How, when, and why do physicians choose careers in academic medicine? A literature review.

PURPOSE: Medicine has different pathways in which physicians pursue their vocation. Clinical practice, research, and academia are common paths. The authors examined the literature to identify research-based factors influencing physicians to choose a career path in academic medicine.
METHOD: In the fall of 2006, the authors searched the PubMed database from 1960 to 2006 using the term career academic medicine. Review of articles resulted in the identification of nine themes relating to academic medicine career paths. The authors summarized the important and relevant articles to capture what the literature contributed as a whole to the larger question, "How, when, and why do physicians choose an academic career in medicine?"
RESULTS: A synthesis of articles revealed that (1) values are essential to understanding the decision to enter a career in academic medicine, (2) factors associated with academic medicine career choice include research-oriented programs, gender, and mentors and role models, (3) an obstacle to pursuing this career path is loss of interest in academic careers during residency as residents learn about factors associated with academic careers in medicine, and (4) debt may be a barrier to choosing an academic career in medicine for some individuals in some specialties.
CONCLUSIONS: Despite the study findings, the larger question (stated above) remains essentially unanswered in the literature. The authors propose a call to action by various professional groups and organizations to use rigorous and complex research efforts to seek answers to this very important question.