Journal of General Internal Medicine

, Volume 24, Issue 8, pp 946–949

Internal Medicine Resident Self-report of Factors Associated with Career Decisions

  • Colin P. West
  • Monica M. Drefahl
  • Carol Popkave
  • Joseph C. Kolars
Original Article

DOI: 10.1007/s11606-009-1039-0

Cite this article as:
West, C.P., Drefahl, M.M., Popkave, C. et al. J GEN INTERN MED (2009) 24: 946. doi:10.1007/s11606-009-1039-0

ABSTRACT

BACKGROUND

Little is known about factors contributing to the career decisions of internal medicine residents.

OBJECTIVE

To evaluate factors self-reported by internal medicine residents nationally as important to their career decisions.

DESIGN

Cross-sectional survey conducted in October of 2005, 2006, and 2007 as part of the national Internal Medicine In-Training Examination (IM-ITE).

PARTICIPANTS

Postgraduate year 3 internal medicine residents taking the IM-ITE.

MEASUREMENTS

Residents rated the importance of nine factors in their career decisions on 5-point Likert scales. Univariate statistics characterized the distribution of responses. Associations between variables were evaluated using Cochran-Mantel-Haenszel statistics for ordinal data. Multivariate analyses were conducted using logistic regression.

RESULTS

Of 17,044 eligible residents taking the IM-ITE, 14,890 (87.4%) completed the career decision survey questions. Overall, time with family was the factor most commonly reported as of high or very high importance to career decisions (69.6%). Women were more likely to assign greatest importance to family time (OR 1.22, 95% confidence interval 1.12–1.31, p < 0.001) and long-term patient relationships (OR 1.34, 95% confidence interval 1.23–1.46, p < 0.001). Across debt levels, financial considerations were of greatest importance more often for residents owing >$150,000 (OR 1.33, 95% confidence interval 1.09–1.62, p < 0.001). Across specialties, mentor specialty was rated lowest in importance by residents pursuing hospitalist and general internal medicine careers.

CONCLUSIONS

Greater attention to factors reported by residents as important to their career decisions may assist efforts to optimize the distribution of physicians across disciplines. In addition to lifestyle and practice considerations, these factors may include mentor specialty. As this factor is less commonly reported as important by residents planning careers in generalist fields, attention to effective mentoring may be an important element of efforts to increase interest in these areas.

KEY WORDS

career decisioncareer planACGMEgraduate medical educationinternship and residency

Supplementary material

11606_2009_1039_MOESM1_ESM.pdf (116 kb)
ESM 1(PDF 119 kb)

Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Colin P. West
    • 1
    • 2
  • Monica M. Drefahl
    • 1
  • Carol Popkave
    • 3
  • Joseph C. Kolars
    • 4
  1. 1.Division of General Internal MedicineMayo ClinicRochesterUSA
  2. 2.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA
  3. 3.Research CenterAmerican College of PhysiciansPhiladelphiaUSA
  4. 4.Division of Gastroenterology and HepatologyMayo ClinicRochesterUSA