Abstract
Objective
Methods
Results
Conclusions
Keywords
AMA FREIDA Online: American Medical Association Fellowship and Residency Electronic Interactive Database. Pediatric Residency Programs. Available at: https://freida.ama-assn.org/search/list?spec=43086&page=1. Accessed March 28, 2022, 2022.
- Naifeh MM
- Stevenson MD
- Abramson EL
- et al.
Winn AS, Myers R, Grow HM, et al. Pediatric resident perspectives on the impact of COVID-19 on training. Hosp Pediatr. 2021:hpeds.2021-005994 [e-pub ahead of print]. https://doi.org/10.1542/hpeds.2021-005994.
- Naifeh MM
- Stevenson MD
- Abramson EL
- et al.
- Wilder JL
- Parsons CR
- Growdon AS
- et al.
- Pelletier JH
- Rakkar J
- Au AK
- et al.
Doximity. 2021 physician compensation report. Fifth Annual Study. 2021; Available at:https://c8y.doxcdn.com/image/upload/v1/Press%20Blog/Research%20Reports/Doximity-Compensation-Report-2021.pdf. Accessed October 29, 2022.
- Vinci RJ.
Bureau of Labor Statistics. Occupational outlook handbook. physicians and surgeons. Job Outlook. Available at: https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm#tab-6. Accessed October 28, 2022.
Methods
Results
Characteristic | Respondents N = 1767 N (%) | Nonrespondents N = 1613 N (%) | P Value |
---|---|---|---|
Gender | .341 | ||
Female | 1275 (72.2%) | 1140 (70.7%) | |
Male | 492 (28.6%) | 473 (29.3%) | |
Medical school location | .438 | ||
American medical graduate | 1286 (72.8%) | 1392 (86.3%) | |
International medical graduate | 327 (18.5%) | 375 (23.2%) | |
Training program area | .0935 | ||
Midwest | 393 (22.2%) | 386 (23.9%) | |
Northeast | 469 (26.5%) | 436 (27.0%) | |
South | 645 (36.5%) | 526 (32.6%) | |
West | 260 (14.7%) | 265 (16.4%) | |
Training program type | .0437 | ||
Categorical pediatrics | 1564 (88.5%) | 1432 (90.6%) | |
Medicine-Pediatrics | 203 (11.5%) | 151 (9.4%) | |
Number of years out of residency | |||
<1 year | 151 (8.5%) | N/A | |
≥1 year or more | 172 (9.7%) | N/A | |
Current resident/chief resident | 1444 (81.7%) | N/A | |
Debt | |||
<$200,000 | 857 (48.5%) | N/A | |
≥$200,000 | 820 (46.4%) | N/A | |
Unknown/declined/missing | 90 (5.1%) | N/A | |
Total N = 1770 N (%) | Categorical Pediatrics N = 1564 N (%) | Medicine-Pediatrics N = 203 N (%) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Postresidency Position (Mutually Exclusive Categories) | No Impact | Overall | Career Choice | Employment Search | Employment Offers | No Impact | Overall | Career Choice | Employment Search | Employment Offers | No Impact | Overall | Career Choice | Employment Search | Employment Offers |
Out of US gen peds/PH job market n = 1048 | 929 (88.6) | 119 (11.4) | 79 (7.5) | 51 (4.9) | 36 (3.4) | 822 (90.8) | 83 (9.2) | 59 (6.5) | 31 (3.4) | 20 (2.2) | 107 (74.8) | 36 (25.2) | 20 (14) | 20 (14) | 16 (11.1) |
Fellowship n = 772 | 696 (90.2) | 76 (9.8) | 54 (7.0) | 25 (3.2) | 19 (4.5) | 642 (91.1) | 63 (8.9) | 44 (6.2) | 21 (3.0) | 17 (4.5) | 54 (80.6) | 13 (19.4) | 10 (14.9) | 4 (6.0) | 2 (5.3) |
Chief residency n = 214 | 192 (89.7) | 22 (10.3) | 17 (7.9) | 10 (4.7) | 3 (1.9) | 175 (89.7) | 20 (10.3) | 15 (7.7) | 10 (5.1) | 3 (2.1) | 17 (89.6) | 2 (10.5) | 2 (10.5) | 0 (0) | 0 (0) |
Adult position n = 53 | 32 (60.4) | 21 (39.6) | 8 (15.1) | 16 (30.2) | 14 (28.6) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 32 (60.4) | 21 (39.6) | 8 (15.1) | 16 (30.2) | 14 (28.6) |
Other n = 9 | 9 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 5 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 4 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
In US general pediatrics/pediatric hospitalist job market † n = 722Respondents in US general pediatrics/pediatric hospitalist job market included respondents who indicated their postresidency position was outpatient general pediatrics, outpatient and inpatient general pediatrics, pediatric hospitalist, newborn nursery/neonatal intensive care unit staff, urgent care/emergency medicine, locum tenens/per diem/moonlighting, or unknown, unable to secure a job yet. | 326 (45.1) | 393 (54.4) | 104 (14.4) | 225 (31.2) | 299 (41.4) | 286 (43.3) | 373 (56.6) | 99 (15.0) | 210 (31.9) | 289 (43.9) | 40 (66.7) | 20 (33.3) | 5 (8.3) | 15 (25.0) | 10 (16.7) |
Outpatient general pediatrics n = 431 | 203 (47.1) | 228 (52.9) | 48 (11.1) | 126 (29.2) | 175 (46.2) | 184 (45.7) | 219 (54.3) | 44 (10.9) | 119 (29.5) | 173 (11.1) | 19 (67.9) | 9 (32.1) | 4 (14.3) | 7 (25) | 2 (8) |
Outpatient and Inpatient pediatrics n = 69 | 45 (66.2) | 23 (33.8) | 4 (5.9) | 13 (19.1) | 16 (28.1) | 40 (65.6) | 21 (34.4) | 4 (6.6) | 11 (18) | 15 (15) | 5 (71.4) | 2 (28.6) | 0 (0) | 2 (28.6) | 1 (16.7) |
Pediatric hospitalist n = 74 | 37 (50.7) | 36 (49.3) | 15 (20.6) | 27 (36.5) | 29 (43.9) | 27 (47.4) | 30 (52.6) | 15 (26.3) | 24 (42.1) | 23 (23) | 10 (62.5) | 6 (37.5) | 0 (0) | 3 (18.8) | 6 (40) |
Newborn nursery / neonatal intensive care unit staff n = 11 | 3 (27.3) | 8 (72.7) | 5 (45.5) | 7 (63.6) | 6 (60) | 3 (27.3) | 8 (72.7) | 5 (45.5) | 7 (63.6) | 6 (6) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Urgent care / emergency medicine n = 17 | 6 (35.3) | 11 (64.7) | 2 (11.8) | 4 (23.5) | 10 (66.7) | 6 (35.3) | 11 (64.7) | 2 (11.8) | 4 (23.5) | 10 (10) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
Locum tenens / per diem / moonlighting n = 4 | 2 (50) | 2 (50) | 2 (50) | 2 (50) | 1 (25) | 1 (25) | 1 (25) | 1 (25) | 1 (25) | 0 (0) | 1 (25) | 1 (25) | 1 (25) | 1 (25) | 1 (25) |
Unknown, unable to secure a job yet n = 116 | 30 (26.1) | 85 (73.9) | 28 (24.4) | 46 (40) | 62 (76.5) | 25 (23.2) | 83 (76.9) | 28 (25.9) | 44 (40.7) | 62 (62) | 5 (71.4) | 2 (28.6) | 0 (0) | 2 (28.6) | 0 (0) |
Area of Career Impact of COVID-19 Pandemic | Number | % |
---|---|---|
Overall impact (career choice, employment search, or employment offer) | 393 | 54.7 |
Employment search | ||
a. No impact | 455 | 63.3 |
b. Not applicable (postponed employment search, secured employment prior to COVID-19 pandemic, fellow/chief) | 18 | 2.5 |
c. Not applicable, as I secured employment prior to the COVID-19 pandemic | 21 | 2.9 |
d. Decided to work part-time instead of full-time | 24 | 3.3 |
e. Decided to work full-time instead of part-time | 14 | 2.0 |
f. Decided to do locum tenens / per diem/ moonlighting | 39 | 5.4 |
g. Modified decisions based on family commitments | 107 | 14.9 |
h. Other | 81 | 11.3 |
Total | 719 | 100 |
Employment offers, † 39 participants skipped this question via an intentional skip pattern. This table includes participants entering US general pediatrics or pediatric hospitalist job market. This table excludes participants pursuing fellowship, chief residency, military, outside of the US, pediatric subspecialty, or positions caring for adults only. | ||
a. No impact | 312 | 45.9 |
b. Have not applied yet | 69 | 10.2 |
c. Unable to secure a position in chosen location | 156 | 22.9 |
d. Unable to secure a position in chosen type of practice (eg, academics, outpatient care, hospitalist) | 110 | 16.2 |
e. Unable to secure a full-time position | 81 | 11.9 |
f. Unable to secure a part-time position | 29 | 4.3 |
g. Only able to secure position without benefits (eg, locum tenens, per diem, moonlighting) | 17 | 2.5 |
h. Contract cancelled/rescinded | 9 | 1.3 |
i. Contract modified | 5 | 0.7 |
j. Delayed start of employment | 33 | 4.9 |
k. Earlier start of employment | 8 | 1.2 |
l. Other | 66 | 9.7 |
Total | 680 | 100 |
Factor | Categorical Pediatrics and Medicine-Pediatrics | Categorical Pediatrics Only | ||
---|---|---|---|---|
Adjusted Odds Ratio | 95% Confidence Interval | Adjusted Odds Ratio | 95% Confidence Interval | |
Postresidency plans | ||||
Out of general pediatrics/pediatric hospitalist job market | Reference | Reference | Reference | Reference |
Outpatient general pediatrics | 3.83 | 2.22–6.60 | 4.87 | 2.73–8.70 |
Outpatient/inpatient general pediatrics | 9.36 | 7.12–12.29 | 12.39 | 9.16–16.76 |
Pediatric hospitalist | 9.02 | 5.60–14.52 | 13.49 | 7.87–23.12 |
Unknown, unable to secure a job yet | 23.97 | 15.00–38.31 | 35.57 | 21.31–59.36 |
Gender | ||||
Female | Reference | Reference | Reference | Reference |
Male | 0.94 | 0.72–1.24 | 1.00 | 0.74–1.35 |
Medical school graduate location | ||||
American Medical Graduate | Reference | Reference | Reference | Reference |
International Medical Graduate | 1.90 | 1.39–2.59 | 1.94 | 1.39–2.70 |
Debt | ||||
<$200,000 | Reference | Reference | Reference | Reference |
≥$200,000 | 1.09 | 0.85–1.4 | 1.01 | 0.77–1.32 |
Unknown/declined/missing | 1.47 | 0.86–2.49 | 1.56 | 0.87–2.80 |
Geographic location | ||||
South | Reference | Reference | Reference | Reference |
Midwest | 0.84 | 0.61–1.16 | 0.89 | 0.62–1.28 |
Northeast | 0.76 | 0.55–1.04 | 0.72 | 0.51–1.02 |
West | 1.15 | 0.80–1.66 | 1.13 | 0.76–1.68 |
Training area | N/A | |||
Categorical pediatrics | Reference | Reference | ||
Medicine-Pediatrics | 1.53 | 1.04–2.25 |
Theme | Example Quotes |
---|---|
Limited job availability | I am hearing from recruiters that a lot of seasoned physicians are returning to the applicant pools due to changes in their employment status from the impact of the pandemic. Some are also citing budget cuts due to loss they have endured from the effect of the pandemic. |
Unable to stay at my planned academic institution despite their desire for me to stay secondary to hiring freeze from funding lost 2/2 COVID-19 | |
I had a job lined up throughout my entire residency training and when COVID hit they had to take the job offer back since they could not meet their RVU during COVID. | |
Anxiety over employment | Significant anxiety related to current unemployment and the prospect of loan repayment. |
Visa sponsorship | Visa sponsorship is affected by COVID and budget cuts in institutions and currently unable to secure a job. |
Timing | There was a delay with credentialing because there was a longer wait time to obtain DEA and license. |
I was planning on several locum tenens jobs prior to a permanent position but opted for permanent for stability. | |
Contract was rescinded briefly during pandemic and then employer reached out again. | |
No one is hiring so pursued fellowship earlier than anticipated. | |
Smaller pool of potential employers, more urgency in signing contract when opportunities arose. | |
Change in career choice | Due to increased competition for pediatric emergency medicine fellowship, which I believe was COVID related, I did not match and will be seeking a full time job instead of proceeding to fellowship. |
Has made me think about the importance of doing a PICU fellowship. | |
I am going to be an academic general pediatrician, and I am starting AGP fellowship this cycle. Part of the reason I pursued this fellowship is because I understand there is more stability in terms of job securement within a hospital system, as opposed to private practice. The lockdowns devastated many private practices. | |
Fellowship more competitive | The fellowship match was unprecedented and difficult, and [I] found it beyond difficult to connect with people, and I was told I was knocked down lists due to not having a fellowship at my current (large, academic) institution. |
Prioritized life outside of work | COVID-19 has made me realize that I want to be closer to my family for Fellowship and accordingly will likely apply primarily in the South Eastern US. |
I've decided to prioritize lifestyle [and] time with family and friends over work. | |
Limited options available, especially with limited options for reliable and affordable childcare. |
Discussion
Winn AS, Myers R, Grow HM, et al. Pediatric resident perspectives on the impact of COVID-19 on training. Hosp Pediatr. 2021:hpeds.2021-005994 [e-pub ahead of print]. https://doi.org/10.1542/hpeds.2021-005994.
- Pelletier JH
- Rakkar J
- Au AK
- et al.
- Hu X
- Dill MJ.
Murphy B. COVID-19 capsizes the physician job market: trends youshould know. Transition to Practice 2020;https://www.ama-assn.org/residents-students/transition-practice/covid-19-capsizes-physician-job-market-trends-you-should. Accessed January 9, 2022.
National Resident Matching Program. NRMP releases results of the pediatric specialties match for appointment year 2022. 2021; Available at: https://www.nrmp.org/about/news/2021/12/nrmp-pediatric-specialties-match-results/. Accessed October 28, 2022.
American Board of Pediatrics. Number of first-year trainees in US based programs, according to the ABP. 2022; Available at: https://www.abp.org/content/comparison-abp-data-nrmp-match-data. Accessed October 28, 2022.
American Board of Pediatrics. Yearly growth in pediatric fellows by subspecialty by demographics and program characteristics. 2022; Available at:https://www.abp.org/content/yearly-growth-pediatric-fellows-subspecialty-demographics-and-program-characteristics. Accessed October 28, 22, 2022.
American Board of Pediatrics. Comparison of ABP data to the NRMP match data. 2022; Available at: https://www.abp.org/content/comparison-abp-data-nrmp-match-data. Accessed November 4, 2022.
National Resident Matching Program. Results and data: specialtiesmatching service 2022 appointment year. 2022; Available at:https://www.nrmp.org/wp-content/uploads/2022/03/2022-SMS-Results-Data-FINAL.pdf. Accessed October 29, 2022.
National Resident Matching Program. NRMP program results 2018-2022 specialties matching service. 2022; Available at:https://www.nrmp.org/wp-content/uploads/2022/03/NRMP-SMS-Program-Results-2018-2022.pdf. Accessed November 4, 2022.
National Resident Matching Program. Results and data: specialtiesmatching service 2022 appointment year. 2022; Available at:https://www.nrmp.org/wp-content/uploads/2022/03/2022-SMS-Results-Data-FINAL.pdf. Accessed October 29, 2022.
Acknowledgments
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Conflict of Interest: The authors have no conflicts of interest relevant to this article to disclose. Mr Turner, Ms Gregg, and Dr Leslie are employees of the American Board of Pediatrics. The content is solely the responsibility of the authors and does not necessarily represent the official views of the American Board or Pediatrics or the American Board of Pediatrics Foundation.
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