Malpractice litigation as a factor in choosing a medical specialty.

Although many factors have been identified as influencing specialty choice, there has been no research focusing on the effects of the current climate of medical practice, including litigation. Our study examines medical students' and residents' awareness of the malpractice litigation environment and their reasons for choosing a specialty that is at either high or low risk for malpractice suits. Longitudinal data showed that students continued to choose high-risk specialties (40%) even though they perceived problems in the current climate of litigation. Among the reasons for their choices were enjoyment and being able to practice in a procedure-oriented specialty that is effective in its mode of treatment. Those who chose low-risk specialties (60%) rated as important the variety of diseases seen and the opportunity to know patients well. Issues related to the malpractice climate were important only to those who switched from a high- to a low-risk specialty. These findings have implications for professional staffing needs.