A NEW ANALYSIS has found that among U.S. medical students, hospital medicine may be of greatest interest to women, people who are part of a sexual and racial minority, and people who have higher levels of educational debt.
A study looked at data from Association of American Medical Colleges surveys of medical school students who graduated between 2018 and 2020. There were nearly 50,000 respondents to those three years of surveys.
The study, published in BMC Medical Education, looked at respondents who answered the following question affirmatively: “Do you plan, at some point in your career, to work as a hospitalist (i.e., full-time care of hospitalized patients)?”
The study found that 19% of survey respondents said they were interested in working as a hospitalist. But when researchers looked at how medical students answered that question, they found some interesting differences.
Students interested in hospital medicine, for example, had an average of $170,000 in educational debt compared to $155,000 for all respondents. Medical students who answered “yes” were also more likely to be female (52.6% vs. 49.9%); bisexual (3.9% vs. 3.1%) or gay/lesbian (4.5% vs. 3.8%), and not heterosexual (89.4% vs. 91%). They were also more likely to be Hispanic (7.4% vs. 4.9%), African American (6.3%vs 5.3%), or Asian (24.2 vs. 20.5%), not white (51.4% vs. 58.7%).
The study looked at survey questions that asked medical students to describe the factors that influenced their career choices in medicine. Researchers found that factors such as role models and the ability to do a fellowship were more important to medical students interested in hospital medicine than to those in the overall population of medical students.
Here are some of the factors that students interested in hospital medicine rated higher than medical students as a whole:
- Role models (82.4% vs. 80.5%).
- Ability to do a fellowship (69.3% vs. 60.7%).
- Length of training (44.1% vs. 42.8%).
Researchers found that factors like the competitiveness of a specialty or family expectations played less of a role in the choice of students choosing hospital medicine. Here are some of the factors that students interested in hospital medicine rated lower than medical students as a whole:
- Interest in higher pay (42.4% vs. 46.7%).
- Influence of future family plans (54.6% vs. 57%).
- Work/life balance (73.5% vs. 76.8%).
On a smaller scale, researchers found differences between students interested in adult hospital medicine and pediatric hospital medicine. Students who said they were interested in adult hospital medicine, for example, said the following factors were more important to them than students interested in pediatric hospital medicine:
- Competitiveness of specialty (41.2% for potential adult hospitalists vs. 23% for potential pediatric hospitalists).
- Educational debt (24.3% vs. 9.7%).
- Options for fellowship training (79.8% vs. 72.3%).
- Salary expectations (48.9% vs. 16.6%).
- Work/life balance (82.5% vs. 79.8%).
Finally, medical students interested in adult hospital medicine were less likely to plan to enroll in a loan forgiveness program than those interested in pediatric hospital medicine (34.3% vs. 44.6%).
Finally, medical students interested in adult hospital medicine were less likely to plan to enroll in a loan forgiveness program than those interested in pediatric hospital medicine.
This is a good example of a survey that reports statistically significant outcomes that, because of the huge n-number and small numerators, are largely meaningless at the hospital or university level. For my Nickle, the data that compares pediatric vs adult hospitalist financial attitudes is the only story here.