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Critical Care Research and Practice
Volume 2018 (2018), Article ID 9496241, 6 pages
Research Article

Intensive Care Unit Rotations and Predictors of Career Choice in Pulmonary/Critical Care Medicine: A Survey of Internal Medicine Residency Directors

1School of Medicine, University of California San Francisco, San Francisco, CA, USA
2Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
3Department of Surgery, Massachusetts General Hospital Biostatistics Center, Boston University, Boston, MA, USA
4Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Massachusetts General Hospital, Boston, MA, USA

Correspondence should be addressed to Daniel J. Minter

Received 4 November 2017; Revised 27 January 2018; Accepted 6 February 2018; Published 6 March 2018

Academic Editor: Thomas J. Esposito

Copyright © 2018 Daniel J. Minter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The United States (US) is experiencing a growing shortage of critical care medicine (CCM) trained physicians. Little is known about the exposures to CCM experienced by internal medicine (IM) residents or factors that may influence their decision to pursue a career in pulmonary/critical care medicine (PCCM). Methods. We conducted a survey of US IM residency program directors (PDs) and then used multivariable logistic regression to identify factors that were predictive of residency programs with a higher percentage of graduates pursuing careers in PCCM. Results. Of the 249 PDs contacted, 107 (43%) completed our survey. University-sponsored programs more commonly had large ICUs (62.3% versus 42.2%, ), primary medical ICUs (63.9% versus 41.3%, ), and closed staffing models (88.5% versus 41.3%, ). Residents from university-sponsored programs were more likely to pursue specialty fellowship training () overall but equally likely to pursue careers in PCCM as those from community-sponsored programs. Factors predictive of residencies with a higher percentage of graduates pursuing training in PCCM included larger ICUs (>20 beds), residents serving as code leaders, and greater proportion of graduates pursuing specialization. Conclusions. While numerous differences exist between the ICU rotations at community- and university-sponsored IM residencies, the percentage of graduates specializing in PCCM was similar. Exposure to larger ICUs, serving as code leaders, and higher rates of specialization were predictive of a career choice in PCCM.