Published online December 16, 2008
PEDIATRICS Vol. 123 Supplement January 2009, pp. S26-S30 (doi:10.1542/10.1542/peds.2008-1578H)

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SUPPLEMENT ARTICLE

General Pediatrics Resident Perspectives on Training Decisions and Career Choice

Gary L. Freed, MD, MPH^a,b, Kelly M. Dunham, MPP^a,b, M. Douglas Jones, Jr, MD^c, Gail A. McGuinness, MD^d,e, Linda Althouse, PhD^e and the Research Advisory Committee of the American Board of Pediatrics

^a Child Health Evaluation and Research Unit, Ann Arbor, Michigan
^b Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan
^c Department of Pediatrics, University of Colorado Denver, School of Medicine, Aurora, Colorado
^d Executive Vice-president
^e American Board of Pediatrics, Chapel Hill, North Carolina

OBJECTIVE. Little is known regarding at what point during the training period residents in pediatrics make decisions on their future career choices. As part of a dedicated process of reexamining the structure of residency training in pediatrics, the American Board of Pediatrics sought information to better understand the influences, process, and sequencing of both residency program selection and career decision-making among residents.

METHODS. All pediatrics resident physicians in all training programs in the United States and Canada (N = 8290) received the survey as part of the general pediatrics in-training examination. The survey focused on exploring how and when pediatrics residents make career choices and assessed perceived flexibility of their individual pediatrics residency program.

RESULTS. The response rate was 95%. Location was the most important factor in selecting a residency program for 42% of all residents. Almost half of the pediatrics residents planned to pursue fellowship training after residency, a proportion that changed little across the 3 training years (level 1: 47%; level 2: 49%; level 3: 47%). Those who planned to pursue a general pediatrics career (either with or without inpatient care) were more likely than those who intended to pursue fellowship training to report that lifestyle was the most important factor in their career choice (63% vs 21%).

CONCLUSIONS. Not surprisingly, different priorities motivate pediatricians to pursue specific programs for training and specific career options. The finding that those with the highest priority regarding lifestyle are more likely to pursue generalist training has implications for the generalist workforce, because those persons may also be more likely to seek part-time employment. Lifestyle concerns may need to be addressed in subspecialty training and subsequent subspecialty careers to ensure a continued flow of residents into fellowship training.

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Key Words: residency • training • career choice • pediatrics

Abbreviations: AMG—US and Canadian medical school graduate • IMG—international medical school graduate • AAP—American Academy of Pediatrics

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Accepted Sep 22, 2008.

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