Factors Influencing Resident Career Choices in Emergency Medicine

Objective: To assess the attitudes of residents in emergency medicine regarding a career in academics.

Design: A 22-item questionnaire was administered to residents in conjunction with the yearly American Board of Emergency Medicine inservice examination. Demographic information and factors influencing career intent were elicited. Respondents were classified by intent on a career in emergency medicine. A three-way analysis of variance was used to address group differences for eight specific factors impacting on career decision. Chi-square analysis was used to address questions involving relationships among variables with dichotomous or categorical responses.

Results: The survey was distributed to 1,654 residents, and 1,238 (75%) completed the questionnaire. Motivating factors demonstrating significant differences between those residents planning an academic career and those not interested in academe were a desire to do research, desire to teach, desire to make a contribution to medicine, and exposure to role models, with less emphasis on the need for free time for other interests and less concern regarding practice location. More than 80% of those not going into academic emergency medicine believed they were adequately exposed to research in residency compared with 65% of those intent on a career in academe (P less than .01). Research in medical school, residency, and authorship of a research paper were significantly more prevalent for those residents desiring a career in academe (P less than .01). Twenty-six percent of residents responded that their role models for research were less than adequate. Seventeen percent of residents intend to take fellowship training. The most popular fields for fellowships were toxicology (25%), emergency medical services (21%), pediatrics (15%), and research (9%).

Conclusion: The results of this survey address attitudes among residents toward a career in academic emergency medicine. Factors such as motivation, role models, and exposure to research may help academicians plan strategies to meet the future needs of academic emergency medicine.