Which U.S. medical graduates plan to become specialty-board certified? Analysis of the 1997-2004 National Association of American Medical Colleges graduation questionnaire database

Background: Predictors of U.S. allopathic medical-school graduates' board-certification plans have not been characterized. Method: Using multivariable logistic regression, graduates' responses to 11 questions on the 1997-2004 Association of American Medical Colleges Graduation Questionnaire were analyzed to identify independent predictors of plans for specialty-board certification. Results: The proportion of 108,408 graduates planning specialty-board certification decreased from 97.3% in 1997 to 88.4% in 2004. Among 101,805 (93.9%) graduates with complete data, graduates who were Hispanic, rated their clinical clerkships, quality of medical education, and confidence in clinical skills more highly, had any debt, and planned "University- faculty" careers were more likely to plan becoming board certified. Females, Asians/Pacific Islanders, and graduates who planned to practice in underserved areas, planned "other" nonclinical-practice careers, and graduated with MD/other (non-PhD) degrees were less likely to plan becoming board certified. Conclusion: Specialty-board certification does not appear to be among the professional goals for a growing proportion of U.S. medical graduates.