Stability and Change of Medical Specialty of Residents over Four Years of Postgraduate Training in Germany

Aim We analyzed medical residents' preferences in Germany with regard to the specialization fields after 4 years of postgraduate training and compared them to their preferences in the years before, e.g. at the end of undergraduate education in a gender comparative perspective, including the influence of parenthood. Methods The study is based on annual postal surveys of students of 7 medical faculties in Germany from their last year of medical school ("Practical Year") until after 4 years of postgraduate training. The return rate at baseline was 48 % and in the 4 surveys thereafter the rates were 85 % and above. In all samples, about two-thirds of respondents were women, which corresponds to the actual gender distribution in under-and postgraduate training. Descriptive statistics and regression analyses were used. Results Compared to the end of undergraduate education, anaesthesiology and general practice were the disciplines which gained in attraction, whereas surgical disciplines lost significantly in their attraction. These developments were similar in both genders. Specialized internal medicine, paediatrics and gynaecology lost attraction among female physicians only. We found important correlations of disciplinary preferences with parenthood and with the preference for part-time work after graduation. Conclusion The data show that "feminization" is not the reason why both anaesthesiology and general practice gained in attraction, since this happened over the 4 years among both male and female physicians. The loss in attraction in all great clinical disciplines, especially in surgery, orthopaedics and urology, may lead to severe problems in supply of medical manpower in the hospital, especially when combined with preference for part-time work.