Perceived Barriers to Career Advancement: Medical Students and Resident Physicians
November 2023 | Volume 22 | Issue 11 | e17 | Copyright © November 2023
Published online October 13, 2023
Akshitha Thatiparthi , Amylee Martin , Olive Anagu , Fiore Casale , Gabrielle Baker , Cristina Nguyen , Natasha Atanaskova Mesinkovska , Janiene Luke
aUniversity of California Irvine, Department of Dermatology, Irvine, CA
bLoma Linda University, Department of Dermatology, Loma Linda, CA
cDavid Geffen School of Medicine at UCLA, Los Angeles, CA
*indicates co-first authorship with both authors contributing equally
Abstract
Background: The path to becoming a physician is challenging, with various barriers influencing medical student and resident physician residency and fellowship training career decisions. Studies comparing perceived obstacles at disparate training levels are limited and given these obstacles are dynamic, studies are frequently needed to evaluate perceived barriers to pursuing residency specialty or fellowship of interest for physician trainees.
Objective: To evaluate and compare perceived barriers to obtaining residency specialty or fellowship of choice for medical students and resident physicians, respectively.
Methods: A Likert scale survey assessing perceived barriers was administered via the listservs of medical schools and organizations in 2021. Differences in the Likert scale score mean between medical students and resident physicians were measured with student t-tests (2-sided).
Results: A total of 404 medical trainees participated (301 medical students and 103 resident physicians). Medical students indicated lack of opportunity to obtain alpha omega alpha membership as the most crucial perceived barrier (mean Likert scale score ± standard deviation, 4.01±1.97), followed by USMLE Step 1 score (3.92±1.89) and lack of home program in specialty/fellowship of interest (3.62±1.85). Similarly, resident physicians implicated the lack of a home program in a specialty/fellowship of interest as the most prominent barrier (3.48±1.78), followed by lack of connections/networking (3.17±1.50) and probability of matching (3.14±1.44).
Conclusions: The lack of a home program was an important barrier to pursuing a specialty or fellowship of choice for both medical students and resident physicians, respectively, and may have been heightened during the COVID-19 pandemic.
J Drugs Dermatol. 2023;22(11):e17-e20 doi:10.36849/JDD.7005e
INTRODUCTION
Recent survey-based studies have investigated various factors influencing medical students' career choices, including academic status, socioeconomic factors, and mentorship.1,2 Perceived barriers to career advancement faced by resident physicians in comparison to medical students have yet to be elucidated. We aimed to evaluate and compare perceived barriers to attaining the desired residency specialty/fellowship of interest for both groups.
MATERIALS AND METHODS
Differences in perceived career barriers faced by United States (US)-based medical students and resident physicians were assessed using a Likert scale survey. Face validity was achieved through survey review by ten academic dermatology/psychiatry faculty members. Listservs of medical schools and organizations were utilized to distribute the survey through RedCap, an electronic data capture tool hosted at the University of California, Irvine (UCI).3 Statistical analyses were conducted using Stata/SE 16.1. Differences in prevalence rates and means between groups were measured using Chi-squared tests and student t-tests (2-sided) for categorical variables and continuous variables, respectively. The UCI Institutional Review Board determined the study to be exempt status.
RESULTS
A total of 415 medical trainees accessed the survey (Table 1), with 404 submitted responses (301 medical students [61% 3rd/4th years] and 103 resident physicians of all training levels), and a survey response rate of 97.4% (surveys completed/surveys opened*100). Medical students indicated lack of opportunity to obtain alpha omega alpha (AOA) membership as the most crucial perceived barrier (mean Likert scale score ± standard deviation, 4.01±1.97), followed by USMLE Step 1 score (3.92±1.89), lack of home program in specialty/fellowship
