Predictors of young physicians practicing specialties without prior graduate medical education.
OBJECTIVE
This study identifies predictors of young physicians practicing specialties for which they did not report having graduate medical education.


METHODS
A secondary analysis was conducted using a nationally representative survey of young physicians, Practice Patterns of Young Physicians, 1987 (United States). Physicians were under 40 years of age and in uninterrupted practice more than one but fewer than six complete years.


METHODS
Young physicians who practiced specialties without prior graduate medical education (GME) in these specialties were compared to young physicians who practiced only the specialties for which they reported GME. Comparisons were made on sociodemographic characteristics, international medical graduate status, number and types of GME specialties, year completed GME, and preference for a practice position that was not offered.


METHODS
Sample size was 4,440, including 345 (7.8 percent) physicians who practiced specialties without prior GME. Logistic regression analysis was used to identify predictors of young physicians practicing specialties without prior GME.


RESULTS
Physicians who practiced specialties without prior GME more likely were younger, members of minorities other than Black, and with a physician father, high medical school educational debt, and GME in the more generalist specialties. Interaction effects occurred among sex, marital status, and having had GME in internal medicine. Goodness-of-fit analyses indicated that the predictors were useful, but classification table results indicated that at best two out of three cases could be correctly classified.


CONCLUSIONS
Practicing specialties without prior graduate medical education in those specialties was related to sociodemographic characteristics and type of specialty training, but a fuller understanding of the circumstances affecting physician specialty changes will require querying physicians directly about their practice choices.
Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo 14214.
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Bertram
D000328:Adult; D002321:Career Choice; D004501:Education, Medical; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data* / Q000639:trends; D008913:Minority Groups; D016017:Odds Ratio; D011364:Professional Practice / Q000639:trends*; D011897:Random Allocation; D012737:Sex Factors; D012959:Socioeconomic Factors; D013038:Specialization; D014481:United States