Dataset Information

Role Models' Influence on Specialty Choice for Residency Training: A National Longitudinal Study.

ABSTRACT: Background :Role models in medical school may influence students' residency specialty choice. Objective :We examined whether medical students who reported clinical exposure to a role model during medical school would have an increased likelihood of selecting the role model's specialty for their residencies. Methods :We conducted a 5-year prospective, national longitudinal study (2011-2016) of medical students from 24 US allopathic medical schools, starting from the middle of their third year. The primary outcome measure was type of residency specialty choice 4 years after graduation. Main predictors were the clinical specialty of a student's most admired physician and the relative importance of 7 potentially influential factors for specialty choice in the fourth year of medical school. Results :From 919 eligible participants, 564 (61%) responded to the first survey; 474 of the respondents (84%) completed the follow-up survey. We excluded 29 participants who were not in their fourth year by the time of the follow-up survey. Of the follow-up respondents, 427 (96%) had specialty data 4 years after graduation. In our multivariate models, exposure to an admired generalist physician prior to medical school (odds ratio [OR] = 2.21, 95% confidence interval [CI] 1.03-4.73) and during medical school (OR = 2.62, 95% CI 1.69-4.05) had the strongest odds with respect to training in a generalist residency 4 years after graduation. Role model exposure also predicted specialty choice among those training in surgical and radiology, ophthalmology, anesthesiology, and dermatology (ROAD) specialties. Conclusions :Personal exposure to role models in medical school is an important predictor of residency training in that role model's specialty.

SUBMITTER: Yoon JD

PROVIDER: S-EPMC5901792 | biostudies-other | 2018 Apr

REPOSITORIES: biostudies-other

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Role Models' Influence on Specialty Choice for Residency Training: A National Longitudinal Study.

Yoon John D JD Ham Sandra A SA Reddy Shalini T ST Curlin Farr A FA

Journal of graduate medical education 20180401 2

<h4>Background</h4>Role models in medical school may influence students' residency specialty choice.<h4>Objective</h4>We examined whether medical students who reported clinical exposure to a role model during medical school would have an increased likelihood of selecting the role model's specialty for their residencies.<h4>Methods</h4>We conducted a 5-year prospective, national longitudinal study (2011-2016) of medical students from 24 US allopathic medical schools, starting from the middle of t ...[more]

PMID: 29686752

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Project description:ObjectivesTo examine sex differences in the specialty training recruitment outcomes of UK medical graduates; and whether sex differences were explained by prior academic attainment and previous fitness to practise (FtP) declarations.DesignRetrospective longitudinal cohort study.SettingAdministrative data on entrants to all UK medical schools from the UK Medical Education Database.Participants10 559 doctors (6 155; 58% female) who entered a UK medical school in 2007 or 2008 and were eligible to apply for specialty training by 2015.Primary outcome measureOdds of application, offer and acceptance to any specialty training programme, and on to each of the nine largest training programmes, adjusting for sex, other demographics, prior academic attainment, FtP declaration and medical school.ResultsAcross all specialties, there were no sex differences in applications for specialty training, but women had increased odds of getting an offer (OR=1.40; 95% CI=1.25 to 1.57; p<0.001) and accepting one (OR=1.43; 95% CI=1.19 to 1.71; p<0.001). Seven of the nine largest specialties showed significant sex differences in applications, which remained after adjusting for other factors. In the adjusted models, Paediatrics (OR=1.57; 95% CI=1.01 to 2.46; p=0.046) and general practice (GP) (OR=1.23; 95% CI=1.03 to 1.46; p=0.017) were the only specialties to show sex differences in offers, both favouring women. GP alone showed sex differences in acceptances, with women being more likely to accept (OR=1.34; 95% CI=1.03 to 1.76; p=0.03). Doctors with an FtP declaration were slightly less likely to apply to specialty training overall (OR=0.84; 95% CI=0.71 to 1.00; p=0.048) and less likely to accept an offer to any programme (OR=0.71; 95% CI=0.52 to 0.98; p=0.036), after adjusting for confounders.ConclusionsSex segregation between medical specialties is due to differential application, although research is needed to understand why men are less likely to be offered a place on to GP and Paediatrics training, and if offered GP are less likely to accept.

Project description:PurposeSexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice.MethodsMedical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM.ResultsThe percentage of SGM in each specialty was inversely related to specialty prestige (P?=?0.001) and positively related to perceived SGM inclusivity (P?=?0.01). Prestigious specialties were perceived as less SGM inclusive (P?<?0.001). Medical school climate did not predict specialty prestige (P?=?0.82). SGM were more likely than non-SGM to indicate that sexual and gender identity strongly influenced specialty choice (P?<?0.01). SGM most frequently rated personality fit, specialty content, role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM.ConclusionSpecialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

Project description:Background: Despite being a vital part of medical workforce planning and development, how medical students and graduates choose their career specialty is still not well understood. This study aimed to identify the factors medical graduates consider important influences in their choice of specialty after their first year of practice, and to test the validity of relying on respondent recall to measure changes in specialty choice.Methods: The baseline survey was administered online to all final year students in Ireland's six medical schools. Those who consented to follow-up (n =?483) were surveyed 18?months later (June 2018), during the final month of first year of practice.Results: The baseline survey had a 67% (n =?483) response rate. At the follow-up survey, (n =?232, 48% response rate) the top specialty choices were: Medicine, n =?54 (26%); Surgery, n =?34 (16%); General Practice, n =?28 (13%); Anaesthesia, n =?16 (8%) and Paediatrics, n =?14 (7%). Of the 49 respondents (28%) reporting a change of specialty since baseline, 13 (27%) selected the same specialty in both surveys; of the 121 (69%) reporting no change, 22 (18%) selected a different specialty at follow-up. Over 90% of respondents rated as 'important or 'very important': 'Own aptitude', 'Work-life balance' and 'What I really want to do'. Over 75% rated as 'not at all', or 'not very important' 'Current financial debt' and 'Inclinations before medical school'. When adjusted for sex and age, compared with Medicine, General Practice rated as more important: continuity of patient care (RRR 3.20 CI(1.59-6.41), p =?0.001); working hours/conditions (RRR 4.61 CI(1.03-20.60), p =?0.045) and a career that fit their domestic circumstances (RRR 3.19 CI(1.27-8.02), p =?0.014). Those choosing Surgery rated as less important: patient contact (RRR 0.56 CI(0.33-0.95), p =?0.033) and working hours/conditions (RRR 0.55 CI(0.31-0.96), p =?0.035).Conclusions: The different demographic and motivational profiles by specialty choice are consistent with other studies suggesting a distinct profile for doctors intending to enter General Practice. In addition, our results suggest longitudinal study designs guard against recall bias and so provide more robust medical workforce models to inform and direct recruitment drives and interventions in future medical workforce planning.

Dataset Information

Role Models' Influence on Specialty Choice for Residency Training: A National Longitudinal Study.

Publications

Role Models' Influence on Specialty Choice for Residency Training: A National Longitudinal Study.

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