By Scott Gottlieb New York

An increasing number of US medical students are picking their specialty on the basis of assumptions about the lifestyle that it would permit--including more time for family and leisure activities--rather than traditional factors such as pay and prestige.

The finding suggests there might be shortages of doctors in specialties such as surgery and obstetrics as medical students shun fields in which they are required to be on call during many off duty hours (JAMA 2003;290:1173-8).

Researchers collected six years of data, from 1996 to 2002.

They classified 16 specialties as having either a controllable or uncontrollable lifestyle, partly on the basis of the number of hours that doctors were required to be on call or to spend in the hospital.

For each of the selected specialties, the investigators counted the number of students ranking a particular specialty as his or her first choice.

From 1996 to 2002 the percentage of students choosing some specialties rose: anaesthesiology from 1.1% to 6.4%; dermatology from 0.2% to 2.3%; and radiology from 3.3% to 6.1%.

In contrast, the proportion of students choosing family practice and general surgery declined between 1996 and 2002 from 16.1% to 9.5% and from 10.4% to 7.6% respectively.

MIKE WINTROATH/AP

Medical students from the University of Arkansas for Medical Sciences discuss life after medical school

Three factors--the number of work hours a week, adequate time for vocational pursuits, and number of call nights during practice--were weighted more highly than other motivators.

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