Obstetrics anyone? How family medicine residents' interests changed

To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their residency programs.

Residents in each of 4 consecutive years, starting July 1991, were surveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for analysis.

Family medicine residency programs at the University of Toronto in Ontario.

Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit.

Changes in attitudes and plans during the residency program as ascertained from responses to entry and exit questionnaires.

Analysis was based on 215 paired questionnaires. Women residents had more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obstetrics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduation, residents perceived lifestyle factors and compensation as very important negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated.

Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for producing more physicians willing to practise obstetrics than trying to change the minds of those uninterested in such practice.