The survey results were announced earlier this month at the Florida Obstetric and Gynecological Society (FOGS) annual meeting in West Palm Beach. Aaron Deutsch, MD, lead author of the study and chief resident in the USF Department of Obstetrics and Gynecology, presented the findings. The paper received the 2006 first-place resident research award from FOGS.
"Florida is already a state without enough obstetrician/gynecologists to meet the needs of patients. In some parts of the state, women must wait several months to see an obstetrician, and there are no perinatologists or maternal-fetal medicine specialists to take care of high-risk pregnancies," Dr. Deutsch said. "Our findings suggest this shortage may get even worse."
The USF researchers sent surveys to all fourth-year medical students in Florida in fall 2005. The senior year is when medical students find out where they will conduct their residencies - the period of specialized training for licensed medical graduates in their chosen medical field.
Florida mirrors a national trend of fewer medical students applying for ob/gyn residencies. The USF researchers hypothesized that student concerns about the rising cost of malpractice premiums and medical liability in Florida may contribute to the marked decline of students specializing in ob/gyn.
Half of the Florida students surveyed - 42 percent men and 58 percent women - responded. The respondents were divided into three groups - students who selected ob/gyn as a career (had applied to ob/gyn residencies); those who considered ob/gyn as a career but ultimately decided against it; and those who never considered ob/gyn. Of the students selecting a career in ob/gyn, 86 percent reported they are considering leaving Florida to practice because of the medical liability concerns.
Overall, interest in another specialty and lifestyle concerns - work hours and unpredictable schedule - were major reasons students cited for not choosing ob/gyn careers, whether they initially considered the specialty or not. However, the survey demonstrated a significant split in concerns about Florida's medical-legal climate between these two groups.
Of the students who considered ob/gyn but decided against it, 32 percent ranked "fear of malpractice" as the first or second deterrent to entering the field, compared to 21 percent who never considered ob/gyn. Nearly 27 percent of students who considered ob/gyn ranked "fear of being sued" as a first or second deterrent compared to 7 percent who never considered the specialty.
"It appears that some students may have chosen ob/gyn except for the fear of high malpractice insurance costs and lawsuits are associated with our field of medicine," Dr. Deutsch said.
In 2005, Florida ranked first in the top10 states with the most expensive average base rate medical malpractice premiums for obstetrician-gynecologists, according to the Medical Liability Monitor.
The USF authors acknowledge that students who felt strongly about Florida's malpractice climate may have been more inclined to respond to the survey, and cite the need for more national research to clarify future practitioners' concerns.
Joan McCarthy, MD, USF assistant residency director of ob/gyn, and Kelly Murray, MD, were co-authors of the research paper titled "Why are Fewer Medical Students in Florida Choosing Obstetrics and Gynecology?"