Observational studyBMC medical education2025
Untangling pre-residency and residency determinants of career choice among internal medicine residents: an observational study.
Observational study in BMC medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
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Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundFor most physicians trained in internal medicine (IM), residency represents the last opportunity to compare and contrast generalist versus subspecialty careers. Decisions about subspecialty practice impact physician supply and distribution in the United States. This study tested the association between randomly assigned intern year rotation duration and career choice and assessed the importance of resident characteristics versus residency experiences in predictive modeling.
methodsThis retrospective observational study included all categorical residents graduating from a university-affiliated IM program between 2017 and 2023 (N = 338). The association between randomly assigned intern year rotation duration and career choice was evaluated with univariable and multivariable log-link Poisson regression models. "Career choice" was defined as the field in which residents were practicing one year after residency. Predictive models were built using random forest modeling to compare the relative importance of resident characteristics and residency experiences.
resultsPre-residency career interests and ultimate career choice were highly concordant (P < 0.001, Cramer's V 0.50 (95% CI: 0.41-0.51)), particularly among residents pursuing cardiology, gastroenterology, and hematology/oncology. Rotation duration and career choice were not consistently associated; in multivariable analyses, weeks on service in the intensive care unit were associated with a career in pulmonary/critical care (RR 1.40, 95% CI 1.23-1.56), but there was no association between rotation duration and career in hematology/oncology, cardiology, gastroenterology, or general medicine. Internally cross-validated predictive models revealed that pre-residency demographics and interests were highly discriminative of career choice (AUC 0.824). The addition of residency experiences did not improve model performance (AUC 0.829).
conclusionsPre-residency career interests are a key determinant of career choice and hold greater weight in predictive models than intern year clinical exposure.
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