Table 1

Factors influencing changes in career preferences

Medical lifestyle

  • New career more appealing

  • Shorter residency for new career

  • Happy residents in new career

  • Family considerations have changed

  • New career allows more flexibility

  • Old career less appealing

  • Location needs have changed

Encouragement by physician

  • Problem-based learning physician encouraged new career

  • Clinical physician encouraged new career

  • Lecture physician encouraged new career

Discouragement by physician or negative clinical exposure

  • Problem-based learning physician discouraged old career

  • No mentor found for old career

  • Lecture physician discouraged old career

  • Clinical physician discouraged old career

  • Negative exposure during preclerkship to old career

  • Unhappy residents in old career

Economics or politics

  • Negative health care reform on primary care

  • Political or economic effect on old career

  • Negative health care reform on hospitals

  • Can switch residencies if desired

  • Potential income increased importance

Competence or skill

  • New career more intellectually challenging

  • Greater competence of physicians in new career

  • Lower competence of physicians in old career

  • New career more competitive to enter

Positive clinical exposure

  • Positive clinical exposure to new career

  • Encouragement from mentor in new career

Ease of residency entry

  • New career less competitive to enter

  • Negative performance on evaluations and examinations