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The Influence of Quality-of-Life, Academic, and Workplace Factors on Residency Program Selection

Nuthalapaty, Francis S. MD; Jackson, James R. PhD; Owen, John MD

Special Theme Research Report

Purpose. To examine the influence of quality-of-life, academic, and workplace factors on residency program selection and determine whether factors are valued differently by applicants choosing surgical (SP) versus nonsurgical (NSP) programs.

Method. All 16,183 graduates of U.S. allopathic medical schools registered with the Electronic Residency Application Service were surveyed during the 2003 residency match. A total of 7,183 (44%) applicants responded. Selection prevalence from among 20 possible influential factors and the relative importance assigned to those chosen factors were analyzed.

Results. The most common factors influencing residency program selection were how much the residency program seemed to care about its trainees (98%), how satisfied the current residents are with their program (98%), how well the applicant thought he or she would fit into the program (97%), the geographic location of the residency (95%), and how well the current residents seem to work with each other (94%). Applicants to NSP were more likely to consider geographic location (p < .001), emphasis on interacting with medical students (p = .019), amount of clinical support services (p < .001), frequency of on-call duty (p = .047), types of benefits (p < .001), salary (p = .023), and supplemental income (moonlighting) opportunities (p < .001) than were applicants to SP. SP applicants were more likely to consider emphasis on research in the residency curriculum (p < .001) and how well the current residents worked together (p < .001) than were NSP applicants.

Conclusions. Of factors that influence residency program selection, those related to the characteristics of the workplace environment and geography are the most important. Minimal differences exist between applicants selecting surgical and nonsurgical specialties regarding academic and quality-of-life issues.

Dr. Nuthalapaty is a postgraduate fellow in maternal–fetal medicine, Department of Obstetrics and Gynecology; Dr. Jackson is associate professor of education in medicine and director, Academic Information Management and Institutional Research, Office of Medical Education; and Dr. Owen is professor, maternal–fetal medicine, Department of Obstetrics and Gynecology. All are at the University of Alabama School of Medicine, Birmingham, Alabama.

Correspondence and requests for reprints should be addressed to Dr. Nuthalapaty, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 619 19th Street South, OHB 451, Birmingham, AL 35249-7333; telephone: (205) 934-9616; fax: (205) 975-4375; e-mail: 〈francis@nuthalapaty.net〉.

© 2004 Association of American Medical Colleges