ArticleJournal of general internal medicine2026
How do Internal Medicine Residents from Different Backgrounds Make Subspecialty Career Choices? A Qualitative Analysis.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Psychosocial adversity captured by ICD-10 Z-codes and mortality risk: evidence from the UK Biobank.GeroScience · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMedical career decisions are complex. Gender and racial disparities remain among internal medicine (IM) subspecialty fellows, particularly in procedural subspecialties. This qualitative study aims to thematically explore factors that influence IM resident subspecialty career choice, with a focus on factors specific to women and UIM trainees to better understand existing disparities. This is the first study to explore IM residents own stated reasons to subspecialize into various fields.
methodsWe conducted virtual focus groups with 37 IM residents from multiple institutions, organized by affinity groups based on self-identifying as UIM and non-UIM race or ethnicity. Thematic analysis using inductive coding was used to analyze the data and identify themes applying the Systems Theory Framework (STF) of career development. Key themes were divided into social or contextual factors, individual factors, or uncontrollable factors.
resultsStudy participants were 45.9% women (n = 17) and 51.4% self-identified as UIM (n = 19). In this sample of graduating IM residents who have matched into subspeciality fellowships, contextual factors emerged as the most influential to their career choices. The main contributors to selecting a subspecialty were mentorship and role models, positive experiences and exposure to the field, work-life balance, enjoyment of clinical and/or procedural work, and financial compensation. UIM residents identified their communities and their personal identities (i.e., race, ethnicity, culture) as influential to their career choices. Both women and UIM residents more frequently described the importance of representation and belonging in their career decisions compared to their non-UIM and male counterparts. Family planning emerged as an important factor for women.
conclusionsOur findings lend insights into how academic institutions, medicine subspecialty societies, training programs, and faculty at large can engage trainees in their field. We propose ways to improve the recruitment and retention of women and UIM trainees into the IM subspecialty fields.
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