Changes in U.S. Medical Students’ Specialty Interests over the Course of Medical School
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Studies have examined factors affecting medical students’ specialty choice, but little research exists on stability of these specialty interests.
To describe patterns of change in specialty interests during medical school and examine associations between specialty change patterns and gender, desire for a high-prestige career, and interest in prevention.
Medical students (Class of 2003) at 15 representative US schools were invited to complete surveys during freshman orientation, entry to wards, and senior year.
This analysis used data from 942 students who completed all 3 surveys.
In addition to a number of other items, students were asked to choose the 1 specialty they were most interested in pursuing.
The most common specialty choices among freshman students were pediatrics (20%) and surgery (18%); least common choices were psychiatry and preventive medicine (1% each). General internal medicine was the initial specialty choice for 8%. Most students changed their specialty choices, regardless of initial interest. Only 30% of those initially interested in primary care (PC) remained interested at all 3 time points, compared to 68% of those initially interested in non-PC. Female versus male students were more commonly interested in PC at all 3 time points. Senior students interested in non-PC specialties were more likely to desire a high-prestige career (48%) than those interested in PC (31%).
Medical students may benefit from more intensive introduction to some specialties earlier in pre-medical and medical education. In addition, increasing the prestige of PC fields may shape the physician workforce.
- Weissman SH, Haynes RA, Killian CD, Robinowitz C. A model to determine the influence of medical school on students’ career choices: psychiatry, a case study. Acad Med. 1994;69:58–9. CrossRef
- Sierles FS, Dinwiddie SH, Patroi D, Atre-Vaidya N, Schrift MJ, Woodard JL. Factors affecting medical student career choice of psychiatry from 1991–2001. Acad Psychiatry. 2003;27:260–8. CrossRef
- Rosenthal MP, Rabinowitz HK, Diamond JJ, Markham FW. Medical students’ specialty choice and the need for primary care. Prim Care. 1996;23:155–67.
- Cochran A, Melby S, Neumayer LA. An internet-based survey of factors influencing medical student selection of a general surgery career. Am J Surg. 2005;189:742–6. CrossRef
- Sanfey HA, Saalwachter-Schulman A, Nyhof-Young JM, Eidelson B, Mann BD. Influences on medical student career choice: gender or generation? Arch Surg. 2006;141:1086–94. CrossRef
- Pamies RJ, Lawrence LE, Helm EG, Strayhorn G. The effects of certain student and institutional characteristics on minority medical student specialty choice. J Nat Med Assoc. 1994;86:136–40.
- Newton DA, Grayson MS, Whitley TW. What predicts medical student career choice? J Gen Intern Med. 1998;13:200–3. CrossRef
- Barshes NR, Vavra AK, Miller A, Brunicardi FC, Goss JA, Sweeney JF. General surgery as a career: a contemporary review of factors central to medical student specialty choice. J Am Coll Surg. 2004;1999:792–9. CrossRef
- Kassebaum DG, Szenas PL. Factors influencing the specialty choices of 1993 medical school graduates. Acad Med. 1994;69:164–70.
- Ruhnke GW. Physician supply and the shifting paradigm of medical student choice. JAMA. 1997;277:70–1. CrossRef
- Tonkin P. Effect of rising medical student debt on residency specialty selection at the University of Minnesota. Minn Med. 2006;89:46–9.
- Novielli K, Hojat M, Park PK, et al. Change of interest in surgery during medical school: a comparison of men and women. Acad Med. 2001;76:S58–61. CrossRef
- Stoll M. The Best Medical Schools. 2000 Edition. New York, NY: Princeton Review Publishing; 1999.
- Association of American Medical Colleges. Applicant age at anticipated matriculation, 1992–2001. http://www.aamc.org/data/facts/archive/famg112001a.htm. Accessed 26 February 2008.
- Association of American Medical Colleges. Total enrollment by gender and race/ethnicity, 1992–2001. http://www.aamc.org/data/facts/archive/famg82001.htm. Accessed 26 February 2008.
- Association of American Medical Colleges. Medical schools. http://www.aamc.org/medicalschools.htm. Accessed 26 February 2008.
- National Institutes of Health. Support to U.S. Medical Schools, Fiscal Year 2000. http://grants.nih.gov/grants/award/rank/medschrank00.txt. Accessed 26 February 2008.
- Frank E, Carrera JS, Elon L, Hertzberg VS. Basic demographics, health practices, and health status of U.S. medical students. Am J Prev Med. 2006;31:499–505. CrossRef
- Frank E, Carrera JS, Elon L, Hertzberg VS. Predictors of US medical students’ prevention counseling practices. Prev Med. 2007;44:76–81. CrossRef
- Henderson SJ, Elon L, Frank E. Self-report of quality of medical student health care. Med Educ. 2007;41:632–7. CrossRef
- Dillman DA. Mail and Telephone Surveys: The Total Design Method. New York, NY: Wiley; 1978.
- Shah BV, Barnwell BG, Bieler GS. SUDAAN User’s Manual, Release 8.0: Software for the Statistical Analysis of Correlated Data. Research Triangle Park, NC: Research Triangle Institute; 2001.
- Markert RJ. Change in specialty choice during medical school. J Fam Pract. 1983;17:295–300.
- Zeldow PB, Preston RC, Daugherty SR. The decision to enter a medical specialty: timing and stability. Med Educ. 1992;26:327–32. CrossRef
- Kassebaum DG, Szenas PL. Medical students’ career indecision and specialty rejection: roads not taken. Acad Med. 1995;70:938–43.
- Babbott D, Baldwin DC, Jolly P, Williams DJ. The stability of early specialty preferences among U.S. medical school graduates in 1983. JAMA. 1988;259:1970–5. CrossRef
- Bland CJ, Meurer LN, Maldonado G. Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature. Acad Med. 1995;70:620–41. CrossRef
- Rogers LQ, Fincher RM, Lewis LA. Factors influencing medical students to choose primary care or non-primary care specialties. Acad Med. 1990;65:S47–8. CrossRef
- Kassler WJ, Wartman SA, Silliman RA. Why medical students choose primary care careers. Acad Med. 1991;66:41–3. CrossRef
- Fincher RM, Lewis LA, Rogers LO. Classification model that predicts medical students’ choices of primary care or non-primary care specialties. Acad Med. 1992;67:324–7. CrossRef
- Weinstein P, Gipple C. Some determinants of career choice in the second year of medical school. J Med Educ. 1975;50:194–8.
- Freed DH. Hospitalists: evolution, evidence, and eventualities. Health Care Manager. 2004;23:238–56.
- Wachter RM. Reflections: the hospitalist movement a decade later. J Hosp Med. 2006;1:248–52. CrossRef
- West CP, Popkave C, Schultz HJ, Weinberger SE, Kolars JC. Changes in career decisions of internal medicine residents during training. Ann Int Med. 2006;145:774–9.
- Jennett PA, Kishinevsky M, Bryant H, Hunter KL. Major changes in medical careers following medical school graduation: when, how often, and why. Acad Med. 1990;65:48–9. CrossRef
- Changes in U.S. Medical Students’ Specialty Interests over the Course of Medical School
Journal of General Internal Medicine
Volume 23, Issue 7 , pp 1095-1100
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- medical students
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- Author Affiliations
- 1. Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA
- 2. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- 3. Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada
- 4. Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA