Exploring Influences on Specialty Aspirations

Context The number of physicians in primary care is declining, with fewer medical students pursuing the field. Lower financial compensation in primary care is often cited as a reason, but the impact of socioeconomic status and environmental factors during upbringing on specialty choices has not been thoroughly explored.

Objective To determine whether an association exists between socioeconomic factors and the intended specialties of medical students at the start of their medical education, specifically focusing on the associated average salaries of these specialties.

Study Design This IRB-approved cross-sectional study utilizes survey data from four classes of medical students attending a medical school in Dallas, TX at the beginning of their education. Specialties were categorized as low (<$300,000/year), medium ($300,000-$450,000), and high (>$450,000) paying based on the 2022 AMGA Compensation report.

Dataset The dataset includes survey responses from 284 medical students, with a 29.5% response rate from 962 students surveyed.

Population Studied Medical students at a single institution at the beginning of their education.

Instrument Data were collected via a survey assessing the average annual parental income, highest level of education attained by either parent, and predominant area of upbringing (e.g. rural, urban). The survey also inquired about students' intended specialty choices and prior experience with health disparities.

Outcome Measures The outcome analyzed is the income level associated with the intended specialty choices.

Results A significant Kendall’s tau correlation was found between the area students grew up in and the average income associated with their desired specialty (τ_b = -0.133, p = 0.026), suggesting that students from smaller areas tend to aspire to higher-paying specialties. No significant associations were found between health disparity experiences, parental education level, parental income, and the salary associated with the intended medical specialty.

Conclusion Geographical background influences specialty choices among medical students, with those from smaller areas tending to aim for higher-paying specialties. No significant relationships were found between intended specialty salaries and parental education, parental income, or health disparity experiences. Future research should explore the association between geographical background and specialty aspiration.