title: Distress and empathy do not drive changes in specialty preference among US medical students.
abstract: BACKGROUND
  Although medical student specialty choices shape the future of the healthcare workforce, factors influencing changes in specialty preference during training remain poorly understood.
  
  
  OBJECTIVE
  To explore if medical student distress and empathy predicts changes in students' specialty preference.
  
  
  METHODS
  A total of 858/1321 medical students attending five medical schools responded to surveys in 2006 and 2007. The survey included questions about specialty choice, burnout, depression, quality of life, and empathy.
  
  
  RESULTS
  A total of 26% (205/799) changed their specialty preference over 1 year. Depersonalization--an aspect of burnout--was the only distress variable associated with change in specialty preference (OR, odds ratio 0.962 for each 1-point increase in score, p = 0.03). Empathy at baseline and changes in empathy over the course of 1 year did not predict change in specialty preference (all p > 0.05). On multi-variable analysis, being a third year (OR 1.92), being male (OR 1.48), and depersonalization score (OR 0.962 for each point increase) independently predicted a change in specialty preference. Distress and empathy did not independently predict students' losing interest in primary care whereas being a fourth-year student (OR 1.83) and being female (OR 1.83) did.
  
  
  CONCLUSIONS
  Among those who did have a major change in their specialty preference, distress and empathy did not play a major role.
authors.affiliation: College of Medicine, Mayo Clinic, Rochester, MN 55906, USA. dyrbye.liselotte@mayo.edu
authors.forename: Liselotte N
authors.initials: LN
authors.lastname: Dyrbye
authors.forename: Anne M
authors.initials: AM
authors.lastname: Eacker
authors.forename: William
authors.initials: W
authors.lastname: Harper
authors.forename: David V
authors.initials: DV
authors.lastname: Power
authors.forename: F Stanford
authors.initials: FS
authors.lastname: Massie
authors.forename: Daniel
authors.initials: D
authors.lastname: Satele
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Thomas
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
mesh_terms: D002055:Burnout, Professional / Q000523:psychology*; D002321:Career Choice; D016009:Chi-Square Distribution; D003861:Depersonalization / Q000523:psychology; D004645:Empathy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012737:Sex Factors; D013038:Specialization; D013315:Stress, Psychological / Q000523:psychology; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States