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Long Hours Tied to Declining Interest in Internal Medicine

Internal medicine residencies are doing poorly among factors students value in career choice

TUESDAY, Sept. 9 (HealthDay News) -- While internal medicine interns work long hours, are often sleep deprived and miss educational activities, medical students cite favorable educational experiences, lifestyle factors and positive feelings towards caring for internal medicine patients as affecting their decision to choose internal medicine as a career, according to two reports published in the Sept. 10 issue of the Journal of the American Medical Association.

Vineet M. Arora, M.D., of the University of Chicago, and colleagues performed a prospective cohort study of interns examining whether on-call workload was associated with reductions in on-call sleep, increased total shift duration, and lower likelihood of participation in educational activities among internal medicine interns on the University of Chicago inpatient general medicine service between 2003 and 2005. The investigators found interns averaged 2.8 hours of sleep while on-call, worked 29.9 hours per shift, and spent 11 percent of their time on internal medicine in educational activities.

Karen E. Hauer, M.D., of the University of California San Francisco, and colleagues performed a multi-institutional, Web-based survey examining decision making regarding internal medicine careers and modifiable factors related to this decision. The authors report that overall, 23.2 percent of the 1,177 respondents planned careers in internal medicine and 2 percent planned to pursue general internal medicine. Only 19.4 percent of students believed the core clerkship made a career in general internal medicine seem more attractive, while 48.8 percent felt the core clerkship made a subspecialty internal medicine career more attractive.

"Our large sample of U.S. medical students expressed reservations about careers in internal medicine because of patient complexity, the practice environment and the lifestyle compared with other specialties. Students' career choices regarding internal medicine result from the interplay of lifestyle, personal and professional satisfaction, and the challenges of caring for the chronically ill in a health care system that still focuses on acute care," Hauer and colleagues write.

Abstract - Arora
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Abstract - Hauer
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