Factors correlated with residents' decisions to enter academic dermatology

The demand for dermatologic services and training at academic medical centers has outpaced the growth in the field's academic workforce. Recruitment of graduating residents has been proposed as a solution to the shortage of academic dermatologists. The purpose of this study was to further our current understanding of the factors that support the recruitment and retention of academicians. A survey questionnaire was mailed to graduates of the dermatology residency program at the University of North Carolina, and data were gathered retrospectively from participants' residency application materials. The factors from residency applications that predicted initial practice setting and the driving factors behind the choice of initial practice in academia were analyzed using generalized linear models. Of the department's 39 graduates between 2005 and 2014, 37 (95%) completed our survey. Sixteen graduates (43%) remained in academia upon completion of residency, whereas fourteen graduates (38%) are currently in academic practices. Those who had obtained a PhD before starting residency were more likely than their peers to initially accept academic positions (RR 2.73, 95% CL 1.64, 4.71, p = 0.05). However, other applicant characteristics available from residency application materials poorly predicted graduates' likelihood of remaining in academia at the time of graduation. In free-text survey responses, graduates who joined academic practices upon completion of residency were significantly more likely to cite teaching opportunities (PR 3.01, 95% CL 1.60-5.78, p = 0.05) and practice environment (PR 2.97, 95% CL 1.51-6.37, p = 0.05) as factors that had strongly influenced their initial career decisions. Because it is difficult to predict which residency applicants will ultimately pursue careers in academia, promoting the desirable aspects of the academic practice setting during residency training may be a better strategy for addressing the academic workforce shortage than the selection of residency applicants who possess specific characteristics.