Academic Medicine Open Forum

AAMC's annual physician workforce projections report came out just this past Friday. The report was prepared pre-COVID, which leaves me thinking about the many significant social, economic, technology, scientific, and – of course - workforce changes that will likely occur throughout and after this global crisis. I have many questions about the physician workforce implications of the pandemic, but I am going to start with just one: Will interest in entering some specialties change as a result of COVID-19? Will we see increased (or decreased) interest in specialties like infectious diseases or global health, emergency medicine, or pulmonology?

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Michael Dill
Director, Workforce Studies
Association of American Medical Colleges
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Before I respond to the questions, I wonder if it is important for you to know whether the respondents are Medical Doctors, students, administrators, or researchers?  I suspect these self-identifiers would drive the response. Regardless, I'll provide my response - I do not think COVID-19 will mediate specialty interest.  Rather, I think the people predisposed to infectious disease interest (for example) will remain interested (and simply cite COVID-19 experiences as encouraging that interest).  I do not think there will be a significant number of students who will change their interest owing to current circumstances.  That said, it is possible workforce demands drive profession uptake.  That is, if there is an impression that the "only" way to become a medical doctor is to become an infectious disease doctor, then yes, we might expect more people becoming infectious disease doctors.  Otherwise, I do not think COVID-19 will exert a disproportionate effect on specialty choice.  Incidentally, there may be a "noninfectious" way to consider this issue.  Perhaps someone has done research that examines whether [students or residents] were more likely to shift their practice interest to pediatrics upon having a child?  Without knowing, I'd assume there are so many factors that contribute to specialty choice, that having children wouldn't significantly contribute-above and beyond-other factors (e.g., salary, urban/rural practice setting, training requirements, etc.).  Now, I say this as a Ph.D., M.P.H. health service researcher.  It's possible those trying to "match" for residency or medical school students are best positioned to provide an externally valid response.

Thank you for asking this important workforce question.  I look forward to more critical consideration, reflection, and strategizing.

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Matthew Hudson
Director of Cancer Care Delivery Research
Prisma Health
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Original Message:
Sent: 06-30-2020 13:37
From: Michael Dill
Subject: Will we see changes in specialty trends?

AAMC's annual physician workforce projections report came out just this past Friday. The report was prepared pre-COVID, which leaves me thinking about the many significant social, economic, technology, scientific, and – of course - workforce changes that will likely occur throughout and after this global crisis. I have many questions about the physician workforce implications of the pandemic, but I am going to start with just one: Will interest in entering some specialties change as a result of COVID-19? Will we see increased (or decreased) interest in specialties like infectious diseases or global health, emergency medicine, or pulmonology?

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Michael Dill
Director, Workforce Studies
Association of American Medical Colleges
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First, sorry it took me 2 months to figure out I could reply to your message through this forum! Second, thank you for your thoughtful response to my comment. As someone who has studied specialty choice for some time, I think you are correct in your assessment. Specialty choice is complex and largely driven but what future physicians want to do. Your thoughts on labor market constraints are interesting, too. I have heard, anecdotally, that those forces often work through informal communications channels. That is, medical students often hear through "the grapevine" that certain specialties are in greater or lesser demand, and that this information may influence which specialties they consider - but I have never seen that phenomenon studied. And I suspect it is still only factor amongst many. Nonetheless, perhaps that could be one way in which the pandemic does influence, however, slightly, specialty choice? Thanks again for your thoughts.

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Michael Dill
Director, Workforce Studies
Association of American Medical Colleges
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Original Message:
Sent: 07-06-2020 10:59
From: Matthew Hudson
Subject: Will we see changes in specialty trends?

Before I respond to the questions, I wonder if it is important for you to know whether the respondents are Medical Doctors, students, administrators, or researchers?  I suspect these self-identifiers would drive the response. Regardless, I'll provide my response - I do not think COVID-19 will mediate specialty interest.  Rather, I think the people predisposed to infectious disease interest (for example) will remain interested (and simply cite COVID-19 experiences as encouraging that interest).  I do not think there will be a significant number of students who will change their interest owing to current circumstances.  That said, it is possible workforce demands drive profession uptake.  That is, if there is an impression that the "only" way to become a medical doctor is to become an infectious disease doctor, then yes, we might expect more people becoming infectious disease doctors.  Otherwise, I do not think COVID-19 will exert a disproportionate effect on specialty choice.  Incidentally, there may be a "noninfectious" way to consider this issue.  Perhaps someone has done research that examines whether [students or residents] were more likely to shift their practice interest to pediatrics upon having a child?  Without knowing, I'd assume there are so many factors that contribute to specialty choice, that having children wouldn't significantly contribute-above and beyond-other factors (e.g., salary, urban/rural practice setting, training requirements, etc.).  Now, I say this as a Ph.D., M.P.H. health service researcher.  It's possible those trying to "match" for residency or medical school students are best positioned to provide an externally valid response.

Thank you for asking this important workforce question.  I look forward to more critical consideration, reflection, and strategizing.

------------------------------
Matthew Hudson
Director of Cancer Care Delivery Research
Prisma Health

Original Message:
Sent: 06-30-2020 13:37
From: Michael Dill
Subject: Will we see changes in specialty trends?

AAMC's annual physician workforce projections report came out just this past Friday. The report was prepared pre-COVID, which leaves me thinking about the many significant social, economic, technology, scientific, and – of course - workforce changes that will likely occur throughout and after this global crisis. I have many questions about the physician workforce implications of the pandemic, but I am going to start with just one: Will interest in entering some specialties change as a result of COVID-19? Will we see increased (or decreased) interest in specialties like infectious diseases or global health, emergency medicine, or pulmonology?

------------------------------
Michael Dill
Director, Workforce Studies
Association of American Medical Colleges
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The AAMC has published a new data snapshot illustrating recent trends in graduates now practicing in primary care and in rural and underserved areas. The analysis shows that the percentage of graduates now practicing in these areas is lower than in the previous four years. However, schools with a stated public mission to produce graduates into these types of practice have graduated a higher percentage of students across these areas.

Access the Data

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Stephanie Weiner
Director, Digital Strategy & Engagement
Association of American Medical Colleges
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Original Message:
Sent: 06-30-2020 13:37
From: Michael Dill
Subject: Will we see changes in specialty trends?

AAMC's annual physician workforce projections report came out just this past Friday. The report was prepared pre-COVID, which leaves me thinking about the many significant social, economic, technology, scientific, and – of course - workforce changes that will likely occur throughout and after this global crisis. I have many questions about the physician workforce implications of the pandemic, but I am going to start with just one: Will interest in entering some specialties change as a result of COVID-19? Will we see increased (or decreased) interest in specialties like infectious diseases or global health, emergency medicine, or pulmonology?

------------------------------
Michael Dill
Director, Workforce Studies
Association of American Medical Colleges
------------------------------