Longitudinal assessment of the timing of career choice among pediatric residents.

OBJECTIVE: To determine the timing of and key factors in resident decision making to pursue either a career in general pediatrics or subspecialty training. DESIGN: We used a 10-item fixed-choice questionnaire that focused on exploring how and when pediatric residents make career choices. SETTING: The survey was administered to all categorical pediatric residents in the United States and Canada as part of the General Pediatrics In-Training Examination in 2007 and 2009. The 2007 level 1 residents and 2009 level 3 residents were matched by a unique person identifier to create a longitudinal data set. PARTICIPANTS: A total of 2305 individuals completed the survey as level 1 residents in 2007 and level 3 residents in 2009, representing a retention rate of 83.5%. MAIN OUTCOME MEASURES: Change in individual and aggregate pediatric resident response over time. RESULTS: A similar number of individuals planned to pursue fellowship training in 2007 and 2009 (1026 vs 1062). Among this group, 745 (72.6%) of the 2009 residents were the same individuals who had indicated that they planned to pursue fellowship training in 2007. A total of 258 (71.9%) of all residents who reported in 2007 that they intended to pursue careers in general pediatrics with little or no inpatient care were still planning to do so in 2009. CONCLUSIONS: Most pediatricians make their decisions regarding pursuit of a career in primary care or to complete a fellowship before they ever enter residency training. It is unknown whether a similar timeline of decision making is consistent across specialties.