The impact of the COVID-19 pandemic on enrollment in undergraduate health-related studies in Spain

Ma ch‑Amenguale al.
BMC Medical Educa ion (2023) 23:386
h ps://doi.o g/10.1186/s12909‑023‑04347‑5
RESEARCH Open Access
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BMC Medical Educa ion
The impac o  heCOVID‑19 pandemic
onen ollmen inunde g adua e heal h‑ ela ed
s udies inSpain
Jaume‑Miquel Ma ch‑Amengual1,2, I ene Camb a‑Badii1,2,3*, Consolación Pineda Galán4,
Es e Busque s‑Alibés1,3, Mon se Masó Aguado1, Anna Ramon‑A ibau1, Lydia Fei o G ande5,
Agus í Comella Cayuela1,2, Nu ia Te ibas i Sala3, Elena And ade‑Gómez6, Naia a Ma ínez‑Pe ez7 and
Ja ie Je ez‑Roig1
Abs ac
The aim o his s udy was o de e mine whe he he pandemic has ein o ced he choice o pu suing heal h‑ ela ed
bachelo ’s deg ees, and o iden i y unde lying ac o s ha could con ibu e o ha impac . This is a c oss‑sec ional
s udy using an online su ey o 2,344 s uden s o nu sing, physio he apy, medicine, psychology and podia y who
s a ed heal h‑ ela ed bachelo ’s deg ees a e he COVID‑19 ou b eak in Spanish highe educa ion ins i u ions. The
pandemic in luenced he choice o hese s udies by inc easing he desi e o help o he s (33.2%), by inc easing ci i‑
zenship alues (28.4%), and by inc easing he desi e o con ibu e o imp o ing he si ua ion o he coun y (27.5%).
Women had a signi ican ly g ea e in luence on he inc ease in social alues ela ed o he p ac ice o he p o ession
p oduced by he pandemic, whe eas men and he bachelo ’s deg ee in podia y we e mo e in luenced by sala y
p ospec s. An inc eased desi e o help o he s was signi ican ly highe among women and nu sing and medical s u‑
den s. Podia y and psychology we e he deg ees we e mos in luenced by he pandemic, as mo e s uden s decided
o pu sue hem, some hing hey had p e iously doub ed, while in nu sing, psychology, and medicine he pandemic
ein o ced hei in e es in pu suing he deg ee he mos . S uden s pe sonally a ec ed by COVID‑19 epo ed being
mo e in luenced in econside ing hei p o essional pa h and in ein o cing hei desi e o pu sue he heal h‑ ela ed
s udies.
Keywo ds COVID‑19, Heal h, Educa ion, Highe , G adua e, S uden s, Social change
*Co espondence:
I ene Camb a‑Badii
i ene.camb a@u ic.ca
1 Resea ch G oup On Me hodology, Me hods, Models and Ou comes
o Heal h and Social Sciences (M3O), Facul y o Heal h Sciences
and Wel a e, Cen e o Heal h and Social Ca e Resea ch (CESS), Uni e si y
o Vic‑Cen al Uni e si y o Ca alonia (UVic‑UCC), Vic, Spain
2 Chai in Medical Educa ion, Uni e si y o Vic‑Cen al Uni e si y
o Ca alonia (UVic‑UCC), Vic, Spain
3 G í ols Founda ion Chai o Bioe hics, Uni e si y o Vic‑Cen al Uni e si y
o Ca alonia (UVic‑UCC), Vic, Spain
4 Depa men o Physio he apy, Uni e si y o Málaga, Málaga, Spain
5 Facul y o Medicine, Complu ense Uni e si y o Mad id, Mad id, Spain
6 Facul y o Heal h Sciences, La Rioja Uni e si y, Log oño, Spain
7 Depa men o Nu sing, Facul y o Medicine and Nu sing, Uni e si y
o he Basque Coun y UPV/EHU, Leioa, Spain
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Ma ch‑Amenguale al. BMC Medical Educa ion (2023) 23:386
Backg ound
The SARS-CoV-2 ou b eak and he subsequen COVID-
19 pandemic s a ed in Decembe 2019 and was decla ed
a global public heal h eme gency in Ma ch 2020. Espe-
cially du ing 2020, i led o an o e bu dening o local
heal hca e sys ems and o lockdowns and o he es ic-
i e measu es o con ol he sp ead o he disease.
F on line heal h p o essionals played a key ole in he
pandemic wo ldwide, acing unce ain y, excessi e wo k-
loads, and high exposu e o he i us [1, 2]. They also
ecei ed social ecogni ion and we e called he oes, e en
hough his e m was seen as p oblema ic [2].
One o he i s ocuses o esea ch s udies on he
e ec s o he pandemic on college s uden s was he
impac on men al heal h [3–9]. New s udies on he
ca ee pa h o heal h science unde g adua e s uden s also
eme ged, ocusing on how ca ee plans pos g adua ion
we e a ec ed by he COVID-19 pandemic [6, 10–12].
In China, app oxima ely one- i h o medical s uden s
epo ed an inc eased inclina ion o become a clinician
o o choose espi a o y medicine and in ec ious diseases
as hei u u e special ies [10]. Se e al s udies in he US
on s uden s o medicine [4, 10, 13], den is y and den-
al hygiene [14], u ology [15], and o ola yngology [16]
showed ha he COVID-19 pandemic may exe some
in luence on s uden s’ u u e medical ca ee choices.
A s udy ca ied ou in China a e he COVID-19 ou -
b eak in 2020 epo ed ha 6.7% o he s uden s eg e ed
hei ca ee choice because o bad expe iences associa ed
wi h iden i y, gende , and ha ing expe ienced physical
o e bal iolence [17]. These changes we e also s ud-
ied pa icula ly wi h den is y s uden s, which included
conce ns abou employmen , dis up ions, unce ain y in
pu suing al e na i e ca ee plans, and long- e m s abili y
in he p o ession [14]. S udies conduc ed in he US and
Canada iden i ied ha he pandemic a ec ed he choice
o medical special y in app oxima ely one- i h o medi-
cal s uden s [3, 4]. This may be a ibu ed o signi ican
ba ie s o p og ess in aining [4, 5, 10, 18–20] and he
nega i e impac o pe cei ed men al s ess du ing he
COVID-19 pandemic [21].
On he o he hand, s udies on nu sing s uden s ca -
ied ou in Japan [22] and in he US [23], and on medi-
cal s uden s in China [24], showed ha he pandemic
ein o ced he eeling o belonging o he p o ession and
alida ed hei in e es . In China, 86% o nu sing s uden s
poin ed ou a posi i e in luence on he image o nu sing
[25]. Also in China, he epo ed choice o nu sing as a
u u e ca ee inc eased om 51 o 63% a e he COVID-
19 pandemic [26]. In he US, nu sing s uden s epo ed
ha COVID-19 in luenced hei in e es in his ield [27].
P e ious esea ch on he impac o he COVID-19
pandemic on s uden s’ ca ee s has ocused on hei
pe cep ions and ideas [4, 11, 20, 24, 28–30]. The cu en
needs o socie y and he pe cep ion o a wo ldwide heal h
c isis ha ex ends in ime may ha e inc eased in e -
es in pu suing uni e si y deg ees ela ed o he heal h
and social sec o s. The cons an messages in he media
ega ding he indispensable ole o heal h p o ession-
als du ing he pandemic ega ding p e en ion, diagnosis
and ea men may ha e inc eased he in e es and he
in e es and he deg ee o ep esen a ion o heal h p o-
essions. Some p e ious esea ch sugges s ha because
o hese messages s uden s may ha e been highly mo i-
a ed o pu sue hese bachelo ’s deg ees, bo h ins u-
men ally and oca ionally, meaning ha hei mo i a ion
o s udy was la gely based on i s pe cei ed use ulness o
hei u u e success in hei chosen p o ession [31, 32].
Mo i a ion can be unde s ood as a “majo de e minan
o he quali y o lea ning and success” [33], and i can be
linked wi h se e al ac o s such as scien i ic in e es in
he heal h sciences, good job oppo uni ies, willingness
o help o se e o he s, amily’s medical backg ound and
many mo e [34, 35].
To he bes o ou knowledge, no s udies on he impac
o he COVID-19 pandemic on he mo i a ion o Span-
ish unde g adua e s uden s o pu sue heal h sciences
ha e been published. The e o e, we hypo hesized ha
he COVID-19 pandemic inc eased s uden s’ in e es
in choosing hese deg ees in Spain. We conduc ed his
s udy wi h he aim o de e mining whe he he pan-
demic has ein o ced he choice o pu suing unde g adu-
a e deg ees in heal h sciences, and o iden i y unde lying
ac o s ha could con ibu e o ha impac . The spe-
ci ic objec i es a e: 1) o desc ibe mo i a ional ac o s in
choosing heal h- ela ed bachelo ’s deg ees and o ana-
lyze di e ences by gende ; 2) o analyze he impac o
he COVID-19 pandemic in choosing a heal h- ela ed
bachelo ’s deg ee in Spain by gende and deg ee; 3) o
analyze he impac o he pandemic in choosing a heal h-
ela ed bachelo ’s deg ee in Spain a e being a ec ed by
COVID-19, i.e., s uden s ha ing con ac ed COVID-19
and s uden s wi h se e e COVID-19 o ha ing ela i es
wi h se e e COVID-19.
Me hods
Design
This is an obse a ional (c oss-sec ional) s udy using an
online su ey.
S udy popula ion
The a ge popula ion consis ed o s uden s (o
any age and gende ) who s a ed, o he i s ime,
heal h- ela ed bachelo ’s deg ees (nu sing, physi-
o he apy, medicine, psychology, occupa ional he apy,
podia y, pha macy, nu i ion, social wo k, biomedical
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Ma ch‑Amenguale al. BMC Medical Educa ion (2023) 23:386
enginee ing, biomedical sciences and human biology)
a e he COVID-19 pandemic – i.e., he academic yea s
2020–21 and 2021–22 – in Spanish highe educa ion
ins i u ions (p i a e, public o mixed).
We con ac ed highe educa ion ins i u ions in Spain o
in o m hem abou he p ojec and ask o hei pa ici-
pa ion. Then we used h ee s a egies o each s uden s in
he pa icipa ing ins i u ions: du ing a scheduled lec u e
(a leas one p ojec membe joined he ace- o- ace o
online lec u e); h ough an e-mail o message wi h a link
o he su ey; and indi ec ly h ough social media (using
Twi e and Ins ag am).
Sampling selec ion andsample size
The sampling sou ce was i s -yea unde g adua e s u-
den s en olled in a Spanish uni e si y in nu sing, physi-
o he apy, medicine, psychology, and podia y bachelo ’s
deg ees.
– Inclusion c i e ia: s uden s en olled o he i s ime
in he i s yea o hese bachelo ’s deg ees in he aca-
demic yea s 2020–21 and 2021–22.
– Exclusion c i e ia: S uden s o o he bachelo ’s
deg ees, second-yea s uden s ha ha e epea ed a
subjec in he i s yea o he deg ee, s uden s no
en olled in Spanish uni e si ies. To imp o e he
e aci y o he da a, wo con ol ques ions o he
ob ious co ec answe ype we e included in he
ques ionnai e: 1. The COVID-19 pandemic has made
people wash hei hands mo e equen ly; 2. The
COVID-19 pandemic has made people ha e o wea
a mask in public places. Ques ionnai es in which
he wo con ol ques ions con ained w ong answe s
(s ongly o somewha disag ee) we e excluded.
– Sample size: he s udy popula ion included a o al
o 50,013 s uden s di ided in o wo coho s, 25,001
s uden s o he academic yea 2020–21 and 25,012
o he academic yea 2021–22. To calcula e he ep-
esen a i eness o he sample, he numbe o places
o e ed in Spanish uni e si ies o he academic yea s
2020–21 and 2021–22 was conside ed. This in o ma-
ion is a ailable in he da abase o he Gene al Sec e-
a ia o Uni e si ies o he Minis y o Uni e si ies
(Go e nmen o Spain) [36]. Only bachelo ’s deg ees
wi h a 10% o lowe sampling e o we e included.
O e all, 3,070 comple ed ques ionnai es om s u-
den s om 34 Spanish uni e si ies we e ecei ed.
The esponse a e calcula ed om he numbe o
accesses o he online ques ionnai e link (7,614)was
40.3%. A e applying eligibili y and exclusion c i e-
ia, 2,344 we e included in his s udy (see Fig.1): 844
nu sing s uden s, 602 physio he apy s uden s, 459
medical s uden s, 308 psychology s uden s and 131
podia y s uden s. 2,216 (94.5%) came om uni e -
si y ec ui men and 128 (5.5%) came om ec ui -
men ia social ne wo ks. The a e o alid esponses
ecei ed was 30.8% (35.7% o esponses ecei ed
h ough uni e si y ec ui men and 9.1% o ec ui -
men h ough social ne wo ks).
The o e all sampling e o o bo h coho s was 2.0%
(95% CI) and 2.7% o coho 20/21 and 3.0% o coho
21/22 (see Supplemen a y Table1).
Da a collec ion ins umen and a iables s udied
The online su ey was buil wi h he Encues aFacil pla -
o m (h ps:// www. encue s a a cil. com/) and consis ed o
sociodemog aphic in o ma ion and da a ega ding he
main ac o s in luencing he s uden s’ ca ee choices and
he impac o COVID-19 on hei heal h, hei social ela-
ionships and choice o deg ee. The sel - epo ing ques-
ionnai e was p epa ed by he esea ch eam based on
p e ious s udies [3, 22, 37].
The ques ionnai e was composed o 32 ques ions: 19
sociodemog aphic ques ions, 11 s udy ques ions on
mo i a ion and he impac o he pandemic on he choice
o he bachelo ’s deg ee, and 2 con ol ques ions. Mos o
he ques ions we e closed-ended.
The ollowing sociodemog aphic a iables we e
included: age, gende , na ionali y, en olled in a heal h-
ela ed bachelo ’s deg ee, academic yea (2020–21 o
2021–22), housing ( amily home, s uden housing,
sha ed o indi idual place), s udy unding ( amily, wo k,
schola ship and/o s udy loan), amily mon hly income
(≤ 499, 500–999, 1000–1499, 1500–1999, 2000–2499,
2500–2999, 3000–4999, ≥ 5000 eu os) and expe ience
wo king in he socio-heal h and/o biomedical sec-
o (no/yes). Fo he pu pose o his s udy, we asked o
s uden s’ pe sonal his o y o COVID-19 and COVID-19
cases (no/yes) among ela i es, iends o cohabi an s. I
any esponse was a i ma i e, he pa icipan was asked
i he e ec s o p og ession o he illness we e se e e.
The nex se o ques ions/s a emen s e e ed o eigh
possible ac o s a ec ing hei choice o a heal h- ela ed
bachelo ’s deg ee: willingness o help o he s, oca ion,
in e es in he con en , amily adi ion, job pe spec i es,
abili y o ind a job, job p es ige and good sala y. Among
hese, s uden s we e asked o selec up o h ee ac o s.
The ollowing se consis ed o 10 ques ions/s a emen s
abou he impac o he pandemic on: 1. econside ing
he ca ee pa h; 2. s udying he heal h- ela ed deg ee
( ha was p e iously unclea ); 3. u he s eng hening
he willingness o pu sue he heal h- ela ed deg ee; 4.
choosing he deg ee because o he desi e o help o he s;
5. choosing he deg ee because o he desi e o con ib-
u e o imp o ing he si ua ion in he coun y; 6. choosing
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Ma ch‑Amenguale al. BMC Medical Educa ion (2023) 23:386
he deg ee because i inc eased he eeling o belong-
ing o he communi y; 7. choosing he deg ee because i
inc eased ci izenship alues; 8. choosing he deg ee due
o good employmen p ospec s; 9. choosing he deg ee
due o good sala y p ospec s; 10. choosing he deg ee due
o he inc eased p es ige o he p o ession. A 5-poin Lik-
e scale om 1 (s ongly disag ee) o 5 (s ongly ag ee)
was c ea ed. Responses we e dicho omized in 4 and 5 as
high- e y high impac e sus 1–3 as no o low impac .
To es he ques ionnai e, a pilo s udy was conduc ed
on 106 s uden s om one Spanish uni e si y om Ma ch
o Ap il 2021. Pa icipan s we e asked abou he cla -
i y o ques ions; only se en epo ed ha ing p oblems
unde s anding one o mo e ques ions, and hei ecom-
menda ions we e conside ed o he inal e sion o he
su ey. These modi ica ions we e no subs an ial, and
hese esponses we e included in he inal sample.
Adminis a ion p ocedu e
The inal su ey was opened be ween 21 Ap il 2021 and
24 May 2022.
Fig. 1 Sample selec ion low‑cha o heal h‑ ela ed unde g adua e s uden s in Spain
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Ma ch‑Amenguale al. BMC Medical Educa ion (2023) 23:386
– Me hods o sending he su ey: in mos cases, he
su ey was sen by email, con aining a b ie p esen-
a ion o he s udy wi h a link o he ques ionnai e
o s uden s en olled in he pa icipa ing uni e si-
ies. A b ie ace- o- ace p esen a ion explaining he
pu pose o he s udy and encou aging pa icipa ion
was also made a he pa ne uni e si ies. We in o-
duced se e al con ol mechanisms associa ed wi h
he online su ey design. The Encues a acil pla o m
allows o con igu e a single and manda o y esponse
o ce ain ques ions, which educes esponse e o s
and blank da a. In addi ion, se e al online mailboxes
we e used o da a collec ion, one o each o he i e
pa ne uni e si ies o he p ojec , one mailbox o
o he uni e si ies, and ano he mailbox o he col-
lec ion o esponses h ough ec ui men ia social
ne wo ks.
– Incen i es o pa icipa ion: he e we e no incen i es
o pa icipa ion.
– Response ime: he es ima ed esponse ime o he
ques ionnai e was i e minu es.
– Follow-up and eminde s: se e al eminde s encou -
aging pa icipa ion we e made a he pa icipa ing
uni e si ies.
Da a analysis
A desc ip i e analysis was pe o med o de e mine he
cha ac e is ics o he sample. Fo quan i a i e a iables,
he mean and s anda d de ia ion we e shown. None o
he o dinal a iables had no mal dis ibu ion (Kolmogo-
o –Smi no es ). Fo he associa ion o nominal a i-
ables, Pea son’s Chi-squa e es was used. The Chi-squa e
es o linea end, also called linea by linea associa-
ion, was used o analyze si ua ions in which an o de ed
exposu e a iable con ains h ee o mo e ca ego ies, and
he ou come a iable is o bina y ype. All analyses we e
pe o med wi h SPSS e sion 28.
Rega ding he eliabili y o he ques ionnai e, i was
calcula ed by C onbach’s alpha o he ques ionnai e,
which was 0.873—exceeding he limi o 0.8 o basic
esea ch [38–40]. An explo a o y ac o analysis was
pe o med wi h esul s o Kaise –Meye –Olkin (KMO
0.874 (p < 0.001). To al a iance explained 60.1%, which
is wi hin he accep able limi o social s udies o 60%
[41], wi h a ac o ial s uc u e o 3 ac o s (maximum
likelihood ex ac ion me hod and oblimin o a ion ac o ).
Fac o 1 included social a iables (Con ibu ing o he
coun y, Belonging o he communi y, Ci izenship alues,
Helping o he s, Rein o cing willingness), ac o 2 occupa-
ional a iables (Sala y p ospec s, P ospec s o employ-
men , Inc eased p es ige), and ac o 3 econside a ion
a iables (P e iously unclea , Reconside ing p o essional
pa h).
E hical aspec s
The s udy was ca ied ou in acco dance wi h he Hel-
sinki Decla a ion, he Gene al Regula ion (EU) 2016/679
o Ap il 27 and he Spanish O ganic Law 3/2018 o
Decembe 5 on he p o ec ion o pe sonal da a and gua -
an ee o digi al igh s. Pa icipa ion was olun a y and
anonymous, and each pa icipan was in o med abou
he objec i es o he p ojec and he op ion o abandon
he su ey a any ime. In o med consen was ob ained
om all he pa icipan s. The s udy was app o ed by he
E hics Commi ee o he Uni e si y o Vic-Cen al Uni-
e si y o Ca alonia (code 145/2021).
Resul s
O e all, 3,070 ques ionnai es om s uden s o 34 Span-
ish uni e si ies we e ecei ed. A e applying eligibili y
c i e ia, 2,344 we e included in his s udy (see Fig.1): 844
nu sing s uden s, 602 physio he apy s uden s, 459 medi-
cal s uden s, 308 psychology s uden s and 131 podia y
s uden s.
Table1 includes a desc ip i e analysis o he sample.
Mos pa icipan s we e emale (1,767; 75.5%), and he
mean age o he sample was 21.1; 2,025 (86.4%) we e
Spanish and 1,293 (55.2%) li ed wi h hei amilies; 1,786
(76.3%) s uden s epo ed a amily income be ween 1,000
and 4,999€. The majo i y o he s uden s (1,891; 80.7%)
had amily suppo o pay o hei s udies, and 780
(33.3%) had a schola ship; 438 (19.2%) had wo k expe i-
ence in he socio-heal h and/o biomedical sec o , and
o hese 307 (70.3%) we e ac i e du ing he pandemic.
O he sample analyzed, 706 (30.1%) s uden s epo ed
ha ing su e ed om COVID-19, and 60 (2.6%) epo ed
ha ing se ious complica ions o sequelae. 1,832 (78.2%)
had a amily membe , cohabi an o close iend wi h
COVID-19, and 483 (20.6%) had complica ions o se e e
e ec s.
Table 2 includes gene al ac o s a ec ing he choice
o heal h- ela ed bachelo ’s deg ees. The mos selec ed
mo i a ional ac o was willingness o help o he s, ol-
lowed by oca ion and in e es in he con en . Family a-
di ion, p o essional p es ige and pe spec i es o a good
sala y, on he o he hand, we e he leas selec ed i ems.
When compa ing gende s, women we e signi ican ly
mo e p one o choose a heal h- ela ed bachelo ’s deg ee
o help o he s (+ 12.3%) and oca ion (+ 9.0%). Men we e
signi ican ly mo e mo i a ed by good sala y p ospec s
(+ 14.5%) and job p es ige (+ 6.0%).
O e all, 985 (42.0%) pa icipan s indica ed ha he
pandemic ein o ced hei willingness o choose a

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Table 1 Sociodemog aphic cha ac e is ics o pa icipan s (n = 2,344)
Va iables Academic yea 20–21 Academic yea 21–22 To al
n = 1,294 n = 1,050 n = 2,344
n o mean (% o s anda d de ia ion)
Gende
Female 1,006 (77.7) 761 (72.5) 1,767 (75.4)
Male 284 (21.9) 282 (26.9) 566 (24.1)
O he 4 (0.3) 7 (0.7) 11 (0.5)
Age (yea s), ange 17–60 21.36 (6.26) 20.82 (5.82) 21.12 (0.07)
Coun y o o igin
Spain 1,118 (86.4) 907 (86.4) 2,025 (86.4)
O he om Eu ope 140 (10.8) 118 (11.2) 258 (11.0)
Ame ica 27 (2.1) 19 (1.8) 46 (2.0)
A ica 5 (0.4) 4 (0.4) 9 (0.4)
Asia 3 (0.2) 2 (0.2) 5 (0.2)
Oceania 1 (0.1) 0 (0) 1 (0.1)
Regions
Andalusia 230 (17.8) 224 (21.3) 454 (19.4)
A agon 38 (2.9) 18 (1.7) 56 (2.4)
Balea ic Islands 40 (3.1) 54 (5.1) 94 (4.0)
Basque Coun y 126 (9.7) 105 (10.0) 231 (9.9)
Cana y Islands 9 (0.7) 18 (1.7) 27 (1.2)
Can ab ia 14 (1.1) 13 (1.2) 27 (1.2)
Cas ile and Leon 42 (3.2) 45 (4.3) 87 (3.7)
Cas ile‑La Mancha 13 (1.0) 11 (1.0) 24 (1)
Ca alonia 272 (21.0) 225 (21.4) 497 (21.2)
Communi y o Mad id 128 (9.9) 56 (5.3) 184 (7.8)
Ex emadu a 6 (0.5) 19 (1.8) 25 (1.1)
Galicia 97 (7.5) 24 (2.3) 121 (5.2)
La Rioja 15 (1.2) 12 (1.1) 27 (1.2)
Na a e 11 (0.9) 13 (1.2) 24 (1.0)
P incipali y o As u ias 11 (0.9) 5 (0.5) 16 (0.7)
Region o Mu cia 11 (0.9) 7 (0.7) 18 (0.8)
Valencian Coun y 23 (1.8) 45 (4.3) 68 (2.9)
Fo eigne s 32 (2.5) 13 (1.2) 45 (1.9)
No speci ied 176 (13.6) 143 (13.6) 319 (13.6)
Bachelo
Nu sing 520 (40.2) 324 (30.9) 844 (36.0)
Physio he apy 339 (26.2) 263 (25.0) 602 (25.7)
Medicine 229 (17.7) 230 (21.9) 459 (19.6)
Psychology 167 (12.9) 141 (13.4) 308 (13.1)
Podia y 39 (3.0) 92 (8.8) 131 (5.6)
Housing
Family esidence 798 (61.7) 495 (47.1) 1,293 (55.2)
S uden esidence 162 (12.5) 214 (20.4) 376 (16)
Sha ed place 275 (21.3) 275 (26.2) 550 (23.5)
Indi idual place 59 (4.6) 66 (6.3) 125 (5.3)
Funding sou ce
Family 1,037 (80.1) 854 (81.3) 1,891 (80.7)
Schola ship 443 (34.2) 337 (32.1) 780 (33.3)
Job 233 (18.0) 196 (18.7) 429 (18.3)
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heal h- ela ed bachelo ’s deg ee. In addi ion, a p opo -
ion o hem epo ed ha he pandemic had had an in lu-
ence on he ype o s udy hey chose: 779 (33.2%) we e
mo i a ed by he desi e o help o he s, 666 (28.4%) by
he desi e o inc ease ci izenship alues, and 645 (27.5%)
by he desi e o imp o e he si ua ion o he coun y. A
lowe p opo ion o s uden s e e ed o a g ea e in e -
es in choosing a bachelo ’s deg ee o socioeconomic
easons: 594 (25.3%) because i inc eased employmen
p ospec s, and 497 (21.2%) because i inc eased p o es-
sional p es ige. The emaining ac o s/i ems had posi i e
esponses wi h a p opo ion o lowe han 20.0%.
Table3 shows he esul s o he bi a ia e analysis by
gende . Women we e signi ican ly mo e in luenced by
he pandemic in wan ing o s udy he ca ee . They also
had a signi ican ly g ea e in luence on he inc ease in
social alues ela ed o he p ac ice o he p o ession p o-
duced by he pandemic: ein o cemen o he in e es
in choosing a heal h- ela ed bachelo ’s deg ee, helping
o he s, ci izenship alues, con ibu ion o he coun y,
belonging o he communi y, econside ing p o essional
pa h and employmen p ospec s. On he o he hand, a
signi ican ly highe p opo ion o men epo ed choosing
he deg ee o sala y p ospec s.
In he analysis by bachelo ’s deg ee (Table 4), he e
we e signi ican di e ences in 5 o he 10 a iables. Mo e
s uden s o nu sing (450; 53.3%), psychology (139; 45.1%)
and medicine (200; 43.6%) epo ed ha he pandemic
ein o ced hei in e es in choosing he deg ee. The
in luence o he pandemic on an inc eased desi e o help
o he s was signi ican ly supe io in nu sing (319; 37.8%)
and medicine (171; 37.3%). Also, he impac on he eel-
ing o belonging o he communi y was s onge in s u-
den s o nu sing (190; 22.5%) and medicine (89; 19.4%).
Podia y was he deg ee wi h a signi ican ly highe p o-
po ion o s uden s (39; 29.8%) epo ing he in luence o
Table 1 (con inued)
Va iables Academic yea 20–21 Academic yea 21–22 To al
n = 1,294 n = 1,050 n = 2,344
n o mean (% o s anda d de ia ion)
Loan 75 (5.8) 57 (5.4) 132 (5.6)
Family income (eu os)
≤ 499 86 (6.6) 80 (7.6) 166 (7.1)
500–999 130 (10) 83 (7.9) 213 (9.1)
1000–1499 244 (18.9) 161 (15.3) 405 (17.3)
1500–1999 191 (14.8) 148 (14.1) 339 (14.5)
2000–2499 191 (14.8) 156 (14.9) 347 (14.8)
2500–2999 154 (11.9) 131 (12.5) 285 (12.2)
3000–4999 215 (16.6) 195 (18.6) 410 (17.5)
≥ 5000 83 (6.4) 96 (9.1) 179 (7.6)
Expe iencea (missing = 58)
No 1,031 (83.1) 817 (78.1) 1,848 (80.8)
Yes 209 (16.9) 229 (21.9) 438 (19.2)
Du ing he Pandemic 145 (69.4) 162 (71.1) 307 (70.3)
a Expe ience wo king in he socio‑heal h and/o biomedical sec o
Table 2 Desc ip i e and bi a ia e analysis (by gende ) o he mo i a ional ac o s o choose a heal h‑ ela ed deg ee (n = 2,333)
* S a is ically signi ican (< 0.05)
To al n (%) Women n (%) Men n (%) Chi p alue
Helping o he s 1,812 (77.3) 1,419 (80.3) 385 (68) 36.896 < 0.001*
Voca ion 1,381 (58.9) 1,079 (61.1) 295 (52.1) 14.165 < 0.001*
In e es in con en 1,310 (55.9) 995 (56.3) 305 (53.9) 1.020 0.312
Good p o essional oppo uni ies 749 (32) 542 (30.7) 203 (35.9) 5.317 0.021*
Good sala y p ospec s 337 (14.4) 192 (10.9) 144 (25.4) 10.594 < 0.001*
P ospec s o employmen 298 (12.7) 218 (12.3) 79 (14) 1.013 0.314
Wo k p es ige 199 (8.5) 125 (7.1) 74 (13.1) 19.780 < 0.001*
Family adi ion 79 (3.4) 53 (3) 26 (4.6) 3.330 0.068
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he pandemic on sala y p ospec s. Podia y (136; 17.6%)
and psychology (136; 16.9%) we e he deg ees in which
mo e new s uden s decided o en oll (be o e he pan-
demic hey had di e en in e es s). Di e ences be ween
deg ees we e no s a is ically signi ican o he emain-
ing a iables.
Table5 shows he esul s o he bi a ia e analysis o
he COVID-19 a iables. S uden s in ec ed by he dis-
ease p esen ed a highe (+ 3.7%) in luence o he pan-
demic on econside ing hei p o essional pa h. S uden s
a ec ed mo e, i.e., who hemsel es se e ely su e ed he
disease o who had ela i es ha did, epo ed being
mo e in luenced by he pandemic in he econside a ion
o hei p o essional pa h (+ 4.9%), in he ein o cemen
o hei willingness o pu sue a heal h- ela ed bachelo ’s
deg ee (+ 5.6%) and in he ecen decision o pu sue i
(+ 3.2%). The es o he compa isons we e no s a is i-
cally signi ican .
In o de o be e s udy he impac o he pandemic,
s uden s we e ini ially asked om a se o ac o s which
ones had made hem s udy he deg ee and hen asked
abou he in luence he pandemic had had on hese ac-
o s. Table6 shows he s uden s who we e mos in lu-
enced by he pandemic in hei choice o deg ee. S uden s
who ini ially did no indica e his ac o as in luencing
hei choice o deg ee and la e s a ed ha he pandemic
had in luenced hem o conside his ac o as a de e -
minan de e minan a e he ones mos in luenced by he
pandemic wi h ega ds o he ac o s s udied.
Table 3 Analysis o he impac o he COVID‑19 pandemic in choosing a heal h‑ ela ed deg ee in Spain by gende (n = 2,333)
* S a is ically signi ican
a One‑sample binomial success a e (Cloppe ‑Pea son)
To al n (%) [95% CI]aWomen n (%) [95% CI]aMen n (%) [95% CI]aChi p alue
Reconside ing p o essional pa h 411 (17.5) [0.16—0.191] 327 (18.5) [0.167—0.204] 84 (14.8) [0.12—0.18] 3.967 0.046*
P e iously unclea 256 (10.9) [0.097—0.123] 203 (11.5) [0.1—0.131] 52 (9.2) [0.069—0.119] 2.332 0.127
Rein o cing willingness 985 (42.0) [0.4—0.441] 802 (45.4) [0.43—0.477] 178 (31.4) [0.276—0.355] 34.19 < 0.001*
Helping o he s 779 (33.2) [0.313—0.352] 610 (34.5) [0.323—0.368] 164 (29.0) [0.253—0.329] 5.949 0.015*
Con ibu ing o he coun y 645 (27.5) [0.257—0.294] 529 (29.9) [0.278—0.321] 113 (20.0) [0.167—0.235] 21.377 < 0.001*
Belonging o he communi y 435 (18.6) [0.17—0.202] 368 (20.8) [0.19—0.228] 67 (11.8) [0.093—0.148] 22.834 < 0.001*
Ci izenship alues 666 (28.4) [0.266—0.303] 541 (30.6) [0.285—0.328] 125 (22.1) [0.187—0.257] 15.299 < 0.001*
P ospec s o employmen 594 (25.3) [0.236—0.272] 469 (26.5) [0.245—0.287] 124 (21.9) [0.186—0.255] 4.856 0.028*
Sala y p ospec s 374 (16.0) [0.145—0.175] 260 (14.7) [0.131—0.165] 112 (19.8) [0.166—0.233] 8.234 0.004*
Inc eased p es ige 497 (21.2) [0.196—0.229] 369 (20.9) [0.19—0.229] 127 (22.4) [0.191—0.261] .619 0.431
Table 4 Analysis o he impac o he COVID‑19 pandemic in choosing a heal h‑ ela ed deg ee in Spain, by bachelo (n = 2,344),
acco ding o linea ‑by‑linea associa ion es
* S a is ically signi ican (< 0.05)
Nu sing n (%) Physio he apy n (%) Medicine n (%) Psychology n (%) Podia y n (%) Linea -
by-Linea
Associa ion
p alue
Reconside ing p o essional
pa h 175 (20.7) 75 (12.5) 55 (12.0) 83 (26.9) 23 (17.6) 45.365 0.913
P e iously unclea 100 (11.8) 51 (8.5) 30 (6.5) 52 (16.9) 23 (17.6) 30.714 0.010*
Rein o cing willingness 450 (53.3) 158 (26.2) 200 (43.6) 139 (45.1) 38 (29.0) 116.478 < 0.001*
Helping o he s 319 (37.8) 169 (28.1) 171 (37.3) 91 (29.5) 29 (22.1) 27.646 0.001*
Con ibu ing o he
coun y 263 (31.2) 128 (21.3) 135 (29.4) 89 (28.9) 30 (27.5) 19.946 0.173
Belonging o he com‑
muni y 190 (22.5) 88 (14.6) 89 (19.4) 51 (16.6) 17 (13.0) 5.551 0.018*
Ci izenship alues 277 (32.8) 156 (25.9) 116 (25.3) 81 (26.3) 36 (27.5) 12.866 0.214
P ospec s o employmen 257 (30.5) 127 (21.1) 87 (19.0) 87 (28.2) 36 (27.5) 28.966 0.734
Sala y p ospec s 136 (16.1) 106 (17.6) 55 (12.0) 38 (12.3) 39 (29.8) 28.296 0.001*
Inc eased p es ige 196 (23.2) 113 (18.8) 84 (18.3) 77 (25.0) 27 (20.6) 9.192 0.778
Page 9 o 13
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Fou hund ed se en y- h ee s uden s (20.3%) we e
in luenced by he pandemic o s udy he deg ee because
o good employmen p ospec s. he occupa ion pe spec-
i es. This is he only ac o ha p esen s signi ican di -
e ences be ween men and women, whe e women ha e
a highe pe cen age han men (+ 4.2%). Fou hund ed
six s uden s (17.4%) we e in luenced by he pandemic o
choose he deg ee o inc ease hei p o essional p es ige,
253 (10.8%) because o good sala y p ospec s and 106
(4.5%) because o he desi e o help o he s.
Discussion
The p esen s udy in es iga ed he impac o he COVID-
19 pandemic on he choice o heal h- ela ed unde g adu-
a e s udies in Spain, and one o i s main indings was ha
he pandemic a ec ed ca ee choice and mo i a ions in a
signi ican p opo ion o s uden s. This was mo e e iden
among s uden s a ec ed by COVID-19, since whe he
hey hemsel es o a close ela i e su e ed he disease;
he pandemic ein o ced hei in e es in pu suing a
heal h- ela ed bachelo ’s deg ee. Di e ences be ween
gende s and deg ees we e also obse ed o some de e -
mining ac o s.
Rega ding he gene al mo i a ing ac o s o pu sue
hese ypes o s udies, he mos selec ed ones in ou
sample we e he willingness o help o he s, oca ion and
in e es in he con en . Heal hca e s uden s usually pu -
sue hei u u e p o ession due o in insic ac o s such
as pe sonal mo i a ions (e.g., in e es in he sciences) and
humani a ian ac o s (e.g., se e he communi y, help and
ca e o o he s), sociodemog aphic ac o s (e.g. gende ,
socioeconomic s a us), ex insic ac o s (e.g., employabil-
i y, inancial secu i y, expec a ions o sala y, di e si y o
job oppo uni ies) and in e pe sonal ac o s (e.g., am-
ily, iends, p es ige, social in luence and ecogni ion [34,
37]. Acco ding o a p e ious s udy, hese media o s we e
al e ed du ing he COVID-19 pandemic, no only in he
en olled unde g adua e s uden s [14] bu also in u u e
s uden s conside ing s udying a heal h- ela ed deg ee,
because he main in e es s we e ocused on he desi e o
help o he s, ein o ce ci izenship alues, and imp o e he
coun y’s si ua ion. The speci ic ac o s ha can media e
he impac o he pandemic on unde g adua e s uden s
may be classi ied in sociodemog aphic (e.g., age, gende ),
con ex ual and socioeconomic (income, u ban a ea),
heal h- ela ed (e.g., men al heal h, o e all heal h s a us)
and pandemic- ela ed (e.g., exposu e o nega i e in o -
ma ion, expe iences du ing he pandemic) e ms.
Mos p e ious s udies on he impac o COVID-19 on
uni e si y s uden s ha e ocused on he e ec s on men-
al heal h due o he es ic ions associa ed wi h he
pandemic [42]. This phenomenon could ha e enhanced
Table 5 Analysis o he impac o he COVID‑19 pandemic in choosing a heal h‑ ela ed deg ee in Spain, a e being a ec ed by
COVID‑19 (n = 2,344), acco ding o Chi squa e es
* S a is ically signi ican (< 0.05)
a S uden s in ec ed by COVID‑19
b S uden s wi h se e e COVID‑19 o ha ing ela i es wi h se e e COVID‑19
COVID-19aSe e e COVID-19b
Yes n (%) No n (%) Chi p alue Yes n (%) No n (%) Chi p alue
Reconside ing p o essional pa h 142 (20.1) 269 (16.4) 4.648 0.031* 115 (21.1) 296 (16.2) 9.54 0.002*
P e iously unclea 81 (11.5) 175 (10.7) 0.316 0.574 70 (13.4) 186 (10.2) 4.35 0.037*
Rein o cing willingness 300 (42.5) 685 (41.8) 0.920 0.762 242 (46.4) 743 (40.8) 5.39 0.020*
Helping o he s 248 (31.1) 531 (32.4) 1.633 0.201 181 (34.7) 598 (32.8) 0.686 0.408
Con ibu ing o he coun y 197 (27.9) 448 (27.4) 0.076 0.783 151 (29.0) 494 (27.1) 0.722 0.396
Belonging o he communi y 127 (18.0) 308 (18.8) 0.217 0.642 116 (22.3) 319 (17.5) 6.090 0.014*
Ci izenship alues 188 (26.6) 478 (29.2) 1.581 0.209 140 (26.9) 526 (28.9) 0.783 0.376
P ospec s o employmen 194 (27.5) 400 (24.4) 2.440 0.118 125 (24.0) 469 (25.7) 0.644 0.422
Sala y p ospec s 127 (18.0) 247 (15.1) 3.114 0.078 75 (14.4) 299 (16.4) 1.216 0.270
Inc eased p es ige 169 (23.9) 328 (20.0) 4.52 0.033* 107 (20.5) 390 (21.4) 0.178 0.673
Table 6 Desc ip i e and bi a ia e analysis (by gende ) o he
impac o he pandemic on he ac o s ha mos in luenced
s uden s’ choice o deg ee. (n = 2,333)
* S a is ically signi ican (< 0.05)
To al Women Men
n (%) n (%) n (%) Chi p alue
Helping o he s 106 (4.5) 74 (4.2) 31 (5.5) 1.658 0.198
P ospec s o
employmen 473 (20.3) 376 (21.3) 97 (17.1) 4.548 0.033*
Sala y p ospec s 253 (10.8) 193 (10.9) 60 (10.6) 0.046 0.830
Inc eased p es ige 406 (17.4) 313 (17.7) 93 (16.4) 0.491 0.484