The impact of the internal medicine sub-internship on medical student career choice.
BACKGROUND
Medical student interest in internal medicine is decreasing. Whether the internal medicine sub-internship affects intent to pursue internal medicine is unknown.


OBJECTIVE
Determine the immediate and longer-term effect of the medicine sub-internship on students' decision to pursue internal medicine residency.


METHODS
Mixed method, single institution, prospective cohort study.


METHODS
Ninety-two students completing an internal medicine sub-internship in 2006.


METHODS
Survey administered prior to and immediately after the sub-internship and prior to the match. Questions included likelihood of applying in internal medicine and perceived impact of the sub-internship on career choice.


RESULTS
Seventy-seven percent of students (N = 63) completed the first two surveys; 63% (N = 58) completed the second and third. Immediately post sub-internship, 21% (N = 13) were less likely to apply in internal medicine and 11% (N = 7) were more likely to apply (net change in plans was not significant, p = 0.38). There was a significant relationship between the perceived impact of the sub-internship and likelihood of applying in medicine (ANOVA comparison across means, p < 0.001). Compared to the second survey, on the third survey more students (41%, N = 24) believed the sub-internship positively impacted their decision to apply in medicine, though overall shifting was not significant (p = 0.39). Key themes describing sub-internship impact included the intense workload, value of experiencing internship, rewards of assuming the physician role, and education received (30%, 25%, 20% and 16% of comments, respectively).


CONCLUSIONS
Overall, there was not a significant effect of the sub-internship on students' decision to apply in internal medicine. Additional research about the relative impact of the sub-internship in relationship to other career choice predictors is needed to better address factors that may encourage or dissuade students from pursuing internal medicine.
University of Pennsylvania School of Medicine, Suite 640, Philadelphia, PA 19104, USA. jennifer.kogan@uphs.upenn.edu
Jennifer R
JR
Kogan
Judy A
JA
Shea
Elizabeth
E
O'Grady
Lisa M
LM
Bellini
Frank
F
Ciminiello
D002321:Career Choice; D015331:Cohort Studies; D003625:Data Collection / Q000379:methods; D006801:Humans; D007388:Internal Medicine / Q000379:methods / Q000639:trends*; D007396:Internship and Residency / Q000379:methods / Q000639:trends*; D011446:Prospective Studies; D013038:Specialization / Q000639:trends*; D013337:Students, Medical / Q000523:psychology*