Distress and empathy do not drive changes in specialty preference among US medical students

Liselotte N. Dyrbye, Anne M. Eacker, William Harper, David V. Power, F. Stanford Massie, Daniel Satele, Matthew R. Thomas, Jeff A. Sloan, Tait D. Shanafelt

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: Although medical student specialty choices shape the future of the healthcare workforce, factors influencing changes in specialty preference during training remain poorly understood. Aim: To explore if medical student distress and empathy predicts changes in students' specialty preference. Methods: A total of 858/1321 medical students attending five medical schools responded to surveys in 2006 and 2007. The survey included questions about specialty choice, burnout, depression, quality of life, and empathy. Results: A total of 26% (205/799) changed their specialty preference over 1 year. Depersonalization an aspect of burnout was the only distress variable associated with change in specialty preference (OR, odds ratio 0.962 for each 1-point increase in score, p=0.03). Empathy at baseline and changes in empathy over the course of 1 year did not predict change in specialty preference (all p>0.05). On multi-variable analysis, being a third year (OR 1.92), being male (OR 1.48), and depersonalization score (OR 0.962 for each point increase) independently predicted a change in specialty preference. Distress and empathy did not independently predict students' losing interest in primary care whereas being a fourth-year student (OR 1.83) and being female (OR 1.83) did. Conclusion: Among those who did have a major change in their specialty preference, distress and empathy did not play a major role.

Original languageEnglish (US)
Pages (from-to)e116-e122
JournalMedical Teacher
Issue number2
StatePublished - Feb 2012

Bibliographical note

Funding Information:
This study was supported by an Education Innovation award from the Mayo Clinic and an intramural grant from the Mayo Clinic Program in Professionalism and Bioethics. Drs Dyrbye and Shanafelt receive salary support from the Mayo Clinic, Department of Medicine Program on Physician Well-Being. Dr Dyrbye receives additional salary support from the Mayo Clinic, College of Medicine Office of Medical Education.


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