Physician Career Choice and Satisfaction

Book excerpt: How and why do doctors select their specialties, work settings and communities in which to practice? Do medical students know what they want to do once they finish their education? Can doctors in training be nudged toward practice in certain under-served geographic areas and in specialties facing a shortage of members? How can practice organizations that have a deficit in applicants recruit the physicians they need? How do practice characteristics differ from one specialty and work-setting to another? What features of a work-setting make for satisfaction and dissatisfaction in the different specialties and practice organizations? This book addresses those questions and others related to the distribution of physicians in the workforce. Data from two studies of physicians in practice and one large-scale study of participants in a summer program for medical students are analyzed to pose answers to these questions. In one study, the graduates from one medical school who were studied as students are followed up nearly half a century later, at the end of their careers, to see what characteristics might have been used to anticipate their eventual decisions. In another, a large sample of physicians in practice in various specialties and parts of the United States were queried about the features of their practices and the degree to which they wanted those features to increase or decrease. Finally, the amount that personal characteristics and program characteristics contributed to the achievement of four types of student goals were determined for 1000 participants in a summer externship program sponsored by the American Medical Student Association Foundation. Implications for medical school selection of students, student self-selection, work-setting design, student educational experiences and community support of the practicing physician are discussed.