{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:07:59Z","timestamp":1789150079193,"version":"build-2803163510"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007184","name":"Yale School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007184","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physician workforce diversity improves access to care, outcomes, and workforce productivity. Yet, women and sexual minorities remain underrepresented in anesthesiology, while representation for low-income trainees remains poorly characterized. How interest in anesthesiology evolves among these groups during medical school remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study of U.S. MD-granting medical school matriculants from 2014\u20132017 used Association of American Medical Colleges data on self-reported sociodemographic characteristics and anesthesiology interest. Students were grouped by interest evolution from matriculation to graduation: never interested (no-no), cultivated (no-yes), lost (yes-no), sustained (yes-yes). Chi-square tests characterized sociodemographic differences across interest paths. Firth logistic regression models assessed odds of cultivated vs never interested and sustained vs lost paths across sociodemographic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 39,910 students in the cohort, 295 (0.7%) sustained, 2,007 (5.0%) cultivated, 494 (1.2%) lost interest, and 37,114 (93.0%) were never interested in anesthesiology. Women were less likely than men to have initial interest (1.5% vs 2.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), whereas initial interest among low-income (2.1% vs 1.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.087) and sexual minority (1.8% vs 2.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.505) students did not significantly differ from majority counterparts. Sustained interest did not differ significantly between women and men (OR: 0.85, 95% CI: 0.63\u20131.14), according to low-income (OR: 0.89, 95% CI: 0.65\u20131.22), or sexual minority status (OR: 0.77, 95% CI: 0.41\u20131.45). Women (OR: 0.50, 95% CI: 0.45\u20130.55) and sexual minority students (OR: 0.79, 95% CI: 0.65\u20130.96) were less likely to cultivate interest than men and heterosexual students, respectively. Low-income students had greater (OR: 1.27, 95% CI: 1.16\u20131.40) odds of cultivating interest compared to non-low-income peers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women\u2019s underrepresentation in anesthesiology is associated with lower initial and cultivated interest. Sexual minority students also demonstrated lower cultivated interest. These disparities identify time points in training where interest diverges by demographic group and may help prioritize where future research \u2014 including studies of targeted interventions \u2014 is most needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358122","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:26:04Z","timestamp":1789147564000},"page":"e0358122","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of demographic characteristics with evolution of interest in anesthesiology during medical school"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1767-5085","authenticated-orcid":true,"given":"Max Y.","family":"Lu","sequence":"first","affiliation":[{"name":"Yale School of Medicine","place":["New Haven, Connecticut, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M.","family":"Hajduk","sequence":"additional","affiliation":[{"name":"Yale School of Medicine","place":["New Haven, Connecticut, United States of America"],"department":["Section of Geriatrics, Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeph","family":"Herrin","sequence":"additional","affiliation":[{"name":"Yale School of Medicine","place":["New Haven, Connecticut, United States of America"],"department":["Section of Cardiology, Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mytien","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Yale School of Medicine","place":["New Haven, Connecticut, United States of America"],"department":["Department of Immunobiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dowin","family":"Boatright","sequence":"additional","affiliation":[{"name":"New York University Grossman School of Medicine","place":["New York, New York, United States of America"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarwat I.","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Yale School of Medicine","place":["New Haven, Connecticut, United States of America"],"department":["Section of General Internal Medicine, Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"issue":"4","key":"pone.0358122.ref001","first-page":"383","article-title":"Diversity improves performance and outcomes","volume":"111","author":"LE Gomez","year":"2019","journal-title":"J Natl Med Assoc"},{"issue":"3","key":"pone.0358122.ref002","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.pec.2014.11.013","article-title":"Medical student socio-demographic characteristics and attitudes toward patient centered care: do race, socioeconomic status and gender matter? A report from the Medical Student CHANGES study","volume":"98","author":"RR Hardeman","year":"2015","journal-title":"Patient Educ Couns"},{"issue":"11","key":"pone.0358122.ref003","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1007\/s11606-017-4127-6","article-title":"Medical School Factors Associated with Changes in Implicit and Explicit Bias Against Gay and Lesbian People among 3492 Graduating Medical Students","volume":"32","author":"SM Phelan","year":"2017","journal-title":"J Gen Intern Med"},{"issue":"1","key":"pone.0358122.ref004","first-page":"414","article-title":"Diversity, equity, and inclusion among anesthesiology trainees","volume":"3","author":"S Patel","year":"2022","journal-title":"Womens Health Rep"},{"issue":"5","key":"pone.0358122.ref005","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1213\/ANE.0000000000007102","article-title":"Diversity, Equity, and Inclusion in US Anesthesiology Residency Matching","volume":"139","author":"AN Sumarli","year":"2024","journal-title":"Anesth Analg"},{"issue":"12","key":"pone.0358122.ref006","article-title":"Female Faculty Representation in Anesthesiology: A Retrospective Cross-Sectional Analysis","volume":"16","author":"J Novoa","year":"2024","journal-title":"Cureus"},{"issue":"9","key":"pone.0358122.ref007","article-title":"Sexual Orientation Diversity and Specialty Choice Among Graduating Allopathic Medical Students in the United States","volume":"4","author":"WS Mori","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"3","key":"pone.0358122.ref008","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/SLA.0000000000006029","article-title":"Association of socioeconomic status, sex, racial, and ethnic identity with sustained and cultivated careers in surgery","volume":"279","author":"M Nguyen","year":"2024","journal-title":"Ann Surg"},{"issue":"9","key":"pone.0358122.ref009","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1001\/jamainternmed.2022.2194","article-title":"Association of Sociodemographic Characteristics With US Medical Student Attrition","volume":"182","author":"M Nguyen","year":"2022","journal-title":"JAMA Intern Med"},{"issue":"5","key":"pone.0358122.ref010","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.11063","article-title":"Medical School Support of Students\u2019 Professional and Personal Development by Sociodemographic Characteristics","volume":"8","author":"M Nguyen","year":"2025","journal-title":"JAMA Netw Open"},{"key":"pone.0358122.ref011","volume-title":"ACGME Data Resource Book: Academic Year 2023-2024","author":"Education ACfGM","year":"2024"},{"issue":"3","key":"pone.0358122.ref012","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1001\/jama.1978.03280300037017","article-title":"Migration of physicians from one specialty to another. A longitudinal study of US medical school graduates","volume":"239","author":"WD Holden","year":"1978","journal-title":"JAMA"},{"issue":"11","key":"pone.0358122.ref013","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0259434","article-title":"Diversity of the physician workforce: Specialty choice decisions during medical school","volume":"16","author":"J Burkhardt","year":"2021","journal-title":"PLoS One"},{"issue":"2","key":"pone.0358122.ref014","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1177\/0730888410392319","article-title":"When does gender matter? Gender differences in specialty choice among physicians","volume":"38","author":"MC Ku","year":"2011","journal-title":"Work and Occupations"},{"key":"pone.0358122.ref015","unstructured":"Colleges AoAM. Matriculating Student Questionnaire (MSQ). https:\/\/www.aamc.org\/data-reports\/students-residents\/report\/matriculating-student-questionnaire-msq"},{"key":"pone.0358122.ref016","unstructured":"Colleges AoAM. Year 2 Questionnaire (Y2Q). https:\/\/www.aamc.org\/data-reports\/students-residents\/report\/year-two-questionnaire-y2q"},{"key":"pone.0358122.ref017","unstructured":"Colleges AOAM. Graduation Questionnaire (GQ). https:\/\/www.aamc.org\/data-reports\/students-residents\/report\/graduation-questionnaire-gq"},{"issue":"10","key":"pone.0358122.ref018","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"E von Elm","year":"2007","journal-title":"PLoS Med"},{"key":"pone.0358122.ref019","unstructured":"Facts glossary. American Association of Medical Colleges."},{"key":"pone.0358122.ref020","unstructured":"Bureau USC. Income distribution to $250,000 or more for households. 2018."},{"issue":"8","key":"pone.0358122.ref021","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.29243","article-title":"Rates of medical student placement into graduate medical education by sex, race and ethnicity, and socioeconomic status, 2018-2021","volume":"5","author":"M Nguyen","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"1","key":"pone.0358122.ref022","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/j.1467-9531.2007.00180.x","article-title":"Regression with missing Ys: an improved strategy for analyzing multiply imputed data","volume":"37","author":"PT Von Hippel","year":"2007","journal-title":"Sociological Methodology"},{"key":"pone.0358122.ref023","doi-asserted-by":"crossref","DOI":"10.1002\/9780470316696","volume-title":"Multiple Imputation for Nonresponse in Surveys","author":"D Rubin","year":"1987"},{"key":"pone.0358122.ref024","doi-asserted-by":"crossref","first-page":"347","DOI":"10.2307\/2669316","article-title":"Making the most of statistical analyses: Improving interpretation and presentation","volume":"44","author":"G King","year":"2000","journal-title":"Am J Pol Sci"},{"issue":"3","key":"pone.0358122.ref025","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1093\/ije\/dyu029","article-title":"Estimating predicted probabilities from logistic regression: different methods correspond to different target populations","volume":"43","author":"CJ Muller","year":"2014","journal-title":"Int J Epidemiol"},{"key":"pone.0358122.ref026","unstructured":"Continuity of specialty preference on the matriculating student questionnaire and the 2019 graduation questionnaire. 2019."},{"issue":"6","key":"pone.0358122.ref027","doi-asserted-by":"crossref","first-page":"103513","DOI":"10.1016\/j.jsurg.2025.103513","article-title":"Association of Residency Applicant Sociodemographic Characteristics With Specialty Choice and Interview Outcomes","volume":"82","author":"NR Lenze","year":"2025","journal-title":"J Surg Educ"},{"issue":"2","key":"pone.0358122.ref028","article-title":"A Qualitative Exploration of the Career-Choice Journey of Women in Anesthesiology","volume":"26","author":"BM Marroquin","year":"2024","journal-title":"J Educ Perioper Med"},{"issue":"1","key":"pone.0358122.ref029","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1213\/ANE.0000000000003691","article-title":"Status of Women in Academic Anesthesiology: A 10-Year Update","volume":"128","author":"MA Bissing","year":"2019","journal-title":"Anesth Analg"},{"issue":"6","key":"pone.0358122.ref030","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/pan.14642","article-title":"Diversity, equity, and inclusion within the Society for Pediatric Anesthesia: A mixed methods assessment","volume":"33","author":"TL Reece-Nguyen","year":"2023","journal-title":"Paediatr Anaesth"},{"issue":"1","key":"pone.0358122.ref031","first-page":"135","article-title":"Wake up to the gender gap in academic anesthesiology and address the pipeline","volume":"36","author":"BM Marroquin","year":"2022","journal-title":"Proc (Bayl Univ Med Cent)"},{"issue":"2","key":"pone.0358122.ref032","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4103\/aer.AER_17_20","article-title":"Survey of workplace perceptions of female anesthesiologists","volume":"14","author":"B Flynn","year":"2020","journal-title":"Anesth Essays Res"},{"issue":"5","key":"pone.0358122.ref033","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1213\/ANE.0000000000004615","article-title":"Motherhood and Anesthesiology: A Survey of the American Society of Anesthesiologists","volume":"130","author":"MB Kraus","year":"2020","journal-title":"Anesth Analg"},{"issue":"1","key":"pone.0358122.ref034","article-title":"Pregnancy and Motherhood for Trainees in Anesthesiology: A Survey of the American Society of Anesthesiologists","volume":"23","author":"MB Kraus","year":"2021","journal-title":"J Educ Perioper Med"},{"issue":"7","key":"pone.0358122.ref035","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1001\/jamainternmed.2017.1394","article-title":"Perceived Discrimination Experienced by Physician Mothers and Desired Workplace Changes: A Cross-sectional Survey","volume":"177","author":"T Adesoye","year":"2017","journal-title":"JAMA Intern Med"},{"issue":"1","key":"pone.0358122.ref036","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1213\/ANE.0b013e3182917da9","article-title":"The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees","volume":"117","author":"GS de Oliveira","year":"2013","journal-title":"Anesth Analg"},{"key":"pone.0358122.ref037","doi-asserted-by":"crossref","first-page":"1478340","DOI":"10.3389\/fpubh.2025.1478340","article-title":"Perceived sexual harassment and gender differences in anesthesiology: a cross-sectional survey","volume":"13","author":"R Shenoy","year":"2025","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0358122.ref038","article-title":"Gender Differences in Perception of Workplace Experience Among Anesthesiology Residents","volume":"20","author":"J Miller","year":"2018","journal-title":"J Educ Perioper Med"},{"issue":"4","key":"pone.0358122.ref039","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1213\/ANE.0000000000005676","article-title":"Gender Differences in Compensation in Anesthesiology in the United States: Results of a National Survey of Anesthesiologists","volume":"133","author":"LB Hertzberg","year":"2021","journal-title":"Anesth Analg"},{"issue":"5","key":"pone.0358122.ref040","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/ALN.0000000000003722","article-title":"Burnout Rate and Risk Factors among Anesthesiologists in the United States","volume":"134","author":"AM Afonso","year":"2021","journal-title":"Anesthesiology"},{"issue":"11","key":"pone.0358122.ref041","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0260387","article-title":"Sexual and gender minority identity in undergraduate medical education: Impact on experience and career trajectory","volume":"16","author":"J Madrigal","year":"2021","journal-title":"PLoS One"},{"issue":"6","key":"pone.0358122.ref042","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1089\/lgbt.2016.0058","article-title":"Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate","volume":"3","author":"NA Sitkin","year":"2016","journal-title":"LGBT Health"},{"issue":"6","key":"pone.0358122.ref043","article-title":"Attitude and perceptions of the other underrepresented minority in surgery","volume":"71","author":"KP Lee","year":"2014","journal-title":"J Surg Educ"},{"issue":"1","key":"pone.0358122.ref044","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1186\/s12909-016-0805-z","article-title":"The prevalence and cost of medical student visiting rotations","volume":"16","author":"M Winterton","year":"2016","journal-title":"BMC Med Educ"},{"issue":"3","key":"pone.0358122.ref045","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1007\/s40670-021-01281-3","article-title":"Clerkship Experiences During Medical School: Influence on Specialty Decision","volume":"31","author":"A Kaminski","year":"2021","journal-title":"Med Sci Educ"},{"issue":"2","key":"pone.0358122.ref046","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/10401334.2021.1891545","article-title":"How Do Clinical Electives during the Clerkship Year Influence Career Exploration? A Qualitative Study","volume":"34","author":"L Sheu","year":"2022","journal-title":"Teach Learn Med"},{"issue":"5","key":"pone.0358122.ref047","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1213\/ANE.0000000000002802","article-title":"Teaching medical students clinical anesthesia","volume":"126","author":"SE Curry","year":"2018","journal-title":"Anesthesia & Analgesia"},{"issue":"1","key":"pone.0358122.ref048","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1186\/s12909-023-04731-1","article-title":"The perceived impact of curricular and non-curricular factors on specialty interests and choice during medical school at a single center in the United States","volume":"23","author":"N Karthik","year":"2023","journal-title":"BMC Med Educ"},{"issue":"3","key":"pone.0358122.ref049","article-title":"Fostering belonging in academic anaesthesiology: faculty and department chair perspectives on supporting women anaesthesiologists","volume":"124","author":"MB Lane-Fall","year":"2020","journal-title":"Br J Anaesth"},{"issue":"4","key":"pone.0358122.ref050","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1213\/ANE.0000000000006575","article-title":"Championing the Mom: The Role of a Mother\u2019s Support Group in Academic Anesthesia Practice","volume":"137","author":"KA Berical","year":"2023","journal-title":"Anesth Analg"},{"issue":"1","key":"pone.0358122.ref051","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1213\/ANE.0000000000005798","article-title":"The \u201cUnexplained\u201d Portion of the Gender Pay Gap in Anesthesiology","volume":"134","author":"ACS Pearson","year":"2022","journal-title":"Anesth Analg"},{"issue":"7","key":"pone.0358122.ref052","doi-asserted-by":"crossref","first-page":"376","DOI":"10.14423\/SMJ.0000000000000995","article-title":"The Costs of Applying to Residency: One Institution\u2019s Efforts to Increase Transparency","volume":"112","author":"AW Kuhn","year":"2019","journal-title":"South Med J"},{"key":"pone.0358122.ref053","unstructured":"Byrd KDD. Exploring the effects of program signaling on interview invitation, ranking and match outcomes. In: 2025."},{"issue":"3","key":"pone.0358122.ref054","article-title":"Research Output Among US Anesthesiology Residency Applicants: A Positive Sign or a Worrisome Trend?","volume":"27","author":"E Saran","year":"2025","journal-title":"J Educ Perioper Med"},{"issue":"10","key":"pone.0358122.ref055","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.38520","article-title":"Variation in Research Experiences and Publications During Medical School by Sex and Race and Ethnicity","volume":"5","author":"M Nguyen","year":"2022","journal-title":"JAMA Netw Open"},{"key":"pone.0358122.ref056","article-title":"Categorizing trends in anesthesiology residency applicants\u2019 research portfolios and impact on matching: a program-level study","author":"J Holloway","year":"2026","journal-title":"Anesth Analg"},{"issue":"2","key":"pone.0358122.ref057","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.55110","article-title":"Strategies and Best Practices to Improve Diversity, Equity, and Inclusion Among US Graduate Medical Education Programs","volume":"6","author":"D Boatright","year":"2023","journal-title":"JAMA Netw Open"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:26:14Z","timestamp":1789147574000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358122"}},"subtitle":[],"editor":[{"given":"Ling-Qun","family":"Hu","sequence":"first","affiliation":[{"name":"The Ohio State University College of Medicine","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":57,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358122","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]}}}