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E. Ray Dorsey, MD, MBA; David Jarjoura, PhD; Gregory W. Rutecki, MD

JAMA. 2003;290:1173-1178.

Context  Recent specialty choices of graduating US medical students suggest that lifestyle may be an increasingly important factor in their career decision making.

Objective  To determine whether and to what degree controllable lifestyle and other specialty-related characteristics are associated with recent (1996-2002) changes in the specialty preferences of US senior medical students.

Design and Setting  Specialty preference was based on analysis of results from the National Resident Matching Program, the San Francisco Matching Program, and the American Urological Association Matching Program from 1996 to 2002. Specialty lifestyle (controllable vs uncontrollable) was classified using earlier research. Log-linear models were developed that examined specialty preference and the specialty's controllability, income, work hours, and years of graduate medical education required.

Main Outcome Measure  Proportion of variability in specialty preference from 1996 to 2002 explained by controllable lifestyle.

Results  The specialty preferences of US senior medical students, as determined by the distribution of applicants across selected specialties, changed significantly from 1996 to 2002 (P<.001). In the log-linear model, controllable lifestyle explained 55% of the variability in specialty preference from 1996 to 2002 after controlling for income, work hours, and years of graduate medical education required (P<.001).

Conclusion  Perception of controllable lifestyle accounts for most of the variability in recent changing patterns in the specialty choices of graduating US medical students.

Author Affiliations: Evanston Northwestern Healthcare (Drs Dorsey and Rutecki) and The Feinberg School of Medicine, Northwestern University (Dr Rutecki), Chicago, Ill; and Northeastern Ohio Universities College of Medicine (Dr Jarjoura) Rootstown. Dr Dorsey is now at the University of Pennsylvania Medical Center Philadelphia.

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