Impact of AOA status and perceived lifestyle on career choices of medical school graduates

BACKGROUND: Based upon student ratings of such factors as predictable work hours and personal time, medical specialties have been identified as lifestyle friendly, intermediate, or unfriendly. Lifestyle friendly programs may be more desirable, more competitive, and for students elected to the Alpha Omega Alpha (AOA) Honor Medical Society, more attainable. OBJECTIVE: The objective of this study was to evaluate whether AOA students increasingly entered lifestyle friendly residency programs and whether trends in program selection differed between AOA and non-AOA graduates. DESIGN: This retrospective cohort study examined PGY-2 data from the Association of American Medical Colleges and the 12 allopathic schools in the Associated Medical Schools of New York. PARTICIPANTS: Data on 1987-2006 graduates from participating schools were evaluated. MAIN MEASURES: Residency program selection over the 20-year period served as the main outcome measure. KEY RESULTS: AOA graduates increasingly entered lifestyle-friendly residencies-from 12.9% in 1987 to 32.6% in 2006 (p<0.01). There was also a significant decrease in AOA graduates entering lifestyle unfriendly residencies, from 31.6% in 1987 to 12.6% in 2006 (p<0.01). Selection of lifestyle intermediate residencies among AOA graduates remained fairly stable at an average of 53%. Similar trends were found among non-AOA students. However, within these categories, AOA graduates increasingly selected radiology, dermatology, plastic surgery and orthopedics while non-AOA graduates increasingly selected anesthesiology and neurology. CONCLUSIONS: While lifestyle factors appear to influence residency program selection, AOA graduates differentially were more likely to either choose or attain certain competitive, lifestyle-friendly specialties. Health care reform should be targeted to improve lifestyle and decrease income disparities for specialties needed to meet health manpower needs.