Factors That Impact Medical Student and House-staff Career Interest in Brain Related Specialties

Purpose: There is a national shortage of physicians in brain related specialties (neurology, neurosurgery and psychiatry), with fewer students training in these specialties. This study explored socio-economic and experiential factors that determined medical trainees' interest in brain related specialties.

Method: Medical students and house-staff at a state university medical school completed a 46-item questionnaire sent as an anonymous email survey.

Results: Survey response rate was 22% (n=258). Eighty-eight (34.1%) trainees were interested in brain related specialties. Prior neuroscience experience (29.6%) and effective medical school neuroscience courses (23.9%) were identified as important by those interested in brain related specialties, while "neurophobia" was reported by 30% of those not interested. Multivariate regression model showed that effective college neuroscience course increased the likelihood for interest in brain related specialties (OR=2.28, 95% CI 1.22, 4.28). Factors which decreased the likelihood included parent's possessing professional degree (OR=0.37, 95% CI 0.17, 0.80), personal annual income>$50,000 (OR=0.40, 0.18, 0.87) and current debt level≥$100,000 (OR=0.33, 0.17, 0.64). The proportion of trainees interested in brain related specialties decreased from 51.7% (1st year medical students) to 27% (4th year students) and 25.3% among house-staff (χ(2) test of trend p=0.001).

Conclusions: Socioeconomic (current personal debt and annual income) and experiential factors (college neuroscience course) influence a medical trainee's interest in brain related specialties. Career guidance and improved, better and early exposure to neurosciences may help mitigate trend for decreased interest in brain related specialties.