ORIGINAL COMMUNICATION
Reaping What We Sow: The Emerging Academic Medicine Workforce

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National efforts to increase diversity of academic medicine faculty led us to study the evolution of medical graduates’ academic medicine career intentions. We conducted a retrospective cohort study of 1997–2004 U.S. allopathic medical graduates who completed both the Association of American Medical Colleges’ Matriculating Student Questionnaire and Graduation Questionnaire, categorizing the evolution of academic medicine career intentions (sustained, emerging, diminished and no intent) by similarities/differences in graduates’ responses to the career choice question on both questionnaires. Multivariable logistic regression models identified independent predictors of sustained and emerging intent (compared with no intent) and diminished intent (compared with sustained intent). Of 87,763 graduates, 67% indicated no intent, 20% emerging intent, 8% sustained intent and 5% diminished intent to pursue an academic medicine career. Asians were more likely and underrepresented minorities less likely to have sustained and emerging intent. Women were more likely to have emerging intent. Graduates planning more extensive career involvement in research at matriculation and reporting greater satisfaction with the quality of their medical education, higher clinical clerkship ratings, and lower debt were more likely to have sustained and emerging intent and less likely to have diminished intent. Graduates planning to practice in underserved areas and choosing family medicine were less likely to have sustained and emerging intent and more likely to have diminished intent (all p<0.05). Findings can inform efforts to develop an academic medicine workforce that can meet our nation’s healthcare needs and more equitably reflect the diversity of our society and medical student population.

REFERENCES (28)

  • I. Ajzen

    The theory of planned behavior

    Org Behav Hum Decis Process

    (1991)
  • Beal A. Healthcare workforce diversity: developing physician leaders. The Sullivan Commission on Diversity in the...
  • R.W. Chesney

    The impact of medical school loans and the promise of loan repayment on entry into a pediatric academic career

    Arch Pediatr Adolesc Med

    (2001)
  • R. Cooter et al.

    Economic diversity in medical education: the relationship between students’ family income and academic performance, career choice, and student debt

    Eval Health Prof

    (2004)
  • R. Graham et al.

    Family practice in the United States: a status report

    JAMA

    (2002)
  • D.B. Jeffe et al.

    The changing paradigm of contemporary U.S. allopathic medical school graduates’ career paths: analysis of the 1997–2004 National AAMC Graduation Questionnaire Database

    Acad Med

    (2007)
  • J.H. Senf et al.

    Family medicine specialty choice and interest in research

    Fam Med

    (2005)
  • W.L. Hays

    Statistics for Psychologists

    (1963)
  • D.W. Hosmer et al.

    Applied Logistic Regression

    (1989)
  • AAMC Division of Diversity Policy and Programs

    Minorities in Medical Education: Facts & Figures 2005

    (2005)
  • G.V. Richard et al.

    Medical career choices: traditional and new possibilities

    JAMA

    (2001)
  • Association of American Medical Colleges (AAMC). Curriculum directory. Combined degree programs...
  • AAMC Division of Diversity Policy and Programs

    Diversity in the Physician Workforce: Facts & Figures 2006

    (2006)
  • Magrane D, Lang J. An overview of women in U.S. academic medicine, 2005–2006. Association of American Medical Colleges...
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    Financial support: Salary support for the work on this study was provided by the Office of Medical Student Education at Washington University School of Medicine in St. Louis, MO.

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