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Debas Academy of Medical Educators Innovations Funding for Education Program of the University of California, San Francisco"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Medical career decisions are complex. Gender and racial disparities remain among internal medicine (IM) subspecialty fellows, particularly in procedural subspecialties. This qualitative study aims to thematically explore factors that influence IM resident subspecialty career choice, with a focus on factors specific to women and UIM trainees to better understand existing disparities. This is the first study to explore IM residents own stated reasons to subspecialize into various fields.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted virtual focus groups with 37 IM residents from multiple institutions, organized by affinity groups based on self-identifying as UIM and non-UIM race or ethnicity. Thematic analysis using inductive coding was used to analyze the data and identify themes applying the Systems Theory Framework (STF) of career development. Key themes were divided into social or contextual factors, individual factors, or uncontrollable factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Study participants were 45.9% women (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917) and 51.4% self-identified as UIM (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919). In this sample of graduating IM residents who have matched into subspeciality fellowships, contextual factors emerged as the most influential to their career choices. The main contributors to selecting a subspecialty were mentorship and role models, positive experiences and exposure to the field, work-life balance, enjoyment of clinical and\/or procedural work, and financial compensation. UIM residents identified their communities and their personal identities (i.e., race, ethnicity, culture) as influential to their career choices. Both women and UIM residents more frequently described the importance of representation and belonging in their career decisions compared to their non-UIM and male counterparts. Family planning emerged as an important factor for women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings lend insights into how academic institutions, medicine subspecialty societies, training programs, and faculty at large can engage trainees in their field. We propose ways to improve the recruitment and retention of women and UIM trainees into the IM subspecialty fields.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-025-09967-9","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T15:52:01Z","timestamp":1763740321000},"page":"653-662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How do Internal Medicine Residents from Different Backgrounds Make Subspecialty Career Choices? 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L.A.H. reports the following relationships outside of the current work: consulting fees\/advisory board from AstraZeneca, Pfizer, research funding from the National Cancer Institute of the NIH under Award Number K12CA260225, and the California Breast Cancer Research Program. All other authors have no disclosures to report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}