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.

Validity evidence supports MERIT as a meaningful measure of resident reflection on QI opportunities. Our findings suggest that dimensions of resident reflection on QI opportunities may include personal, system and Problem of Merit factors. Additionally, residents may be more effective at reflecting on 'problems of merit' than personal and systems factors.

Time is a ubiquitous but often omitted variable in career selection decisions. This study investigates the impact of temporal elements on career selection decisions, thus advancing our understanding of both career decision making, and timing on decision making. We investigate the influence of timing and duration of experience with career options on career selection decisions in an archival study using medical residents' rotation schedules. We also investigate factors that mitigate the influence of timing on career selection decisions by examining the interaction of timing with duration of experience and the diversity of options that an individual experiences. Conditional logit results indicate that decisions often based on career and individual attributes are significantly influenced by the timing and duration of options even when controlling for option attributes. Additionally, significant interactions between timing and diversity of experience and timing and duration of experience revealed boundary conditions for timing.Individuals were more likely to select later appearing career options when they appeared for a greater duration or they experienced a greater diversity of options in their schedule. Results illustrate that schedules over which individuals have no control can influence consequential decisions.

No abstract

the lack of association between MERIT and QIPAT-7 scores indicates a distinction between resident doctors' skills at reflection on QI opportunities and their abilities to develop QI projects. These findings suggest that practice-based reflection and QI project development are separate constructs, and that skilful reflection may not predict the ability to design meaningful QI initiatives. Future QI curricula should consider teaching and assessing QI reflection and project development as distinct components.