Obstetrics anyone? How family medicine residents' interests changed

OBJECTIVE To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their re sidency programs. DESIGN Residents in each of 4 consecutive years, starting July 1991, were s urveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for a nalysis. SETTING Family medicine residency programs at the University of Toronto in Ontario. PARTICIPANTS Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit. MAIN OUTCOME MEASURES Changes in attitudes and plans during the residency p rogram as ascertained from responses to entry and exit questionnaires. RESULTS Analysis was based on 215 paired questionnaires. Women residents ha d more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obsterics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduat ion, residents perceived lifestyle factors and compensation as very importa nt negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated. CONCLUSIONS Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for produ cing more physicians willing to practise obstetrics than trying to change t he minds of those uninterested in such practice.