Career change: In quest of a controllable lifestyle

Over the past decade, top medical students are selecting “controllable lifestyle” (CL) specialties at an increasing rate. CL specialties include anesthesiology, dermatology, emergency medicine, neurology, ophthalmology, pathology, psychiatry, and radiology. The choice of “noncontrollable lifestyle” (NCL) specialties such as family practice, internal medicine, obstetrics/gynecology, and pediatrics was negatively affected by this trend. The effect of CL on the selection of surgical training by top medical students was variable. The purpose of this study was to determine if CL is a factor in career change by young surgeons during and after residency. Graduates of the University of Kentucky College of Medicine from 1975 to 1983 ( n = 796) were questioned regarding the specialty they entered after graduation and whether they remained in that specialty as of March, 1988. NCL and surgery specialties showed a net loss of practitioners during the study period ( P < 0.005) and CL showed a net gain ( P < 0.005). When physicians change specialties, the direction of change occurred from NCL and surgery to CL ( P < 0.05). Change from CL to NCL and surgery occurred infrequently.