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Attitudes and perceptions of internal medicine residents regarding pulmonary and critical care subspecialty training FREE TO VIEW

Scott M. Lorin, MD*; John Heffner, MD; Shannon Carson, MD
Author and Funding Information

Mount Sinai School of Medicine, New York, NY


Chest


Chest. 2004;126(4_MeetingAbstracts):727S. doi:10.1378/chest.126.4_MeetingAbstracts.727S-a
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Abstract

PURPOSE:  To evaluate the attitudes and perceptions of internal medicine (IM) residents regarding Pulmonary and Critical Care Medicine (PCCM) training.

METHODS:  Prospective study. Three university hospitals. An 8-page survey was distributed and collected between March 1st and June 30th, 2002. All IM or IM/pediatric residents training at the three institutions were eligible for the study.

RESULTS:  178 residents in IM from an eligible pool of 297 returned the survey (61% response rate). PCCM accounted for only 3.4% of the career choices. Forty-one percent (41.0%) seriously considered a pulmonary and/or critical care fellowship during their residency. Of these residents, 23.5% found the combination of programs the more attractive option, while 2.8% found pulmonary alone and 14.5% found critical care alone more attractive. Key factors associated with a higher resident interest in PCCM sub-specialty training included more ICU weeks (p=.008), more role models in PCCM (p=.0004), and resident observations of a greater sense of satisfaction among PCCM faculty (p=.04) and fellows (p=.03). The five most commonly cited attributes of PCCM fellowship that would attract residents to the field included intellectual stimulation (69%), opportunities to manage critically ill patients (51%), application of complex physiologic principles (45%), number of procedures performed (31%), and academically challenging rounds (29%). The five most commonly cited attributes of PCCM that would dissuade residents from the field included overly demanding responsibilities with lack of leisure time (54%), stress among faculty and fellows (45%), management responsibilities for chronically ill patients (30%), poor match of career with resident personality (24%), and treatment of pulmonary diseases (16%).

CONCLUSION:  Internal medicine residents have serious reservations about PCCM as a career choice. Our survey demonstrated that a minority of U.S. medical graduates actually would choose PCCM as a career, which suggests that efforts to expand PCCM training capacity might result in vacant fellowship slots.

CLINICAL IMPLICATIONS:  To promote greater interest in PCCM training, efforts are needed to improve the attractiveness of PCCM and address the negative “lifestyle” perceptions of residents.

DISCLOSURE:  S.M. Lorin, None.

Monday, October 25, 2004

2:30 PM - 4:00 PM


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