Purpose: To examine factors that influenced, positively or negatively, the specialty career choices of physicians trained at Yale-New Haven Hospital (YNHH) from 1929 to 1994.
Method: The authors sent questionnaires to 4,888 physicians who had trained or were training in YNHH-sponsored residency programs. The physicians rated 36 factors posited to be influenced in career choice on a seven-point Likert scale from very negative to very positive. The authors compared the means of each factor's ratings by decade of medical school graduation.
Results: The most positively rated influences were similar in each decade from the 1920s to the 1990s. These influences shared characteristics of intellectual curiosity ("intellectual content of the specialty" and "challenging diagnostic problems"), altruism ("interest in helping people" and "opportunity to make differences in people's lives"), and personal identity ("consistent with personality" and "possess the required skill or ability"). Negative factors, such as "demands on time and effort," "stress in the field," and "malpractice costs," were also consistently rated throughout the decades.
Conclusion: The reasons that physicians choose certain specialty careers have not changed significantly over the past 65 years despite all the changes that have occurred in medicine. Physicians continue to seek professional opportunities that are viewed as intellectually challenging and of benefit to others.