Most U.S. Medical Students Reject Careers in Diabetes Care

SAN FRANCISCO — An interest in endocrinology was noted by just over 1% of more than 500 students at 47 U.S. medical schools, and 3 of those 7 students said they wanted to pursue diabetes care.

The findings of the survey, funded and conducted by the diabetes consulting firm Close Concerns Inc., suggest that care of patients with diabetes will fall even more to primary care providers in the future than it does today.

A recent study estimates a 12%-15% undersupply of endocrinologists in the United States (J. Clin. Endocrinol. Metab. 2008;93:1164–6).

“Unless this trend is reversed, in the coming decade the critical shortfall in diabetes specialists may compromise patient care,” Kelly L. Close, founder and president of Close Concerns, and her associates said in a poster presented at the annual scientific sessions of the American Diabetes Association.

The 524 survey respondents represented approximately 5%-10% of medical students who were sent electronic surveys between April 2007 and August 2007; the percentage of respondents varied by school. Thirty-nine percent were first-year students; 23% were second-year; 12%, third-year; and 26%, fourth-year.

Slightly more than a quarter (26%) were from the University of California San Francisco; 17% were from Harvard University, Boston; and 15% were from Columbia University, New York. The remainder came from 44 other medical schools including Emory University, Atlanta; Loma Linda (Calif.) University; Stanford (Calif.) University; Cornell University, New York; Johns Hopkins University, Baltimore; Philadelphia College of Osteopathic Medicine; and Meharry Medical College, Nashville, Tenn.

When asked to rank from 1 to 6 the factors that were most important in choosing a specialty, with 1 being “not important” and 6 being “extremely important,” the group gave the highest ranking (5.1) to “intellectual satisfaction,” followed by 4.7 for “work-life balance” (hours, call frequency), 4.4 for “scope” (specific or broad skills), 4.4 for type of patient interaction (brief/long-term), and 4.4 for location (or location possibilities).

Most students reported having had some exposure to diabetes during medical school. Nearly 36% of the entire group reported having had “a little” exposure to diabetes, 31% reported “some,” and 7% said they had “a lot.”

Although just over 1.3% of the students expressed an interest in pursuing endocrinology and even fewer in diabetes in particular, 26% indicated that they had actually considered a career in diabetes care before deciding against it. When queried about the two most important factors that would attract them to the field of diabetes, nearly half (49%) checked “social importance,” 33% cited the disease's “pandemic status,” 25% named “unique challenges to treat,” and 24% “good work-life balance.”

When asked to check the factors that would deter them from the field of diabetes, 46% checked the statement “It's too difficult to change or impact patient behavior.” That was followed by “not interested in endocrinology” (42%), “lack of procedures” (38%), “overall compensation is too low” (21%), “scientific advances lacking or not as exciting as in other areas” (16%), and “reimbursement too low for time it takes to help patients” (14%).

“We believe that increasing physician interest in diabetes will require significant changes to reimbursement structure and physician economics. New and improved therapies may also increase interest in diabetes care by providing viable alternatives to behavioral modification.”

SAN FRANCISCO — An interest in endocrinology was noted by just over 1% of more than 500 students at 47 U.S. medical schools, and 3 of those 7 students said they wanted to pursue diabetes care.

The findings of the survey, funded and conducted by the diabetes consulting firm Close Concerns Inc., suggest that care of patients with diabetes will fall even more to primary care providers in the future than it does today.

A recent study estimates a 12%-15% undersupply of endocrinologists in the United States (J. Clin. Endocrinol. Metab. 2008;93:1164–6).

“Unless this trend is reversed, in the coming decade the critical shortfall in diabetes specialists may compromise patient care,” Kelly L. Close, founder and president of Close Concerns, and her associates said in a poster presented at the annual scientific sessions of the American Diabetes Association.

The 524 survey respondents represented approximately 5%-10% of medical students who were sent electronic surveys between April 2007 and August 2007; the percentage of respondents varied by school. Thirty-nine percent were first-year students; 23% were second-year; 12%, third-year; and 26%, fourth-year.

Slightly more than a quarter (26%) were from the University of California San Francisco; 17% were from Harvard University, Boston; and 15% were from Columbia University, New York. The remainder came from 44 other medical schools including Emory University, Atlanta; Loma Linda (Calif.) University; Stanford (Calif.) University; Cornell University, New York; Johns Hopkins University, Baltimore; Philadelphia College of Osteopathic Medicine; and Meharry Medical College, Nashville, Tenn.

When asked to rank from 1 to 6 the factors that were most important in choosing a specialty, with 1 being “not important” and 6 being “extremely important,” the group gave the highest ranking (5.1) to “intellectual satisfaction,” followed by 4.7 for “work-life balance” (hours, call frequency), 4.4 for “scope” (specific or broad skills), 4.4 for type of patient interaction (brief/long-term), and 4.4 for location (or location possibilities).

Most students reported having had some exposure to diabetes during medical school. Nearly 36% of the entire group reported having had “a little” exposure to diabetes, 31% reported “some,” and 7% said they had “a lot.”

Although just over 1.3% of the students expressed an interest in pursuing endocrinology and even fewer in diabetes in particular, 26% indicated that they had actually considered a career in diabetes care before deciding against it. When queried about the two most important factors that would attract them to the field of diabetes, nearly half (49%) checked “social importance,” 33% cited the disease's “pandemic status,” 25% named “unique challenges to treat,” and 24% “good work-life balance.”

When asked to check the factors that would deter them from the field of diabetes, 46% checked the statement “It's too difficult to change or impact patient behavior.” That was followed by “not interested in endocrinology” (42%), “lack of procedures” (38%), “overall compensation is too low” (21%), “scientific advances lacking or not as exciting as in other areas” (16%), and “reimbursement too low for time it takes to help patients” (14%).

“We believe that increasing physician interest in diabetes will require significant changes to reimbursement structure and physician economics. New and improved therapies may also increase interest in diabetes care by providing viable alternatives to behavioral modification.”

SAN FRANCISCO — An interest in endocrinology was noted by just over 1% of more than 500 students at 47 U.S. medical schools, and 3 of those 7 students said they wanted to pursue diabetes care.

The findings of the survey, funded and conducted by the diabetes consulting firm Close Concerns Inc., suggest that care of patients with diabetes will fall even more to primary care providers in the future than it does today.

A recent study estimates a 12%-15% undersupply of endocrinologists in the United States (J. Clin. Endocrinol. Metab. 2008;93:1164–6).

“Unless this trend is reversed, in the coming decade the critical shortfall in diabetes specialists may compromise patient care,” Kelly L. Close, founder and president of Close Concerns, and her associates said in a poster presented at the annual scientific sessions of the American Diabetes Association.

The 524 survey respondents represented approximately 5%-10% of medical students who were sent electronic surveys between April 2007 and August 2007; the percentage of respondents varied by school. Thirty-nine percent were first-year students; 23% were second-year; 12%, third-year; and 26%, fourth-year.

Slightly more than a quarter (26%) were from the University of California San Francisco; 17% were from Harvard University, Boston; and 15% were from Columbia University, New York. The remainder came from 44 other medical schools including Emory University, Atlanta; Loma Linda (Calif.) University; Stanford (Calif.) University; Cornell University, New York; Johns Hopkins University, Baltimore; Philadelphia College of Osteopathic Medicine; and Meharry Medical College, Nashville, Tenn.

When asked to rank from 1 to 6 the factors that were most important in choosing a specialty, with 1 being “not important” and 6 being “extremely important,” the group gave the highest ranking (5.1) to “intellectual satisfaction,” followed by 4.7 for “work-life balance” (hours, call frequency), 4.4 for “scope” (specific or broad skills), 4.4 for type of patient interaction (brief/long-term), and 4.4 for location (or location possibilities).

Most students reported having had some exposure to diabetes during medical school. Nearly 36% of the entire group reported having had “a little” exposure to diabetes, 31% reported “some,” and 7% said they had “a lot.”

Although just over 1.3% of the students expressed an interest in pursuing endocrinology and even fewer in diabetes in particular, 26% indicated that they had actually considered a career in diabetes care before deciding against it. When queried about the two most important factors that would attract them to the field of diabetes, nearly half (49%) checked “social importance,” 33% cited the disease's “pandemic status,” 25% named “unique challenges to treat,” and 24% “good work-life balance.”

When asked to check the factors that would deter them from the field of diabetes, 46% checked the statement “It's too difficult to change or impact patient behavior.” That was followed by “not interested in endocrinology” (42%), “lack of procedures” (38%), “overall compensation is too low” (21%), “scientific advances lacking or not as exciting as in other areas” (16%), and “reimbursement too low for time it takes to help patients” (14%).

“We believe that increasing physician interest in diabetes will require significant changes to reimbursement structure and physician economics. New and improved therapies may also increase interest in diabetes care by providing viable alternatives to behavioral modification.”