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Roberts JK, Schub M, Singhal S, Norwood J, Cassini T, Hudler A, Ramadurai D, Smith CC, Desai SS, Weintraub J, Hasler SH, Schwiesow TM, Connors GR, Didwania A, Hargett CW, Wolf M. Exploring US internal medicine resident career preferences: a Q-methodology study. Adv Health Sci Educ Theory Pract 2022:10.1007/s10459-022-10172-0. [PMID: 36264447 DOI: 10.1007/s10459-022-10172-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Career selection in medicine is a complex and underexplored process. Most medical career studies performed in the U.S. focused on the effect of demographic variables and medical education debt on career choice. Considering ongoing U.S. physician workforce shortages and the trilateral adaptive model of career decision making, a robust assessment of professional attitudes and work-life preferences is necessary. The objective of this study was to explore and define the dominant viewpoints related to career choice selection in a cohort of U.S. IM residents. We administered an electronic Q-sort in which 218 IM residents sorted 50 statements reflecting the spectrum of opinions that influence postgraduate career choice decisions. Participants provided comments that explained the reasoning behind their individual responses. In the final year of residency training, we ascertained participating residents' chosen career. Factor analysis grouped similar sorts and revealed four distinct viewpoints. We characterized the viewpoints as "Fellowship-Bound-Academic," "Altruistic-Longitudinal-Generalist," "Inpatient-Burnout-Aware," and "Lifestyle-Focused-Consultant." There is concordance between residents who loaded significantly onto a viewpoint and their ultimate career choice. Four dominant career choice viewpoints were found among contemporary U.S. IM residents. These viewpoints reflect the intersection of competing priorities, personal interests, professional identity, socio-economic factors, and work/life satisfaction. Better appreciation of determinants of IM residents' career choices may help address workforce shortages and enhance professional satisfaction.
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Affiliation(s)
- John K Roberts
- Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3512, Durham, NC, 27710, USA.
| | - Micah Schub
- Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3512, Durham, NC, 27710, USA
| | - Surbhi Singhal
- Department of Medicine, Stanford University, Stanford, CA, USA
| | - Jamison Norwood
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thomas Cassini
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Andi Hudler
- Department of Medicine, University of Colorado, Denver, CO, USA
| | - Deepa Ramadurai
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher C Smith
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sima S Desai
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jennifer Weintraub
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott H Hasler
- Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Aashish Didwania
- Department of Medicine, Northwestern University, Chicago, IL, USA
| | - Charles W Hargett
- Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3512, Durham, NC, 27710, USA
| | - Myles Wolf
- Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3512, Durham, NC, 27710, USA
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