Factors predicting initial career choices in gastroenterology fellows

As academic gastroenterology (GI) fellowship programs often gear trainee recruitment to those displaying potential for academic careers, the aim of the study was to determine whether predictive factors exist that determine whether GI fellows pursue academia versus private practice.

Educational file review was conducted on all GI fellows from Mayo Clinic-Rochester from 1990 through 2003, with demographic variables extracted. The outcome of interest was whether the first job after fellowship was in academics or private practice.

Of 92 fellows completing training, 60 accepted academic positions (65%) (P=0.005, 95% confidence interval: 0.55-0.74), whereas 32 (35%) pursued private practice. Those of Asian descent were significantly more likely to enter academics versus those of African American (P=0.02) or Hispanic (P=0.01) descent. There were nonsignificant trends of more women than men (85% vs. 62%), military than non-military (86% vs. 63%), bachelors of arts than science degrees (70% vs. 50%) and advanced fellowship training than not (74% vs. 61%) going into academics. There was no significant difference in career choices between fellows entering the National Institutes of Health training tract versus the Clinical Scholar or Clinical Investigator tracts. There were no significant associations between age, marital status, hometown population, foreign medical degree, research mentor factors or type of research during fellowship and practice choice.

Although there seem to be predictive variables in determining whether GI fellows enter private practice or academia, the initial practice choice likely results from multiple combined factors.