BACKGROUND: Infectious diseases (ID) remain an essential specialty in medicine; however, fellowship applications have declined despite a growing shortage of ID physicians. As the need for an ID workforce increases, understanding the factors influencing internal medicine (IM) resident physicians' decisions is crucial to guide recruitment. METHODS: A 19-question cross-sectional survey was distributed to IM resident physicians across the United States to assess interest in ID and identify factors influencing specialty selection. Forty-one of 637 programs responded (6.4%) with 380 individual trainee survey responses. RESULTS: Interest in ID was significantly associated with interest in public health (P < .0001), global health (P < .0001), and service-oriented careers (P = .016). Prior exposures, such as mentorship from an ID physician (P = .0002), completing an ID rotation during medical school (P = .0072), and shadowing outside of required rotations (P < .0001), were associated with increased interest. During residency, early exposure to ID in the first (PGY-1) and second (PGY-2) years (P = .044 and P = .0089), outpatient ID electives (P = .022), and ID-related research (P < .0001) were associated with increased interest. Common reasons cited for disinterest included low compensation, the need for additional training, long work hours, and limited procedural opportunities. CONCLUSIONS: Internal medicine residents interested in ID are more likely to report early exposure, mentorship, and alignment with interests in public or global health. Those not interested in ID commonly cited concerns about compensation, training length, and limited procedural opportunities. Recruitment strategies should address these barriers while also enhancing early engagement and mentorship opportunities.
Telchik et al. (Wed,) studied this question.