Longitudinal assessment of the timing of career choice among pediatric residents.

OBJECTIVE To determine the timing of and key factors in resident decision making to pursue either a career in general pediatrics or subspecialty training. DESIGN We used a 10-item fixed-choice questionnaire that focused on exploring how and when pediatric residents make career choices. SETTING The survey was administered to all categorical pediatric residents in the United States and Canada as part of the General Pediatrics In-Training Examination in 2007 and 2009. The 2007 level 1 residents and 2009 level 3 residents were matched by a unique person identifier to create a longitudinal data set. PARTICIPANTS A total of 2305 individuals completed the survey as level 1 residents in 2007 and level 3 residents in 2009, representing a retention rate of 83.5%. MAIN OUTCOME MEASURES Change in individual and aggregate pediatric resident response over time. RESULTS A similar number of individuals planned to pursue fellowship training in 2007 and 2009 (1026 vs 1062). Among this group, 745 (72.6%) of the 2009 residents were the same individuals who had indicated that they planned to pursue fellowship training in 2007. A total of 258 (71.9%) of all residents who reported in 2007 that they intended to pursue careers in general pediatrics with little or no inpatient care were still planning to do so in 2009. CONCLUSIONS Most pediatricians make their decisions regarding pursuit of a career in primary care or to complete a fellowship before they ever enter residency training. It is unknown whether a similar timeline of decision making is consistent across specialties.