found to influence students' career development on all four outcomes, and the magnitude of this impact was greatest on participants' perceived fit with the setting or specialty in which the event took place. There was an association between distress caused by an adverse event and the magnitude of its impact on career outcome variables in both samples, and these relationships were stronger among psychology students than medical students. Directions for future research, as well as recommendations for training stakeholder on the prevention of adverse training experiences and remediation of their negative impact, are discussed.