Disparities in employment outcomes among critical care graduates with different training backgrounds

Abstract. Background. We sought to characterize the impact of critical care training pathways on subsequent employment opportunities. Methods. A survey assessing the postfellowship work environment and barriers to employment in a preferred setting was electronically distributed on September 16, 2019, to program directors and coordinators at all US adult critical care fellowships with instructions to forward it to the prior year’s graduates. Results. Data collection was interrupted by the coronavirus disease 2019 pandemic. Fifty-nine participants were included, reflecting a low rate of return. Most worked in urban areas (76.6%) at academic hospitals (81.7%). Graduates of internal medicine critical care (IMCC) were more likely than pulmonary critical care (PCC) to report their fellowship as a barrier to employment (50% vs 0%; P < 0.05). Emergency medicine graduates were more likely than internal medicine to report their residency as a barrier to employment (83.3% vs 4.6%; P < 0.05). Inability to find a desired position at an academic center (50% vs 5.9%; P < 0.05) and in the preferred metropolitan setting (37.5% vs 0%; P < 0.05) were more common among IMCC than PCC. Conclusion. In this survey of critical care graduates, residency in emergency medicine and fellowship in IMCC were associated with increased barriers to finding desired employment.