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Rebecca S. Miller, MS; Marvin R. Dunn, MD; Michael E. Whitcomb, MD

JAMA. 1997;277(21):1699-1704.

Abstract
Objective.
—To assess the degree and type of difficulty encountered by resident physicians attempting to enter the workforce in 1995.

Design.
—Employment information derived from a 1-page descriptive survey completed by residency program directors from January 1,1996, to June 15,1996, is described and compared with the results of a similar survey completed 1 year earlier.

Setting.
—Directors of 4568 residency programs in 31 specialties and subspecialties accredited by the Accreditation Council for Graduate Medical Education.

Main Outcome Measure.
—The number of 1995 program graduates, their current professional status, and program directors' characterization of the experience of graduates who entered clinical practice, including the number who experienced major difficulties securing an acceptable practice position. Program directors reported actual and anticipated decreases in the number of residency positions and the likely availability of future professional opportunities.

Results.
—The 3819 program directors (83.6%) who completed the survey reported that 20 065 resident physicians completed a residency program during 1995. Of those seeking employment (n=13 215), most entered clinical practice (80.1%) or took an academic position (15.6%); 2.2% were unemployed or had taken a position in a specialty or subspecialty different from the one in which they were last trained. A portion (6.3%) of graduates who entered clinical practice in their specialty or subspecialty experienced difficulty finding a suitable position; the percentage was lowest among graduates of general surgery, psychiatry, and primary care specialties.

Conclusions.
—Survey results regarding the 1995 graduates are consistent with those obtained regarding the 1994 graduates and suggest that the market for physician services in some disciplines continues to be restrictive. We found that graduates of the specialties of anesthesiology and plastic surgery, whom we reported had the greatest difficulty finding acceptable positions in 1994, had less difficulty in 1995, suggesting a possible improvement in the market, less competition, a change in the respondents' perception of "acceptable," or a change in the resident physicians' willingness to pursue different opportunities. The general consistency of our results and their congruence with other published data suggest that this method is useful to identify and monitor trends in the physician market.

Author Affiliations
From the Department of Research and Data Analysis (Ms Miller), Division of Graduate Medical Education (Dr Dunn), American Medical Association, Chicago, III; and Division of Medical Education, Association of American Medical Colleges, Washington, DC (Dr Whitcomb).

Footnotes
Reprints: Rebecca Miller, MS, Division of Graduate Medical Education, American Medical Association, 515 N State St, Chicago, IL 60610 (e-mail: Rebecca_Miller@ama-assn.org).

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