BACKGROUND: Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE: To identify factors that predict the clinical practice of residents following their training. DESIGN: Prospective cohort study. PARTICIPANTS: Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS: Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS: International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, P<.001). Residents with higher loan indebtedness more often became generalists (P=.001). A corresponding trend favoring general internal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P=.08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05
