Author:
Horn Leora,Tzanetos Katina,Thorpe Kevin,Straus Sharon E
Abstract
Abstract
Background
Currently, there are more residents enrolled in cardiology training programs in Canada than in immunology, pharmacology, rheumatology, infectious diseases, geriatrics and endocrinology combined. There is no published data regarding the proportion of Canadian internal medicine residents applying to the various subspecialties, or the factors that residents consider important when deciding which subspecialty to pursue. To address the concern about physician imbalances in internal medicine subspecialties, we need to examine the factors that motivate residents when making career decisions.
Methods
In this two-phase study, Canadian internal medicine residents participating in the post graduate year 4 (PGY4) subspecialty match were invited to participate in a web-based survey and focus group discussions. The focus group discussions were based on issues identified from the survey results. Analysis of focus group transcripts grew on grounded theory.
Results
110 PGY3 residents participating in the PGY4 subspecialty match from 10 participating Canadian universities participated in the web-based survey (54% response rate). 22 residents from 3 different training programs participated in 4 focus groups held across Canada. Our study found that residents are choosing careers that provide intellectual stimulation, are consistent with their personality, and that provide a challenge in diagnosis. From our focus group discussions it appears that lifestyle, role models, mentorship and the experience of the resident with the specialty appear to be equally important in career decisions. Males are more likely to choose procedure based specialties and are more concerned with the reputation of the specialty as well as the anticipated salary. In contrast, residents choosing non-procedure based specialties are more concerned with issues related to lifestyle, including work-related stress, work hours and time for leisure as well as the patient populations they are treating.
Conclusion
This study suggests that internal medicine trainees, and particularly males, are increasingly choosing procedure-based specialties while non-procedure based specialties, and in particular general internal medicine, are losing appeal. We need to implement strategies to ensure positive rotation experiences, exposure to role models, improved lifestyle and job satisfaction as well as payment schedules that are equitable between disciplines in order to attract residents to less popular career choices.
Publisher
Springer Science and Business Media LLC
Subject
Education,General Medicine
Reference39 articles.
1. Canadian Post-MD Education Registry 2003. [http://www.caper.ca]
2. The Canadian Society of Interal Medicine. Care-fully: Defining a Plan for General Internal Medicine in Canada. 2005
3. Hanly JG: Manpower in Canadian academic rheumatology units: current status and future trends. Canadian Council of Academic Rheumatologists. J Rheumatol. 2001, 28 (9): 1944-1951.
4. Rosenthal MP, Marquette PA, Diamond JJ: Trends along the debt-income axis: implications for medical students' selections of family practice careers. Acad Med. 1996, 71 (6): 675-677. 10.1097/00001888-199606000-00024.
5. Doherty MJ, Schneider AT, Tirschwell DL: Will neurology residents with large student loan debts become academicians?. Neurology. 2002, 58 (3): 495-497.
Cited by
61 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献