A model for assessing the gap between physician residency demand and present status.
BACKGROUND
The medical workforce shortage worldwide varies for different residencies.


OBJECTIVE
To determine future gaps in medical specialties in Israel by means of a model and to identify trends and considerations among medical students when they choose their residencies.


METHODS
The gap (Gi) assessment model was based upon current demand (Di) and existing (Ei) status for each residency, using the formula [Gi = (Di-Ei)/Ei]. Ei represented the proportion of specific residencies in 2006-2010 out of all Israeli residency graduates and Di was based on questionnaires filled out by medical students at Sackler and Hadassah medical schools in Tel Aviv and Jerusalem, respectively (N = 909).


RESULTS
The largest relative shortages (Gi ranges from -1 to 1) were in Pathology (G = -1), Rehabilitation Medicine (-0.9), Radiology (-0.8), Family Medicine (-0.8) and Anesthesiology (-0.8). The highest relative demands were in Surgical subspecialties (2.9) and Obstetrics/Gynecology (OB/GYN) (1.6). More females than males chose residencies in OB/GYN (19.5% vs. 7.1%, P < 0.001) and Pediatrics (28.1% vs. 15.4%, P < 0.001). Surgery subspecialties (9% vs. 23.7%, P < 0.001) were male-predominant. The workload consideration was rated higher among females, while income was rated higher among males. Among students in clinical years, compared to pre-clinical, there was a decline in the selection of some professions, including Surgical subspecialties (9.7% vs. 19.5%, P < 0.001).


CONCLUSIONS
The suggested model, based on a survey of demand and current or projected future needs, can be used to assess gaps and plan early interventions. Programs at the level of medical school may affect residency preferences. The decline in selection of surgical professions and the increasing workload as a consideration for residency choice should be given attention.
Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. ygofin@gmail.com
Yoel
Y
Gofin
Arnon
A
Afek
Estela
E
Derazne
Asaf
A
Toker
Ari
A
Shamiss
D000328:Adult; D002321:Career Choice; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007557:Israel; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D015233:Models, Statistical; D010820:Physicians / Q000600:supply & distribution*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires