THE INITIAL EMPLOYMENT STATUS OF PHYSICIANS COMPLETING TRAINING IN 1994

Objective.-To gain information about the career status of residents wh o completed graduate medical education training programs in selected s pecialties and subspecialties during the 1993-1994 academic year. Desi gn.--A descriptive one-page survey of residency program directors, inc luding two mailed follow-up surveys, was conducted from January 1, 199 5, to June 1, 1995. Setting.-Directors of residency programs in 26 spe cialties and subspecialties accredited by the Accreditation Council fo r Graduate Medical Education, totaling 4369 programs. Main Outcome Mea sures.-Program directors identified the number of resident physicians who completed the program, the known career status of those physicians , the number of physicians who had experienced difficulty finding a pr actice position, the characteristics of the full-time clinical practic e positions, and the number of physicians who could not find full-time employment. The perceptions about likely trends in the availability o f practice opportunities for graduates in the future and the likely ch ange in the number of resident positions were also assessed. Results.- A total of 3090 program directors (70.7%) completed the survey. Respon dents reported that 15 999 resident physicians completed training in o ne of the 26 specialties and subspecialties, and 63.2% of these gradua tes were potentially seeking a professional position. Most of those no t seeking a position were pursuing additional training (92.9%). Of tho se seeking employment, the percentage who did not find a full-time pos ition in their specialty or subspecialty ranged between none in urolog y to 10.8% in pathology. Across all specialties, about 70% of graduate s looking for full-time positions entered clinical practice in their s pecialty of training. Physicians pursuing generalist careers had fewer problems finding preferred positions than those pursuing nongeneralis t specialties. Finally, program directors in most nongeneralist specia lties believed that the degree of difficulty their graduates will expe rience in finding a full-time practice position will increase during t he next year. Conclusions.-Physicians attempting to enter practice in some specialties and in some regions of the country are experiencing d ifficulty. In some cases up to 10% of the resident physicians did not find full-time positions in their specialty or subspecialty. The diffe rences noted between the generalist and nongeneralist specialties are consistent with widespread perceptions about the current market. These data establish the baseline for analyzing trends.