Factors influencing career decisions in internal medicine

Intern Med J. 2012 Aug;42(8):918-23. doi: 10.1111/j.1445-5994.2012.02793.x.


Background: Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians.

Aims: To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children.

Methods: A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities.

Results: Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job.

Conclusion: It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Attitude of Health Personnel*
  • Career Choice*
  • Decision Making*
  • Female
  • Humans
  • Internal Medicine*
  • Male
  • New Zealand
  • Physicians / psychology*
  • Sex Factors
  • Surveys and Questionnaires