Factors associated with the choice of a second specialty among internal medicine residency graduates

Abstract

Introduction: After the residency in Internal Medicine, most graduates choose to undergo a new selection process to obtain a second specialty. The phenomenon of early specialization is encouraged as early as in the undergraduate course. Despite this, the demand for general practitioners is growing. Objective: To investigate the factors that lead the newly graduated clinician to undertake a new residency. Method: This is a cross-sectional study that analyzes the responses of Internal Medicine residency graduates from the state of Pernambuco in 2020, through a questionnaire available online by Google Forms, containing questions about social aspects, undergraduate medical course, Medical Residency and intentions for the future career. Results: There were 81 responses of the 104 possible participants (77.88%). Most of these were female (66.67%), graduated from public universities (69.14%) and had already started the Internal Medicine residency shortly after graduation (50.62%). Regarding the specialty choice, 51.85% answered they had decided in the second year of residency, and 80.25% stated that they had undergone the selection process for the second specialty shortly after completing the Internal Medicine residency. The most often chosen career was Cardiology (20%). The factors most often associated with the choice of specialty were, according to the means on the Likert scale, “work in an outpatient setting”, “long-term patient follow-up”, and “more contact with patients”. Conclusion: As far as it could be investigated in the literature, this was the first Brazilian study on specialty choices after the Internal Medicine residency. It was possible to identify the most important reasons for choosing a second specialty among the graduates of this Medical Residency program in Pernambuco in 2020. More studies are needed to establish correlations between the factors of choice with the chosen specialty.

Overview on and Contextual Determinants of Medical Residencies in North Brazil

“…However, idleness rates were not homogeneous among North States; Pará State recorded the lowest idleness rate, whereas Rondônia, Acre, and Amapá had the highest idleness rates, which is consistent with a previous study conducted with data from 2019 [ 1 ]. Factors such as personal and contextual determinants are associated with MRPs idleness and physicians [ 29 ]. Factors associated with the academic infrastructure of MRP-offering institutions and municipalities [ 29 ] stood out, which may explain the differences in idleness rates observed between states.…”

“…Factors such as personal and contextual determinants are associated with MRPs idleness and physicians [ 29 ]. Factors associated with the academic infrastructure of MRP-offering institutions and municipalities [ 29 ] stood out, which may explain the differences in idleness rates observed between states. Studies have shown that proper workplace, better practice and work fields, sufficient physical resources and preceptors, and patients available for practical activities, among others, are factors determining MRPs idleness and professionals’ choice of these programs [ 29 , 30 ].…”

“…Factors associated with the academic infrastructure of MRP-offering institutions and municipalities [ 29 ] stood out, which may explain the differences in idleness rates observed between states. Studies have shown that proper workplace, better practice and work fields, sufficient physical resources and preceptors, and patients available for practical activities, among others, are factors determining MRPs idleness and professionals’ choice of these programs [ 29 , 30 ]. Pará State accounts for the largest number of medical schools, teaching units, and healthcare establishments in comparison to other states in the North Region [ 20 ]; this finding may explain its lower idleness rate than that of other states.…”