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Exploring US internal medicine resident career preferences: a Q-methodology study.

John K Roberts¹, Micah Schub², Surbhi Singhal³

¹Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3512, Durham, NC, 27710, USA. john.roberts@duke.edu.

Advances in Health Sciences Education : Theory and Practice

|October 20, 2022

Summary

Four distinct career viewpoints guide U.S. Internal Medicine (IM) residents’ specialty choices, reflecting a mix of professional goals and personal priorities. Understanding these perspectives can help address physician shortages and improve job satisfaction.

Keywords:

Career decision Internal medicine Medical education research Postgraduate Psychometrics Q-methodology Q-sort

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Area of Science:

Medical Education
Physician Workforce
Career Development

Background:

Career selection in medicine is complex and understudied, particularly regarding resident attitudes and preferences.
Existing U.S. research often emphasizes demographics and debt, overlooking crucial attitudinal factors.
Addressing physician shortages requires a deeper understanding of factors influencing career decisions.

Purpose of the Study:

To explore and define dominant viewpoints influencing career choice among U.S. Internal Medicine (IM) residents.
To identify distinct attitudinal profiles shaping postgraduate career decisions.
To correlate identified viewpoints with actual career selections.

Main Methods:

An electronic Q-sort methodology was employed with 218 IM residents.
Participants sorted 50 statements reflecting diverse opinions on postgraduate career choices.
Factor analysis identified four distinct resident viewpoints, with career choices confirmed at residency's end.

Main Results:

Four dominant viewpoints emerged: 'Fellowship-Bound-Academic,' 'Altruistic-Longitudinal-Generalist,' 'Inpatient-Burnout-Aware,' and 'Lifestyle-Focused-Consultant.'
A significant concordance was observed between residents' identified viewpoint and their ultimate career choice.
These viewpoints represent the interplay of professional identity, personal interests, and work-life satisfaction.

Conclusions:

Contemporary U.S. IM residents exhibit four primary career choice viewpoints.
These perspectives highlight the complex balance residents strike between competing priorities.
Understanding these determinants can inform strategies to mitigate physician workforce shortages and enhance professional fulfillment.