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September 22, 1989

Choice of Specialty: It's Money That Matters in the USA

Author Affiliations

University of Pittsburgh (Pa) School of Medicine

University of Pittsburgh (Pa) School of Medicine

JAMA. 1989;262(12):1630. doi:10.1001/jama.1989.03430120080019

To the Editor.—  Much has been written about the selection of a specialty by medical students. Projected deficits of primary-care physicians and the surplus of several types of subspecialists have focused increased attention on this process. Studies1,2 of specialty selection have suggested that financial rewards have little influence on this choice. I obtained data for numbers of applications and numbers of matched positions in specialties with more than 100 positions in the 1988 National Resident Matching Program. The ratio of these numbers was graphed against average physician income in specialties where this information was available, using data from the Medical Economics Earnings Survey as of September 5, 1988. The results show a correlation between specialty income and the number of applications per available position (Fig 1) and the percent of available positions filled in the match (Fig 2).Although specialty selection is no doubt a multifaceted process, monetary reimbursement