Factors influencing the choice of specialty of Australian medical graduates.
OBJECTIVE
To identify the relative importance of extrinsic determinants of doctors' choice of specialty.


METHODS
A self-administered postal questionnaire.


METHODS
Australian vocational training programs.


METHODS
4259 Australian medical graduates registered in September 2002 with one of 16 Australian clinical colleges providing vocational training programs.


METHODS
Choice of specialist vocational training program; extrinsic factors influencing choice of program, and variation by sex, age, marital status and country of birth.


RESULTS
In total, 79% of respondents rated "appraisal of own skills and aptitudes" as influential in their choice of specialty followed by "intellectual content of the specialty" (75%). Extrinsic factors rated as most influential were "work culture" (72%), "flexibility of working arrangements" (56%) and "hours of work" (54%). We observed variation across training programs in the importance ascribed to factors influencing choice of specialty, and by sex, age and marital status. Factors of particular importance to women, compared with men, were "appraisal of domestic circumstances" (odds ratio [OR], 1.9), "hours of work" (OR, 1.8) and "opportunity to work flexible hours" (OR, 2.6). Partnered doctors, compared with single doctors, rated "hours of work" and "opportunity to work flexible hours" as more important (OR, 1.3), while "domestic circumstances" was more important to doctors with children than those without children (OR, 1.7). In total, 80% of doctors had chosen their specialty by the end of the third year after graduation.


CONCLUSIONS
Experience with discipline-based work cultures and working conditions occurs throughout medical school and the early postgraduate years, and most doctors choose their specialty during these years. It follows that interventions to influence doctors' choice of specialty need to target these critical years.
Harris
Mary G
MG
National Health Workforce Secretariat, North Sydney, NSW, Australia. harris59@bigpond.com
Gavel
Paul H
PH
Young
Jeannette R
JR
D000328:Adult; D017677:Age Distribution; D001291:Attitude of Health Personnel; D001315:Australia; D002321:Career Choice; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013038:Specialization; D013337:Students, Medical / Q000706:statistics & numerical data*