Factors influencing the career decisions of United States hematology oncology fellows training at NCI- and NCCN-designated cancer centers.

Abstract

6144 Background: Factors influencing hematology-oncology fellows' choice of academic medicine as a career are not well defined. Moreover, it appears that trainees' interest in academic medicine wanes as they progress through fellowship training. To better understand the factors that impact on career choices we undertook a survey of hematology-oncology fellows at National Cancer Institute (NCI) and National Comprehensive Cancer Network (NCCN) designated cancer centers. Methods: Program directors at all NCI and NCCN cancer centers were emailed and invited to participate in the study. Surveys were distributed through the offices of all participating programs. Results: A total of 422 fellows were surveyed;236 responded (62.3% RR). 58% were male, 64% were PGY2 and PGY3, 46% had > $100,000 in debt, 22% had a second post-graduate degree and 15% intended to pursue an additional degree after training. 98% had participated in a research project during training; 45% in clinical research, 17% basic science research and 29% in both a clinical and a basic science research project. Fellows choosing an academic career were more likely to have presented (78% vs. 57%; p = 0.001) their research at a scientific meeting. They were also more likely to have published (78% vs. 50%; p < 0.0001). Additional factors associated with choosing an academic career included perceived status (p < 0.0001), faculty mentorship (p < 0.0001), perceived support of research interests (p < 0.000) and desire to teach (p < 0.0001). Regardless of career path fellows ranked job satisfaction, consistency with personality and experience with patients, among the most important factors in their career decisions. Fellows choosing nonacademic careers listed lifestyle factors such as on-call and work hours and time for leisure among the most important factors in their career decision. Conclusions: Strategies are needed to increase fellows' interest in pursuing academic careers. Our data suggest increased opportunities for research and publication along with improved mentorship are key factors necessary to attract fellows into academic careers. In addition, lifestyle issues, real or perceived, require more attention and study. No significant financial relationships to disclose.