Timing of infectious disease clinical rotation is associated with infectious disease fellowship application

Background. With declining interest in infectious disease (ID) noted among internal medicine (IM) residents, national attention has been directed at methods to recruit more prospective ID applicants. The factors driving the recent decline in ID fellowship applications have thus far only been evaluated in survey studies. Since 2008 at our institution, all IM interns were required to complete a 4-week inpatient ID rotation. We evaluated this rotation to determine if any experiential factors could be linked to future ID interest. Methods. Categorical IM interns rotating on the mandatory ID rotation at our institution between July 1, 2008, and June 30, 2015, were included. Interns were grouped by eventual application to ID fellowship (IDA) and nonapplication (non-IDA). Consult numbers and types and characteristics of team members during the rotation were compared. Results. Between July 2008 and June 2015, 143 IM interns met inclusion criteria. Ten (7%) were IDA. There was no difference in number of consults seen, intern, team member, faculty, or fellow characteristics among groups. However, 90% of IDA compared with 46% of non-IDA rotated during the first 6 months of internship (P = .01). Conclusions. During a 7-year period, those interns randomly assigned to rotate on ID in the first 6 months of their intern year were more likely to become future ID applicants. This supports prior self-reported survey data that early exposure to the field may impact future career choice and suggests that incorporating ID early into the intern experience may increase recruitment.