ABSTRACT
BACKGROUND
Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents’ decisions to pursue careers in hospital medicine (HM).
OBJECTIVE
To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education.
DESIGN
Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey.
PARTICIPANTS
16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009–2011, 9,501 of whom completed the survey in all 3 years of residency.
MAIN MEASSURES
Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3.
KEY RESULTS
Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education.
CONCLUSIONS
Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Wachter RM, Goldman L. The emerging role of "hospitalists" in the American health care system. N Engl J Med. 1996;335:514–7.
Pham HH, Devers KJ, Kuo S, Berenson R. Health care market trends and the evolution of hospitalist use and roles. J Gen Intern Med. 2005;20:101–7.
Wachter RM, Goldman L. The hospitalist movement 5 years later. JAMA. 2002;287:487–94.
Flanders SA, Saint S, McMahon LF, Howell JD. Where should hospitalists sit within the academic medical center? J Gen Intern Med. 2008;23:1269–72.
Society of Hospital Medicine. 2013 Media Toolkit. Available at: http://www.hospitalmedicine.org/Content/NavigationMenu/Media/MediaKit/SHM_MediaKit2013.pdf. Accessed January 7, 2014.
West CP, Popkave C, Schultz HJ, Weinberger SE, Kolars JC. Changes in career decisions of internal medicine residents during training. Ann Intern Med. 2006;145:774–9.
Garibaldi RA, Popkave C, Bylsma W. Career plans for trainees in internal medicine residency programs. Acad Med. 2005;80:507–12.
Brotherton SE, Etzel SI. Graduate medical education, 2009–2010. JAMA. 2010;304:1255–70.
Brotherton SE, Etzel SI. Graduate medical education, 2010–2011. JAMA. 2011;306:1015–30.
Brotherton SE, Etzel SI. Graduate medical education, 2011–2012. JAMA. 2012;308:2264–79.
American Board of Internal Medicine. Number of programs and residents. Available at: http://www.abim.org/about/examInfo/data-res/chart-01.aspx. Accessed January 7, 2014.
West CP, Dupras DM. General medicine vs subspecialty career plans among internal medicine residents. JAMA. 2012;308:2241–7.
American Board of Internal Medicine. Percentage of third-year residents by gender and type of medical school. Available at: http://www.abim.org/about/examInfo/data-res/chart-02.aspx. Accessed January 7, 2014.
West CP, Drefahl MM, Popkave C, Kolars JC. Internal medicine resident self-report of factors associated with career decisions. J Gen Intern Med. 2009;24:946–9.
Goldenberg J, Glasheen JJ. Hospitalist educators: future of inpatient internal medicine training. Mt Sinai J Med. 2008;75:430–5.
Hauer KE, Wachter RM, McCulloch CE, Woo GA, Auerbach AD. Effects of hospitalist attending physicians on trainee satisfaction with teaching and with internal medicine rotations. Arch Intern Med. 2004;164:1866–71.
Kripalani S, Pope AC, Rask K, et al. Hospitalists as teachers. J Gen Intern Med. 2004;19:8–15.
Hoff TH, Whitcomb WF, Williams K, Nelson JR, Cheesman RA. Characteristics and work experiences of hospitalists in the United States. Arch Intern Med. 2001;161:851–8.
Hinami K, Whelan CT, Miller JA, Wolosin RJ, Wetterneck TB. Person-job fit: an exploratory cross-sectional analysis of hospitalists. J Hosp Med. 2013;8:96–101.
Baudendistel TE, Wachter RM. The evolution of the hospitalist movement in the USA. Clin Med. 2002;2:327–30.
Glasheen JJ, Siegal EM, Epstein K, Kutner J, Prochazka AV. Fulfilling the promise of hospital medicine: tailoring internal medicine training to address hospitalists' needs. J Gen Intern Med. 2008;23:1110–5.
Wachter RM. The evolution of the hospitalist model in the United States. Med Clin N Am. 2002;86:687–706.
Plauth WH 3rd, Pantilat SZ, Wachter RM, Fenton CL. Hospitalists' perceptions of their residency training needs: results of a national survey. Am J Med. 2001;111:247–54.
Wiese J. Residency training: beginning with the end in mind. J Gen Intern Med. 2008;23:1122–3.
Ranji SR, Rosenman DJ, Amin AN, Kripalani S. Hospital medicine fellowships: works in progress. Am J Med. 2006;119:72. e1–7.
Goodman PH, Januska A. Clinical hospital medicine fellowships: perspectives of employers, hospitalists, and medicine residents. J Hosp Med. 2008;3:28–34.
Acknowledgements
This study had no funding source.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ratelle, J.T., Dupras, D.M., Alguire, P. et al. Hospitalist Career Decisions Among Internal Medicine Residents. J GEN INTERN MED 29, 1026–1030 (2014). https://doi.org/10.1007/s11606-014-2811-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-014-2811-3