Table 4:Factors and quotes identified in focus group discussions
Mentorship, role models and experience on a rotation
“There were really good inspirational people in geriatrics that I identified with and thought I could really learn from them and work with them for a couple of years. That was a big factor.”
“I had mentors in GIM but I didn’t choose it because I don’t think they are as happy in general. Like their satisfaction isn’t as good as the ones that are in specialties.”
“I wonder whether a factor was the amount of exposure you get to fellows. Like in geriatrics I've never seen a fellow and on general medicine you barely saw a fellow. It's mostly staff.”
“A lot of the mentors that I think about are the ones that were actual females with kids that had them during their residency that I’ve met along the way and they were a great resource.”
“Initially all the respirologists were male. Not that they weren’t great mentors but slightly different, I didn’t identify exactly with them.”
“What really clinched my decision was the experience I had on the subspecialty the previous year and sort of the lifestyle and research.”
“I don't know how good those forced [mentorship] programs really are...... it's a personal process.
“I think it was a combination of mentorship and clinical work and essentially the lifestyle that I saw the rheumatologist leading in a non-academic center.”
“It’s a lack of exposure or perceived role for a geriatrician in the community. Or negative exposure in the case of geriatrics.”
Patients, practice type and personal fit
“you’re just very happy to be at work every day and wonderful things with lungs, outpatients, older patients, really sick patients, ICU procedures, bronching …. I haven’t been on any other rotation that I thought like I could do this every day and get excited every day.”
“… the kind of bread and butter of general medicine I don’t enjoy as much as the standard stuff that we see in geriatrics”
“sometimes you can like the idea behind it or the disease process and when you actually
go through the clinical rotation you realize this is not for me.”
Lifestyle and Family
“Trying to match a career with your spouse’s career, knowing you’re not both in very time demanding and inflexible careers is important to family commitments.”
“I think the lifestyle part, especially after I became married and just had a kid, it’s definitely a bonus being in a job that’s more regular hours.”
“It means not having to spend all of my time at the hospital. Opportunities to do other things besides medicine.”
“Lifestyle played a big role and that was one of the reasons I eliminated ICU and cardiology. I didn’t like the prospect of doing in-house call during fellowship…”
“Cardiology is not one of those lifestyle specialties, you’re still going to be doing a lot of
call and the call is heavy.”
Financial and Job Opportunities
“I went through all this school and I’m not going to choose a specialty where I make$150-$200 000. I want a higher earning than that.”
“If you do something interventional, whatever subspecialty you can generate your income more efficiently because you do one day of procedures and that brings you up from one or two days of office work.”
“In choosing rheumatology money was very, very low down on the list as a defining characteristic.”
“I don’t want to work a lot harder [in an academic institution] to generate the same salary [as a community cardiologist].”
“If you go into the community you’re going to work a lot more and you’re going to make a lot more ….. scoping is very lucrative”
“I think geriatrics is the exact opposite of an efficient way to earn an income.”
“The job opportunities are much better in geriatrics. There is much more demand for geriatricians almost everywhere really …..”
“Is there a possibility to practice in your particular area or is it going to be really saturated.”
“The chances of being able to walk into a position [as an academic cardiologist] is
actually quite low and so that’s very negative.”
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