Table 1 Q set (statements included in the Q sort)

1.

My decision is based on the physiology of the subspecialty.

2.

GIM doesn’t get any of the interesting single organ diseases.

3.

The patients in my subspecialty of interest are fascinating.

4.

I really like the general medicine population of patients.

5.

I prefer to be an expert in my area.

6.

With the amount of knowledge, you cannot keep up with GIM.

7.

GIM patients are too complex.

8.

The positive interactions I have had with attendings affected my decision.

9.

The negative interactions I have had with attendings affected my decision.

10.

My decision is predominantly based on experiences as a medical student.

11.

My decision is predominantly based on experiences as a resident.

12.

I value more time for my personal life.

13.

Lifestyle and more control over my practice are important.

14.

I want to be in a field that is in demand.

15.

I am focused on my job prospects.

16.

I want to be in a large city.

17.

I want to work in a smaller community.

18.

The resources of a fellowship program are important.

19.

The skills I need are easier to attain from a subspecialty fellowship than a GIM fellowship.

20.

I want something that pays well given how long I’ve trained.

21.

I like a little bit of everything and variety.

22.

Some specialties are not fairly remunerated & this is an important consideration.

23.

I prefer an outpatient-based practice.

24.

I prefer an inpatient-based practice.

25.

I'd like to do a combination of inpatient and outpatient.

26.

I enjoy procedures.

27.

I want to do procedures as part of my practice.

28.

I want to be done after five years of residency.

29.

I am willing to do as many years as it takes to get the job and subspecialty I want.

30.

I like the fact you can save 1+ years in GIM.

31.

A two-year GIM fellowship is a deterrent.

32.

The fact that subspecialists can also be general internists is important to me.

33.

Prestige and respect from colleagues matter to me.

34.

Prestige and respect from the public matter to me.

35.

I want to be valued in what I’m doing.

36.

GIM is a dumping ground for patients nobody wants.