Diversity of the physician workforce: Specialty choice decisions during medical school

Abstract

Background Despite efforts to increase the overall diversity of the medical student body, some medical specialties have a less diverse applicant pool based on both gender and race than would be expected based on medical graduate demographics. Objectives To identify whether women and Underrepresented in Medicine (URiM) medical students have baseline differences in their career interests or if their career plans change more during medical school when compared to men and non-URIM students. Methods Secondary data analyses of all medical students who applied through ERAS from 2005–2010 was conducted. Binary logistic regression models with the response being a planned career in one of four medical specialties (internal medicine, pediatrics, OB/GYN, and general surgery/surgical specialties) at medical school entry and graduation. Regression models included demographics, student attitudes, debt, academic metrics, and medical school experiences. Results Comparatively, women were less likely to be interested in internal medicine and surgery and more interested in pediatrics and OB/GYN at matriculation. URiM students expressed more interest in OB/GYN and surgery when starting medical school. At graduation, women were less likely to plan for internal medicine and surgery and were more interested in pursuing OB/GYN and pediatrics. URiM students were more likely to plan for a career in internal medicine and less likely to choose pediatrics. Conclusions From matriculation to graduation, women have relatively stable preferences regarding planned medical specialties. In contrast, URiM students’ specialty plans shifted over time among the four specialties, with variation in preferences occurring between matriculation and graduation.

Attractiveness of medical disciplines amongst Swiss first-year medical students allocated to different medical education tracks: cross-sectional study

“…We found that relationships to patients and autonomy were comparatively important to students attracted to general practice which is in line with similar Swiss and international studies [ 19 , 31 ]. Also, in line with results from previous studies, we found a positive association of female sex with attractiveness gynecology/pediatrics [ 27 , 38 ]. In addition, we investigated the association with career in academic or industry sectors and found a strong negative association with female sex.…”

Interest in Serving the Underserved: Role of Race, Gender, and Medical Specialty Plans

“…To better examine the impact of MS on students' decisions and to expound on previously demonstrated associations 15 we examined these trends again upon graduating from MS. To date, a large portion of available literature focuses on specialty selection and the association with URiM status. Here too, both women and URiM students were more likely, than men and non-URiM students, respectively, to express their intent in working with underserved communities.…”

“…With respect to medical specialty choice, the development of an individual physician identity is intrinsically linked with how and where each student envisions their future practice of medicine and can change in concert with career plan reconsiderations. 15 , 16 While any physician regardless of medical specialty type may dedicate their career to the underserved, specific medical specialties are traditionally linked with having a specific focus on providing care in these areas. While these designations are fluid and vary by perspective, historically primary care specialties 17 , 18 and emergency medicine 19–22 have explicitly made this role a part of their professional culture.…”

Recruitment of women in neurosurgery: a 7-year quantitative analysis

“…First, efforts should be focused on introducing the field of neurosurgery to female medical students at matriculation, when the gender gap in surgical specialty interest is widest. 8 In turn, these efforts may encourage female students who otherwise may not have been interested in neurosurgery to begin exploring the field, thus enabling them to get an early start in developing more competitive applications and dispelling negative notions they may have had about the field. Second, research fellowships and opportunities should be specifically targeted to female neurosurgery residents, as our data show that gender disparities in research productivity widen during residency.…”

“…By the end of medical school, female medical students are still less likely than male students to have an interest in surgery or a surgical subspeciality (OR 0.64, 95% CI 0.561-0.727), but by less of a margin. 8 Strategies to address such imbalances and other challenges have been devised and include a focus on mentorship/sponsorship programs and conference scholarships, the establishment of "Women in Surgery" organizations, and awareness efforts regarding burnout. 9 In the absence of multivariable quantitative analyses targeting the early recruitment stage from medical school to residency, the development of an effective plan to bridge gender gaps may prove difficult.…”