PubMed · 10205576
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P M Heisler. 1998. Consider this career path.. https://pubmed.ncbi.nlm.nih.gov/10205576/
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CONTEXT: Recent specialty choices of graduating US medical students suggest that lifestyle may be an increasingly important factor in their career decision making. OBJECTIVE: To determine whether and to what degree controllable lifestyle and other specialty-related characteristics are associated with recent (1996-2002) changes in the specialty preferences of US senior medical students. DESIGN AND SETTING: Specialty preference was based on analysis of results from the National Resident Matching Program, the San Francisco Matching Program, and the American Urological Association Matching Program from 1996 to 2002. Specialty lifestyle (controllable vs uncontrollable) was classified using earlier research. Log-linear models were developed that examined specialty preference and the specialty's controllability, income, work hours, and years of graduate medical education required. MAIN OUTCOME MEASURE: Proportion of variability in specialty preference from 1996 to 2002 explained by controllable lifestyle. RESULTS: The specialty preferences of US senior medical students, as determined by the distribution of applicants across selected specialties, changed significantly from 1996 to 2002 (P<.001). In the log-linear model, controllable lifestyle explained 55% of the variability in specialty preference from 1996 to 2002 after controlling for income, work hours, and years of graduate medical education required (P<.001). CONCLUSION: Perception of controllable lifestyle accounts for most of the variability in recent changing patterns in the specialty choices of graduating US medical students.
CONTEXT: Trends in career choice among specialties have varied greatly. Most notable is the recent decrease in the percentage of US medical student graduates choosing a primary care career, which has important implications for the US physician workforce. OBJECTIVE: To review temporal trends in career choice by graduates of allopathic US medical schools, focusing on US medical doctors entering residencies since 1987. DATA SOURCES: Three databases, the Association of American Medical Colleges Graduation Questionnaire (AAMC GQ), the National Resident Matching Program, and the national Graduate Medical Education census, were used to review temporal trends in the number of US medical doctors entering residencies in primary care, general or subspecialty surgical, and non-primary care and nonsurgical specialties from 1987 to 2002. DATA SYNTHESIS: In 1987, 49.2% of all medical school graduates matched to one of the generalist residencies (internal medicine, pediatrics, or family medicine). The percentage of students matching to primary care specialties declined in the early 1990s, peaked at 53.2% in 1998, and declined to 44.2% in 2002. Concurrent with the latter decline, AAMC GQ data showed a decrease in medical student interest in primary care careers (35.6% in 1999 to 21.5% in 2002). The total percentage of US medical doctors matching to general or subspecialty surgical residencies remained stable at 11% to 12% from 1987 to 2002. During this same period, emergency medicine and plastic surgery increased as a match choice, while anesthesiology, pathology, and psychiatry were more variable over time. CONCLUSIONS: Distribution of medical students' career choices among specialties varied considerably from 1987 to 2002. The debate will continue regarding the appropriate specialty mix within the physician workforce.
CONTEXT: By selecting a specialty to train in, physicians entering graduate medical education (GME) training provide advance information about the future physician workforce. OBJECTIVE: To determine trends in the residency choices of medical school graduates entering GME training. DESIGN, SETTING, AND PARTICIPANTS: The American Medical Association and Association of American Medical Colleges jointly surveyed active programs as well as combined programs in academic year 2002-2003 about active, transferred, and graduated residents. In 2002 the survey was sent to 8064 program directors; 84.2% of them confirmed the status of all active residents and 82.6% completed the program survey. MAIN OUTCOME MEASURES: In addition to overall trends, the specialty choices of graduates of osteopathic schools (DOs) and international medical graduates (IMGs). Also, where native US citizen resident physicians attended medical school if not in the United States, with a focus on Hispanic ethnicity and Spanish-language facility. RESULTS: The census counted 98 258 resident physicians in GME programs in academic year 2002-2003, similar to 5 years ago and reversing a decline over the past few years. There were 23 443 residents in graduate year 1 (GY1) positions, for which prior GME training is not required, a slight increase from 2001-2002. The proportion of GY1 residents without prior GME increased slightly compared with 2001-2002 (92.3% to 93.3%). In 1996-1997, 624 DOs were GY1 residents without prior GME (2.9%); their numbers increased to 1312 (6.0%) in 2002-2003. The number of IMGs in GY1 positions without prior GME also increased over this period, from 5033 (23.5%) to 5623 (25.7%). Over the past 6 years the number of IMG and DO GY1 residents without prior GME in specialties such as general surgery, obstetrics and gynecology, and emergency medicine has increased disproportionately faster than the overall rate. Hispanic native US citizens are more likely to be IMGs than non-Hispanic native US citizens (9.6% vs 5.0%). One third of Hispanic native US citizen IMGs received their medical education in Spanish vs less than 3% of non-Hispanic native US citizen IMGs. CONCLUSIONS: Nearly 25% of physicians in US allopathic training programs in 2002-2003 were IMGs, and the percentage of DOs continues to increase. The number of residents conversant in Spanish could serve a need for a large US minority population.