title: Gastroenterology training and career choices: a prospective longitudinal study of the impact of gender and of managed care.
abstract: OBJECTIVE
  We aimed to determine if gender differences exist in the selection and training of female and male gastroenterology fellows.
  
  
  METHODS
  One hundred seventy-six of 218 training program directors returned an 18-question survey about their programs, including leave policies, training, and prevalence of female faculty. Two cohorts of graduating trainees from 1993 and 1995 (N = 393) returned anonymous surveys regarding their training program experiences, demographics, and business training.
  
  
  RESULTS
  Female gastroenterology trainees are more likely to choose programs according to parental leave policies (p < 0.05), female faculty (0.2990 correlation coefficient), and "family reasons" (p < 0.04) than the male trainees. Female trainees were more likely to remain childless (p < 0.001) or have fewer children at the end of training despite marital status not unlike their male colleagues. Female trainees altered their family planning because of training program restrictions (20% vs 7%, p < 0.001). They perceived gender discrimination (39%) and sexual harassment (19%) during gastroenterology training. Trainees of both sexes had mentorship during training (65% vs 71%, ns); female trainees were more likely to have an opposite sex mentor (71% vs 3.4%) despite an almost 50% prevalence of female full-time and clinical faculty. Female trainees were apt to be less trained in advanced endoscopy (p < 0.005). Trainees of both sexes were influenced by the changing health care environment in career choice (49% vs 42%, ns); neither gender felt adequately prepared for the business aspects of gastroenterology.
  
  
  CONCLUSIONS
  Alterations in gastroenterology training are needed to attract qualified female applicants. New graduates of both sexes lack practice management education.
authors.affiliation: Department of Gastroenterology, Henry Ford Health System, Detroit, Michigan, USA.
authors.forename: Freda L
authors.initials: FL
authors.lastname: Arlow
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Raymond
authors.forename: Robyn G
authors.initials: RG
authors.lastname: Karlstadt
authors.forename: Raquel
authors.initials: R
authors.lastname: Croitoru
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Rybicki
authors.forename: Suriya V
authors.initials: SV
authors.lastname: Sastri
mesh_terms: D000328:Adult; D002321:Career Choice; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D008329:Managed Care Programs; D010822:Physicians, Women / Q000523:psychology; D011336:Probability; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce