PREDICTORS OF YOUNG PHYSICIANS PRACTICING SPECIALTIES WITHOUT PRIOR GRADUATE MEDICAL-EDUCATION

Objective. This study identifies predictors of young physicians practi cing specialties for which they did not report having graduate medical education. Data Source. A secondary analysis was conducted using a na tionally representative survey of young physicians, Practice Patterns of Young Physicians, 1987 (United States). Physicians were under 40 ye ars of age and in uninterrupted practice more than one but fewer than six complete years. Study Design. Young physicians who practiced speci alities without prior graduate medical education (GME) in these specia lties were compared to young physicians who practiced only the special ities for which they reported GME. Comparisons were made on sociodemog raphic characteristics, international medical graduate status, number and types of GME specialties, year completed GME, and preference for a practice position that was not offered. Data Extraction Methods. Samp le size was 4,440, including 345 (7.8 percent) physicians who practice d specialties without prior GME. Logistic regression analysis was used to identify predictors of young physicians practicing specialties wit hout prior GME. Principal Findings. Physicians who practiced specialti es without prior GME more likely were younger, members of minorities o ther than Black, and with a physician father, high medical school educ ational debt, and GME in the more generalist specialties. Interaction effects occurred among sex, marital status, and having had GME in inte rnal medicine. Goodness-of-fit analyses indicated that the predictors were useful, but classification table results indicated that at best t wo out of three cases could be correctly classified. Conclusions. Prac ticing specialties without prior graduate medical education in those s pecialties was related to sociodemographic characteristics and type of specialty training, but a fuller understanding of the circumstances a ffecting physician specialty changes will require querying physicians directly about their practice choices.