Patel Mitesh S, Katz Joel T, Volpp Kevin G
J Grad Med Educ. 2010 Sep;2(3):360-5. doi: 10.4300/JGME-D-10-00047.1.
Factors impacting medical student specialty career choice are poorly understood, but may include income potential and lifestyle features such as limited and predictable work hours.
Data from the National Resident Matching Program and the San Francisco Match were used to examine match rates into higher-income controllable lifestyle (CL), lower-income CL, and noncontrollable lifestyle (NCL) specialties from 2002 to 2007. We studied 3 cohorts: students from highly ranked, research-based medical schools, other US senior medical students, and independent applicants (consisting mostly of graduates from foreign medical schools).
By 2007, 22.5% of students from highly ranked schools matched into a higher-income CL specialty compared with 16.5% of other US seniors and 8.4% of independent applicants. During the study period, students from highly ranked schools increased their match rate in higher-income CL specialties by 7.9%, while all cohorts experienced declines in match rates for NCL specialties. Compared with other US seniors, students from highly ranked schools were more likely to match into higher-income CL specialties (odds ratio [OR], 1.46; 95% confidence interval [CI]: 1.27-1.68), while independent applicants were much less likely to do so (OR, 0.46; 95% CI: 0.42-0.51). Independent applicants had the highest odds (OR, 2.38; 95% CI: 2.25-2.52) of matching into NCL specialties.
All cohorts had declining match rates into NCL specialties from 2002 to 2007. When compared with other US seniors, students from highly ranked schools had the highest odds of matching in higher-income CL specialties, while independent applicants had the highest odds of matching into NCL specialties. These trends are important to consider in light of recent efforts to better balance the physician workforce.
影响医学生专业职业选择的因素尚未得到充分了解，但可能包括收入潜力和生活方式特征，如工作时间有限且可预测。
利用来自国家住院医师匹配计划和旧金山匹配计划的数据，研究2002年至2007年进入高收入可控生活方式（CL）专业、低收入CL专业和不可控生活方式（NCL）专业的匹配率。我们研究了三组人群：来自排名靠前的研究型医学院的学生、其他美国高年级医学生以及独立申请者（主要由外国医学院的毕业生组成）。
到2007年，来自排名靠前学校的学生中有22.5%匹配到高收入CL专业，而其他美国高年级学生为16.5%，独立申请者为8.4%。在研究期间，来自排名靠前学校的学生在高收入CL专业的匹配率提高了7.9%，而所有组在NCL专业的匹配率都有所下降。与其他美国高年级学生相比，来自排名靠前学校的学生更有可能匹配到高收入CL专业（优势比[OR]为1.46；95%置信区间[CI]：1.27 - 1.68），而独立申请者匹配到此类专业的可能性则小得多（OR为0.46；95% CI：0.42 - 0.51）。独立申请者匹配到NCL专业的几率最高（OR为2.38；95% CI：2.25 - 2.52）。
从2002年到2007年，所有组在NCL专业的匹配率都在下降。与其他美国高年级学生相比，来自排名靠前学校的学生匹配到高收入CL专业的几率最高，而独立申请者匹配到NCL专业的几率最高。鉴于最近为更好地平衡医生劳动力所做的努力，这些趋势值得考虑。
