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April 23, 2019; 92 (17) Article

Characteristics of graduating US allopathic medical students pursuing a career in neurology

View ORCID ProfileLaurie Gutmann, Carolyn Cahill, View ORCID ProfileJustin T. Jordan, Charlene E. Gamaldo, Veronica Santini, Imran Ali, Madhu Soni, Rujuta B. Wilson, Rana Said, View ORCID ProfileBarry M. Czeisler, A. Gordon Smith
First published March 29, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007369
Laurie Gutmann
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Carolyn Cahill
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Justin T. Jordan
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Charlene E. Gamaldo
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Veronica Santini
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Imran Ali
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Madhu Soni
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Rujuta B. Wilson
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Rana Said
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Barry M. Czeisler
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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A. Gordon Smith
From the Department of Neurology (L.G.), University of Iowa, Iowa City; Member Insights Department (C.C.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (J.T.J.), Massachusetts General Hospital and Harvard Medical School, Boston; Department of Neurology (C.E.G.), Johns Hopkins University, Baltimore, MD; Department of Neurology (V.S.), Stanford University, CA; Department of Neurology (I.A.), University of Toledo, OH; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Pediatrics & Psychiatry (R.B.W.), UCLA, Los Angeles, CA; Department of Pediatrics (R.S.), UT Southwestern, Dallas, TX; Department of Neurology (B.M.C.), New York University, New York; and Department of Neurology (A.G.S.), Virginia Commonwealth University, Richmond.
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Characteristics of graduating US allopathic medical students pursuing a career in neurology
Laurie Gutmann, Carolyn Cahill, Justin T. Jordan, Charlene E. Gamaldo, Veronica Santini, Imran Ali, Madhu Soni, Rujuta B. Wilson, Rana Said, Barry M. Czeisler, A. Gordon Smith
Neurology Apr 2019, 92 (17) e2051-e2063; DOI: 10.1212/WNL.0000000000007369

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Abstract

Objectives To identify factors associated with medical students becoming neurologists because, despite the increasing burden of neurologic disorders, there is a growing neurologist shortage.

Methods Deidentified data from the Association of American Medical Colleges Matriculating Student Questionnaire (MSQ) and Graduation Questionnaire (GQ) were obtained for the graduation years 2013 to 2014 through 2016 to 2017. Logistic regression was used to assess demographic characteristics and responses to training and career-related questions in association with specialty choice (intent to enter neurology).

Results Of the 51,816 students with complete data, 1,456 (2.8%) indicated an intent to enter a neurology residency. Factors associated with an increased likelihood of entering neurology were a student's rating of excellent for their basic neuroscience course and neurology clerkship, participation in an MD/PhD program, majoring in neuroscience or psychology as an undergraduate, a selection response of “content of the specialty was a strong influence on career choice,” and indicating interest in neurology on the MSQ. Factors associated with a decreased likelihood of entering neurology were a higher-priority response on the GQ for salary, work/life balance, and personal fit of the specialty.

Conclusion Data from surveys at the entry into and graduation from medical school suggest several approaches to increase the number of medical students entering neurology, including a focus on the student-reported quality of the basic neuroscience course and neurology clerkships, targeted engagement with MD/PhD students, and mentoring programs for students interested in neurology. Efforts to improve salaries for neurologists, to reduce medical school debt, and to improve work/life balance may also help to attract more students.

Glossary

AAMC=
Association of American Medical Colleges;
AAN=
American Academy of Neurology;
CI=
confidence interval;
GQ=
Graduation Questionnaire;
IRB=
institutional review board;
MSQ=
Matriculating Student Questionnaire;
NA=
not applicable;
OR=
odds ratio

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • ↵* These authors contributed equally to this work.

  • Editorial, page 786

  • Received September 19, 2018.
  • Accepted in final form January 3, 2019.
  • © 2019 American Academy of Neurology
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Letters: Rapid online correspondence

  • Author response: Characteristics of graduating US allopathic medical students pursuing a career in neurology
    • Laurie Gutmann, Neurologist, University of Iowa
    • Madhu Soni, Neurologist, Rush University
    Submitted January 19, 2020
  • Author response: Characteristics of graduating US allopathic medical students pursuing a career in neurology
    • Laurie Gutmann, Professor, Vice Chair Clinical Research, Department of Neurology, University of Iowa Hospitals and Clinics
    Submitted May 29, 2019
  • Reader response: Characteristics of graduating US allopathic medical students pursuing a career in neurology
    • Jonathan D. Santoro, Pediatric Neurologist, Children's Hospital of Los Angeles, Keck School of Medicine at USC (Los Angeles)
    Submitted May 05, 2019
  • Reader response: Characteristics of graduating US allopathic medical students pursuing a career in neurology
    • Jeel Moya-Salazar, External Researcher, Universidad Norbert Wiener
    • Hans Contreras-Pulache, Neurologist, Universidad Norbert Wiener
    • Eduardo Espinoza-Lecca, College Professor, Programa Nacional de Becas y Crédito Educativo del Perú (PRONABEC)
    Submitted April 29, 2019
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