Health Professions Education in
Minnesota:
Results of the 2002 Minnesota
Health Professions Trainee Exit
Surveys
September 2003
h ealth e conomics p rog ram
Health Policy and Systems Compliance Division
Minnesota Department of Health
Printed with a minimum of 10% post-consumer materials. Please recycle.
Health Professions Education in
Minnesota:
Results of the 2002 Minnesota
Health Professions Trainee Exit
Surveys
September 2003
h ealth e conomics p rog ram
Health Policy and Systems Compliance Division
Minnesota Department of Health
Table of Contents
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Chapter 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Chapter 2: Demographics, Education and Debt . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Chapter 3: Post-Training Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Chapter 4: Labor Market Experiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Chapter 5: Policy Implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Appendix A: Survey methodology and response rates . . . . . . . . . . . . . . . . . . . . . . . . .43
Appendix B: Responses and survey instrument: Advanced Practice Nurses . . . . . . . . . .45
Appendix C: Responses and survey instrument: Chiropractors . . . . . . . . . . . . . . . . . .51
Appendix D: Responses and survey instrument: Dental Students/Residents . . . . . . . . .57
Appendix E: Responses and survey instrument: Resident Physicians . . . . . . . . . . . . . .65
Appendix F: Responses and survey instrument: Physician Assistants . . . . . . . . . . . . . .73
Appendix G: Responses and survey instrument: Pharmacy Students/Residents . . . . . .79
Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87
iii
iv
Executive Summary
The Department of Health (MDH) has long been involved in developing state policy around the
health workforce, as well as in administering programs, such as loan repayment or grant programs,
designed to address shortages or maldistributions of health professionals in Minnesota. The
Department, along with several other Minnesota organizations, also collects data on the demographic characteristics of health care providers and on their distribution throughout the state.
In 2001, in response to a relative lack of data on the dynamics of the health professions labor market in Minnesota, the Minnesota Department of Health’s Medical Education and Research Costs
(MERC) Advisory Committee, a group of educators, administrators and clinicians who advise the
Department on administration of the MERC Fund and on appropriate policy directions for health
professions education in Minnesota, worked with MDH to develop the Minnesota Health
Professions Trainee Exit Surveys. These surveys, now entering their third year, provide a snapshot
of demographics, labor market experiences, and practice characteristics of the graduating cohorts in
six disciplines – medicine, pharmacy, dentistry, advanced practice nursing, physician assisting and
chiropractic. The surveys are designed to shed new light on the experiences and preferences of
health professionals entering the Minnesota workforce, and will over time provide valuable trend
information regarding Minnesota’s health professions labor market.
Surveys were distributed to program directors and graduate medical education administrators at 19
institutions during the spring and summer of 2002. Together, these institutions sponsored over
230 programs with 1,403 expected graduates. A total of 990 graduates responded, 70.6% of the
total population. For additional detail on methodology and response rates, see Appendix A.
1
The survey results presented in this report are intended for use both by policy makers interested in
developing strategies to retain health professionals within Minnesota and by program or institutionlevel administrators interested in a more detailed understanding about where graduates go upon
program completion – and why. MDH will administer these surveys annually. Over time, we
hope these data will be a valuable tool for designing interventions to address maldistributions of
labor by region or specialty and for developing new insight into the dynamics of the health professions labor market.
2
#
Highlights
Characteristics and Educational Background of Trainees
z
Women represent at least a third of all respondents in each of the six surveyed provider type
groups, and represent the majority of pharmacy, P.A. and advanced practice nursing respondents.
z
Among medical residents, women were much more strongly represented in Primary Care
specialties and OB/GYN than in non-Primary Care specialties.
z
Physician Assistants were more likely than other provider types to have attended high school
in Minnesota, with over three-quarters having attended in-state high schools. In comparison, only roughly one-quarter of medical residents had graduated from Minnesota high
schools.
z
A quarter of medical resident respondents were international medical graduates (IMGs), and
less than one-third (27.1%) had attended Minnesota medical schools.
Educational Debt
z
Chiropractic respondents reported the highest levels of educational debt, with 94.6% owing
at least $60,000 (including both undergraduate and professional school debt) and 67%
reporting that they owed $100,000 or more.
z
Graduates of Minnesota medical schools had lower debt levels than did graduates of other
U.S. medical schools, but not as low as IMGs. Almost three-quarters of IMGs had no debt,
compared to just 14.4% of U.S. graduates.
3
z
Primary Care and Non-Primary Care medical residents had similar debt levels, although
Non-Primary Care respondents were more likely to be debt-free.
z
Physician Assistants and chiropractors had the highest debt-to-income ratio of the six
provider types.
Future Plans
z
Roughly a quarter of medical respondents and 20% of dental respondents intended to pursue additional specialty or sub-specialty training upon completion of their current training
program.
z
Among respondents with confirmed practice plans, just 52% of medical residents and 50%
of Chiropractors were staying in Minnesota. Medical residents from Primary Care programs
were significantly more likely to be remaining in Minnesota to practice than were respondents from non-Primary Care programs.
z
Across all provider types, those who had attended Minnesota high schools, colleges, or professional schools were more likely to remain in Minnesota to practice than were those who
attended school elsewhere. The difference between Minnesota and non-Minnesota high
school graduates was most pronounced among chiropractors and medical residents.
z
Fewer than 10% of respondents had committed to practicing in rural areas or in a federallydesignated Health Professional Shortage Area (HPSA). Likelihood of working in a HPSA
was greatest for Advanced Practice Nurses and Family Practice physicians.
z
Primary Care respondents, particularly those in Family Practice, were more likely to have
accepted positions in rural areas or small towns than were non-Primary Care respondents.
Expected First Year Income and Hours
z
Median anticipated first year income for medical residents was $146,600. Respondents in
Primary Care specialties reported lower anticipated first year income than respondents in
non-Primary Care specialties, at $119,300 and $158,900 respectively.
z
Among medical resident respondents, females anticipated working roughly 8 fewer hours
per week than males (40.9 vs 48.8).
z
The majority of dentists (86%) and chiropractors (61%) anticipated working 39 or fewer
hours per week or less.
z
Medical residents completing Primary Care residencies anticipated working fewer hours per
week than non-Primary Care respondents.
Job Search and Labor Market Perceptions
Pharmacy, Advanced Practice Nursing, and Physician Assistant respondents tended to search
z
4
exclusively in Minnesota – mostly in the Twin Cities metropolitan area - while medical residents and chiropractors were more likely to only search outside of Minnesota.
z
Chiropractors and medical residents, in general, searched for a practice position longer than
the other surveyed provider types.
z
The average number of job offers over the course of a job search was lowest for Physician
Assistants at 1.2, compared with 3.5 for medical residents. Physician Assistants were also
the most likely to report having received no offers.
z
Physician Assistants were the most likely to report difficulties in finding a satisfactory position, with almost 75% indicating at least some difficulty. Most often, these difficulties were
attributed to a lack of jobs in the desired practice setting.
z
Across all provider types, practice setting was the single most important factor considered in
the job search. Geographic location and family/spouse considerations were also widely
taken into account.
z
Few respondents considered military, loan, or visa obligations to be important factors in
their job search.
z
Physician Assistants had the most negative view of the Minnesota job market, with more
than half of those who had searched for a job indicating that there were “few” or “very few”
jobs available. Dental and pharmacy respondents were the most optimistic.
5
6
1
Introduction
In recent years, concerns about present and future shortages of certain healthcare providers have
prompted a new wave of research into the healthcare workforce both nationally and at the state
level. In Minnesota alone, numerous organizations or collaborative efforts have been established to
examine the size, composition, and distribution of the healthcare workforce, while others have
expanded or revised their missions to more closely address issues related to recruitment and retention. In general, these efforts are focused not on shortage identification in and of itself, but rather
on determining whether such shortages or maldistributions of healthcare providers have an impact
on access to healthcare and, if so, on developing appropriate policy responses.
Issues related to the size and distribution of the healthcare workforce in Minnesota have long been
of concern to the Medical Education and Research Costs (MERC) Advisory Committee and the
Department of Health, as well. In 1996, when legislation establishing the MERC Fund was
passed, the stated purpose of the fund was relatively straightforward: offsetting a portion of the
clinical training costs faced by hospitals and clinics around the state who are involved in the clinical
training of a set of health professionals. However, the question of whether training of certain
provider types or specialties should be supported at a higher level than others was never far below
the surface. In a 1996 report to the Legislature, MDH recommended establishing a set of ‘guiding
principles’ for the development of the future MERC distribution formula that included a consideration of whether or not programs “encouraged the expansion of any area of training where there is
an anticipated ‘oversupply’ of providers.”1 The current MERC legislation acknowledges this issue
as well, stating that to be eligible for grants from the MERC Fund, programs must ‘emphasize
Primary Care or specialties that are in undersupply in Minnesota.’
7
While workforce issues have long been debated by MERC and have been included in the MERC
statute, the formula governing distribution of MERC funds has not included a component that
would more highly reward any given provider type or specialty, nor have any alternative funding
mechanisms yet been developed to address the distribution of the health professional workforce in
Minnesota. Amidst renewed interest in the issue, the MERC Advisory Committee, a group of educators, administrators and clinicians who advise the Department on administration of the MERC
Fund and on appropriate policy directions for health professions education in Minnesota, formed a
subcommittee to determine whether or not it would be appropriate and feasible for MERC to take
a more proactive role in the workforce issue, either through a modification of the distribution formula or through the establishment of a new funding mechanism that could more explicitly incent
the training of specific provider types, specialties or geographic areas.
After examining medical resident exit surveys designed by the State University of New York at
Albany’s Center for Health Workforce Studies, the committee recommended that MDH develop a
set of similar tools to survey graduating students and residents who were completing programs in
Minnesota that would qualify them to enter one of the professions included in the MERC Fund.
A set of six surveys was developed in the fall of 2000 to be administered to graduating dental students and residents, pharmacy students and residents, resident physicians, and advanced practice
nursing, physician assistant, and chiropractic students. The surveys were first distributed in the
spring of 2001.
This second round of surveys was administered by the Health Economics Program at the
Minnesota Department of Health in the spring and summer of 2002. A total of 1,403 surveys
were administered to expected graduates in over 200 programs at 19 institutions. In order to
increase the response rate, surveys were administered by institutional coordinators, who were given
discretion to distribute the surveys in whichever manner they felt would be most effective for their
students.
It is important to note that while the overwhelming majority of graduating students and residents
in the target programs received surveys, the results are still, in a sense, a point in time snapshot. In
general, exiting students or residents who did not complete their program within several months of
survey administration, as in the case of a student needing an extra quarter or semester to complete
courses, may have been missed.
Table 1.1
Usable responses were received by 990
Response rates by provider type
respondents, for a final response rate of
70.6%, which ranged from a high of 100% Provider Type
Graduates Returned
for Physician Assistants to a low of 55.4% Medical (MD)
698
387
Dental (DDS)
133
99
for resident physicians. This report presPharmacy (PhD)
131
103
ents results for these respondents, with an Physician Assistant (PA)
26
26
Advanced Practice Nursing (APN)
196
172
emphasis on comparing the responses of
Chiropractic (CH)
219
203
respondents from each provider type to
1403
990
questions that were common across all surveys. Findings of particular interest are highlighted.
8
Rate
55.40%
74.40%
78.60%
100.00%
87.80%
92.70%
70.60%
The body of this report is divided into chapters that follow the same general organizational structure as the surveys themselves. Chapter 2 presents demographic data on all 990 respondents,
including gender, race, citizenship and age, as well as responses to questions about where the
respondent attended high school, college, and professional school and their level of educational
debt at the time of program completion. Chapter 3 contains information on the immediate posttraining plans of all respondents and, for those who had accepted a practice position, information
about the characteristics of that practice. Practice-related questions include anticipated first-year
salary, practice setting, ownership level, anticipated weekly hours, and demographics of the area surrounding the practice. Chapter 4 presents information on respondents’ job search experiences,
including the geographic areas that were searched, search duration, level of difficulty finding a satisfactory position, factors that were considered during the job search, and perception of practice
opportunities in Minnesota and nationally. Chapter 5 concludes the report with a discussion of the
implications these findings have for the development of policies related to the health professions
workforce in Minnesota. A set of appendices presents complete results for each provider type.
Technical Note
For the purposes of this report, “Primary Care’ medical specialties are defined as Family Practice,
General Internal Medicine, General Pediatrics and combined Internal Medicine/Pediatrics programs. The definition of Primary Care used in this report does not include OB/GYN.
9
10
2
Demographics,
Education, and Debt
Factors as diverse as gender, race/ethnicity, educational debt level, geographic location of training,
and exposure to diverse populations or settings during training can have a significant impact on
how and where health professionals choose to practice. Recently published studies have found links
between gender and rural location among physicians on a national level, with female physicians less
likely to work in rural areas than male physicians.2 Closer to home, the Minnesota Department of
Health’s Office of Rural Health and Primary Care has found that this trend also holds true among
Minnesota’s practicing dentists.3 Other research has uncovered links between a provider’s race and
service to racially and ethnically diverse populations.4 In Minnesota, as in many other states, the
state, region, or even county in which a new health professional received his or her training can be
a strong predictor of where that provider will eventually practice. For example, more than half of
all pharmacists practicing in Minnesota in 2001 attended the University of Minnesota School of
Pharmacy, and virtually all attended pharmacy school in Minnesota, North Dakota, South Dakota,
Wisconsin or Iowa.5
Given the potential importance of these factors in determining the level of service to underserved
geographic areas or population groups, and in projecting the size and composition of the future
workforce, the ability to more accurately describe the demographics of the newest health professional cohort will be key for the development of policies to address access to health care and
recruitment/retention issues.
11
This chapter examines demographic char- Cases used for analysis in Chapter 1
acteristics of respondents, including gender,
N
172
age, race and citizenship status, and pres- Advanced Practice Nurses (APN)
203
ents responses to questions about where the Chiropractors (CH)
Dental Students/Residents (DDS)
99
respondent attended high school, college,
Resident Physicians (MD)
387
and professional school. This chapter also
Primary Care (PC)
137
presents data on educational debt level.
Non-Primary Care (NPC)
250
Physician Assistants (PA)
Pharmacy Students/Residents (PhD)
Total:
26
103
990
Response Rate
87.80%
92.70%
74.40%
55.40%
55.90%
55.20%
100.00%
78.60%
70.60%
Analysis in this chapter is based on
responses of all survey respondents, a total
of 990 students/residents. The responses of medical resident respondents are presented in the
aggregate and also split out based on Primary Care/Non-Primary Care status. Abbreviations that
will be used for all provider type and specialty groups in charts in this chapter are included in the
table above.
12
Gender
Figure 2.1
Percentage Female, by Provider Type
56.2%
60%
72.8%
76.9%
80%
83.7%
100%
z
z
28.8%
Non-Primary Care MD's
Primary Care MD's
PhD
38.5%
MD
PA
38.4%
DDS
0%
APN
20%
CH
34.5%
40%
The majority of pharmacy, advanced practice nursing and P.A. respondents were women,
and women represented at least a third of all completers in the other surveyed professions as
well.
Although only 16.9% of practicing dentists,6 26.1% of practicing physicians,7 and 45.1% of
practicing pharmacists8 were female in Minnesota in 2002, 38.4%, 38.5% and 72.8% of
respondents from these fields were female in 2002, indicating that the gender balance in
these provider types may begin to more closely reflect Minnesota’s population in the coming
years. In the case of pharmacy, the proportion of female pharmacists may soon be higher
than their percentage of the state’s population.
z
An annual survey conducted by the American Academy of Physician Assistants has found
that, over the last six years, an average of 61% to 67% of new P.A. students nationwide were
female.9 In Minnesota, that proportion is even higher, with 76.9% of the 2002 graduating
class composed of women.
z
Again in 2002, women were much more strongly represented in Primary Care specialties
(and in OB/GYN) than in non-Primary Care specialties. Women represented 56.2% of
respondents in Primary Care and 28.8% in non-Primary Care specialties.
13
Race
Figure 2.2
Percentage Non-white, by Provider Type and Specialty
35%
29.0%
30%
14.1%
6.9%
11.1%
10%
15.2%
15%
15.4%
20%
18.7%
24.7%
25%
5%
Non-Primary Care MD's
Primary Care MD's
PhD
PA
MD
DDS
CH
APN
0%
Of the provider types surveyed, medical residents had the highest percentage of non-white
or Hispanic respondents, at 24.7%.
z

Non-Primary Care respondents were significantly more likely to be non-white
(29.0%) than were Primary Care respondents (15.4%).

Nationally, African Americans, American Indians/Alaskan Natives, and certain persons of Hispanic origin are considered to be under-represented minorities in medicine. Members of these groups represented less than 10% of responding medical
residents.

Across all provider types and medical specialties, Asian/Pacific Islanders were the
single largest non-white group. Respondents who identified as Asian/Pacific
Islanders represented 16.7% of all medical resident respondents and 15.7% of pharmacy respondents. Asian/Pacific Islanders are not usually considered to be an underrepresented minority in medicine.
Responses from chiropractic students indicated that non-whites and/or Hispanics may be
underrepresented in this profession compared with Minnesota’s overall racial and ethnic
makeup.
z
14
High School/Professional School
Figure 2.3
Respondents who attended a Minnesota High School
100%
77.0%
80%
43.8%
24.8%
41.3%
40%
45.4%
57.6%
63.2%
60%
14.4%
20%
0%
APN
CH
DDS
MD
PA
PhD
Primary
Care MD's
Non-Primary
Care MD's
z
Among the provider types surveyed, Physician Assistants and Pharmacists were the most
likely to have graduated from a Minnesota high school (77%, 63.2%). Medical residents
were the least likely to have graduated from Minnesota high schools, at just 24.8%.
z
The majority of medical residents attended out-of-state professional schools. Only roughly
one-fourth (27.1%) of medical residents attended medical school in Minnesota. Among
advanced practice nurses, just over half (56.4%) received their baccalaureate nursing degree
from a Minnesota school.
Citizenship
z
The overwhelming majority of respondents in all six groups were either native-born or naturalized U.S. citizens or permanent residents. J-1 or J-2 temporary visa holders represented
just 2.0% of dental respondents and 14% of medical residents. H-1, H-2, or H-3 visas
were even less common, at just 0.8% for medical residents and 2.5% for Chiropractors.10
z
While roughly a quarter of medical resident respondents (25.3%) were international medical
graduates, roughly 40% of IMG’s were either U.S. citizens or permanent residents.

Non-Primary Care residents were significantly more likely than Primary Care residents to be international medical graduates (32.8% vs 11.7%).
15
Educational debt
Figure 2.4
Educational Debt
100%
11.2%
90%
20.0%
27.4%
18.5%
80%
50.5%
33.2%
70%
67.0%
23.3%
60%
43.7%
50%
60.0%
24.8%
40%
19.2%
14.3%
6.0%
30%
12.2%
20%
33.0%
27.6%
4.0%
30.8%
10%
APN*
None
20.0%
14.1%
3.5%
1.0%
0%
29.0%
1.0%
CH
< $20,000
2.9%
DDS
$20,000 - $59,999
MD
PA
$60,000 - $99,999
1.9%
PhD
$100,000 +
z
Among the provider types, chiropractors again reported the highest debt level. Virtually all
had at least some debt, with 94.6% owing at least $60,000 (including undergraduate and
professional school debt) and 67% reporting that they owed $100,000 or more.
z
Among all U.S. medical graduates (graduates of medical schools in Minnesota and other
states), the average debt load of medical residents was $84,400. The average debt load of
indebted medical residents who graduated from U.S. medical schools was $98,900.
z
International medical graduates (IMG’s) had significantly lower debt than did U.S. medical
school graduates. Graduates of Minnesota medical schools, while facing higher debt loads
than IMG’s, were still better off than graduates of other U.S. medical schools.
16

Nearly three-quarters (71.4%) of IMG’s had no debt, compared with just 14.4% of
U.S. graduates.

The average debt load of indebted respondents was $37,000 for IMG’s, $88,200 for
Minnesota graduates and $105,600 for graduates of other U.S. medical schools.
z
Respondents completing Primary Care and Non-Primary Care residencies reported similar
levels of debt; among those with some debt, Primary Care respondents’ average debt load
was $91,800 and Non-Primary Care respondents averaged $93,400. However, NonPrimary Care respondents were more likely to be debt-free, at 34.8%, than were Primary
Care respondents (18.4%).
z
Physician Assistants and chiropractors had
the highest debt to expected income ratio.
On average, P.A.s owed an amount equal to
117% of their expected first year income,
and chiropractors owed roughly 186% of
their expected first year income. Advanced
Practice Nurses had the lowest debt to
income ratio.
Table 2.1
Provider
Type
APN
CH
DDS
MD
PA
PHD
Average
Debt Load
(U.S. grads
only)
$23,100
$105,400
$86,800
$84,400
$73,100
$72,700
Median
Debt as %
Expected
of Annual
Income
Annual Income
$73,300
$56,800
$98,700
$146,600
$62,500
$85,300
31.5%
185.6%
87.9%
57.6%
117.0%
85.2%
17
18
3
Post-Training Plans
As outlined in Chapter 2, it is important to have a clear picture of the people in the health professions ‘pipeline’ in order to predict the size and composition of the future health workforce and to
project where –or if- these professionals will choose to practice. However, it is equally important to
know whether program graduates are choosing to remain within the state to practice or to pursue
further training, and the types of practices at which they choose to work.
For example, more clearly understanding the out- Cases used for analysis in Chapter 3*
flow of graduates who complete Minnesota trainN
ing programs but leave the state to pursue further
Advanced Practice Nurses (APN)
69
training or to practice elsewhere, as well as the
Chiropractors (CH)
113
number of graduates who follow the opposite pat- Dental Students/Residents (DDS)
46
tern, is crucial to translating raw enrollment and Resident Physicians (MD)
223
13
graduation counts into a true projection of future Physician Assistants (PA)
48
Pharmacy
Students/Residents
(PhD)
practitioners. Better information on hours worked
Total:
512
and anticipated tenure in a geographic area can
help to refine estimates of level of service, turnover,
questions on general future plans, all 990 respondents
and ease of access to medical, dental or other treat- *For
are included in the analysis in this chapter. For all questions
ments. Changes in anticipated first-year income related to characteristics of the respondent’s practice, analysis
to the 512 respondents who indicated that they would
over time can be an important indicator of shifts in isbelimited
going directly into patient care/clinical practice and that they
relative demand for an occupation or specialty.
had accepted a practice position.
Chapter 3 presents data related to respondents’ immediate post-training plans. All survey recipients
were asked about their future plans. Those who indicated they had accepted a practice position or
would be self-employed were then asked a series of questions about the characteristics of their prac19
tice, including the setting (inpatient hospital, community-based facility, long term care, etc), level
of ownership, anticipated hours and income, the demographics of the surrounding area, and how
they anticipated that their time would primarily be spent. With the exception of discussion related
to general future plans, analysis in this chapter is limited to respondents who indicated that they
had already accepted a practice position or would be self-employed; this represented approximately
half of all respondents. It is important to note that this chapter includes the responses of those who
had accepted positions outside of Minnesota and/or outside of the U.S.
20
Future Plans
Figure 3.1
Future Plans
70.9%
PhD
17.5%
11.6%
100.0%
PA
1.8%
65.1%
MD
24.8%
8.3%
4.0%
74.7%
DDS
3.0%
18.2%
2.5%
97.6%
CH
5.3%
4.7%
90.1%
APN
0%
10%
20%
30%
Patient Care
40%
50%
Add'l Trng
60%
Tchg/Rsch
70%
80%
90%
100%
Oth/Und/DKY
z
Across the provider types studied, a large majority planned to go directly into clinical practice upon completion of their current training program, as opposed to working in teaching
or research positions or going on for additional training. In the case of Physician Assistants,
100% of respondents planned to go directly into patient care. While post-graduate programs for Physician Assistants do exist, relatively few P.A.s go on to complete such programs, and no post-graduate option is currently available for P.A.s in Minnesota.
z
Medical resident and dental respondents were the most likely to be going on for additional
training, at 24.8% and 18.2% respectively.

z
Of medical residents who planned to pursue training in a subspecialty, 50%
planned to remain in Minnesota for their training. Of those that were leaving the
state, 40% indicated that they would not be returning to Minnesota following completion of their subspecialty training and an additional 45% were unsure.
International medical graduates (IMGs) were more likely to be pursuing additional training
than were graduates of U.S. medical schools (29.6% for IMGs, 23.2% for U.S. medical
school graduates).
21
Location of Practice: within/outside of MN
Figure 3.2
Respondents whose confirmed patient care plans are in Minnesota
70%
63.0%
60%
80.6%
82.6%
80%
92.3%
90%
85.4%
100%
49.6%
51.6%
50%
39.1%
40%
30%
20%
10%
0%
APN
CH
DDS
MD
PA
PhD
Primary
Care
MD's
Non-Primary
Care
MD's
Among respondents with confirmed practice plans, medical residents and chiropractors were
the least likely to be staying in Minnesota to practice. Just 51.6% of the medical residents
with confirmed plans were remaining in the state, along with just 49.6% of chiropractors.
Physician Assistants and pharmacists were the most likely to be staying in Minnesota, at
92.3% and 85.4% of those with confirmed positions.
z

Respondents completing Primary Care residencies were significantly more likely
than those from non-Primary Care residencies to be remaining in Minnesota for
their upcoming practice (80.6% vs 39.1%).
Exit survey respondents bear out the theory that the location where a health professional
grew up is an important predictor of where they will eventually practice. Graduates of
Minnesota high schools were significantly more likely to remain in Minnesota to practice
than were non-Minnesota high school graduates, a factor which partly explains why medical
residents and chiropractors are less likely to remain in-state than other groups.
z

22
The difference between Minnesota and non-Minnesota high school graduates was
most pronounced among chiropractors (83% of Minnesota graduates with confirmed plans remaining in Minnesota vs 25.8% of non-Minnesota graduates) and
medical residents (85.5% vs 36.4%).
z
Graduates of Minnesota medical schools were significantly more likely to be remaining in
Minnesota to practice than graduates of other U.S. medical schools or IMGs.

Among medical residents with confirmed practice plans, 80.8% of Minnesota medical school graduates were remaining in the state to practice, compared to just
40.9% of IMGs. Conversely, while a quarter of IMGs with confirmed plans had
accepted positions abroad, no Minnesota medical graduates had.
23
Practice Setting
Figure 3.3
Practice Setting
60%
61.7%
65.6%
70%
0%
Hospital Inpatient
Hospital Ambulatory
APN
Community
MD
PA
2.1%
8.3%
8.9%
16.4%
8.2%
9.8%
10%
4.3%
16.1%
20%
25.0%
25.0%
30.2%
30%
31.9%
41.7%
40%
44.8%
50%
Other
PhD
Responses from medical residents showed that a majority planned to work in ambulatory
settings, with close to half of respondents with confirmed plans (44.8%) having accepted
positions in community-based settings and an additional 16.1% in hospital-based ambulatory settings.
z

Medical residents who had accepted positions in small cities or rural areas were significantly more likely to be working in ambulatory facilities than were their urban
counterparts. 63.6% of those planning to work in small cities or rural communities
had accepted positions in community-based settings, compared to 29.2% of those
in major cities.
More than half of pharmacists who had accepted positions were committed to working in
community facilities or retail pharmacies (61.7%), while 31.9% had committed to inpatient
hospital positions. This may signify a coming shift in pharmacy employment in
Minnesota; statewide, just 21.9% of licensed pharmacists worked in hospital settings in
2002.11
z
24
z
Half of Physician Assistant respondents indicated that they would be working in ambulatory
settings, with responses equally split between community-based and hospital-based ambulatory settings.
z
Physician Assistants were also asked about the specialty of the physician with whom they
would primarily be working; the majority indicated that they would be working with a
Family Practice physician (25.0%) or a surgical specialist (33.3%). Nationally, the most
common specialties in which Physician Assistants work are Family Practice and General
Internal Medicine.12
25
Employer and Ownership
Figure 3.4
Physician Employers
Military/ gov't org.
7.3%
Other
3.1%
Self-employed
14.1%
Managed care org.
5.7%
Hospital or clinic
31.3%
Group practice
38.5%
z
Medical residents were asked to report not only the practice setting in which they would be
working but also whether their employer would be a hospital, a managed care organization,
a group practice, or other entity. The largest group of respondents (38.5%) indicated that
they would be employed by a group practice, with 31.3% employed directly by a
hospital/clinic.
z
Even if a medical resident’s upcoming practice was in a hospital setting, the hospital was not
always the actual employer. Among respondents who would be practicing in a hospital
(inpatient or ambulatory setting), 36.4% indicated that they would be employed by a group
practice or a managed care organization.
z
Just 14.1% of medical residents indicated that they would be self-employed in their upcoming practice.
26
Figure 3.5
Level of Ownership
95.7%
91.7%
100%
80%
49.1%
53.1%
58.1%
60%
16.1%
2.3%
8.3%
20.8%
20%
4.3%
30.2%
30.7%
39.5%
40%
0%
None
None currently, but expected in future
CH
z
DDS
MD
PA
Currently owner/partner
PhD
Relatively few respondents reported that they would have any level of ownership in their
upcoming practice. Only chiropractors will be partners or owners/partners in significant
numbers, at 49.1% of respondents. In the future, however, 30.7% of medical residents,
30.2% of chiropractors and 58.1% of dentists expected to have the opportunity to become
owners or partners.
27
Location of Practice: Urban/Rural
Figure 3.6
Location of Practice
PhD
PA
DDS
APN
10%
20%
30%
Major City
8.3%
31.7%
53.4%
0%
40%
50%
Suburban
10.2%
20.4%
42.6%
26.9%
60%
Small City
70%
80%
8.8%
7.0%
18.6%
39.5%
34.9%
CH
8.2%
39.7%
43.3%
6.4%
16.7%
33.3%
50.%
MD
8.5%
40.4%
44.7%
90%
6.7%
100%
Rural
Very few respondents had committed to practices in rural areas. Chiropractic respondents
indicated the highest likelihood to locate in a rural area, at 10.2%.
z

Reflecting national and state data showing that Family Practice physicians represent
a disproportionate share of rural physicians, Family Practice residents were more
likely than respondents in other specialties to locate in rural areas. Nearly half
(47.3%) of Family Practice respondents with confirmed plans were committed to
practices in rural areas or cities with populations under 25,000, compared to just
10.1% of medical residents in other specialties.
At least half of advanced practice nurses and Physician Assistants had committed to working
in the urban core, either in the inner city or in another area within a major city.
Conversely, chiropractors and dentists were much less likely to have committed to an urban
practice
z
Nationally, 21.6% of Physician Assistants work in rural areas;13 however, no Minnesota P.A.
respondents indicated plans to practice in a rural area.
z
28
Health Professional Shortage Areas (HPSAs) are geographic areas or population groups in
which the U.S. Department of Health and Human Services’ Division of Shortage
Designation has determined that there is a shortage of health professionals. Certain health
professionals, including Primary Care physicians, dentists, and P.A.s, are eligible for the
National Health Service Corps Loan Repayment Program if they serve for at least two years
in a HPSA. The Minnesota State Loan Repayment Program is also available to these
providers. Overall, very few respondents had accepted positions in a federally designated
Health Professional Shortage Area (HPSA). Advanced Practice Nurses were the most likely
to have committed to a HPSA practice, at 11.7%. Many respondents did not know
whether or not their upcoming practice was in a HPSA.
z
Figure 3.7
Upcoming Practice in HPSA
14%
12%
11.7%
10%
8.5%
8%
6.7%
6%
5.7%
5.2%
4%
2%
1.9%
2.3%
0.0%
0%
APN
CH
DDS
MD
PA
PhD
Primary
Care MDs
Non-Primary
Care MDs
29
Expected Annual Income
Figure 3.8
Median Expected First Year Income
(base salary plus incentive income)
$140,000
$120,000
$119,300
$146,600
$158,900
$160,000
$62,500
$40,000
$56,800
$60,000
$73,300
$80,000
$85,300
$98,700
$100,000
$20,000
$0
APN
CH
DDS
MD
PA
PHD
Primary
Care MD's
Non-Primary
Care MD's
z
Overall, Primary Care respondents expected significantly lower annual first year incomes
than non-Primary Care respondents. Median expected first year income for medical residents completing Primary Care programs was roughly $40,000 less per year than for respondents in non-Primary Care specialties.
z
While the majority of respondents in all six major groups pronounced themselves at least
‘somewhat’ satisfied with their anticipated first-year income, chiropractic respondents were
the least likely to be ‘very’ satisfied. Just a quarter (26.4%) of chiropractic respondents
declared themselves ‘very’ satisfied with their first-year income, compared to 58.3% of
Physician Assistants and 68.1% of pharmacists. Chiropractors had the highest average debt,
the lowest expected income and the highest debt-to income ratio of the surveyed provider
types.
30
Figure 3.9
Satisfaction with anticipated first-year income
2.1%
100%
5.7%
6.6%
26.4%
18.6%
16.7%
29.8%
42.0%
44.3%
80%
25.0%
44.2%
47.2%
60%
68.1%
58.3%
52.3%
40%
49.2%
37.2%
20%
26.4%
0%
APN
CH
Very Satisfied
DDS
Somewhat Satisfied
MD
PA
PHD
Not Very Satisfied/ Dissatisfied
31
Hours Worked
Figure 3.10
Average Weekly Hours Worked
60
48.8
PA
39.1
35.2
38.4
30
43.2
45.3
MD
42
40
45.8
50
20
10
0
APN
CH
DDS
PHD
Primary
Care MD's
Non-Primary
Care MD's
z
Medical residents anticipated working more hours per week than other provider types, at an
average of 45.8 hours. More than a third (39.6%) anticipated working 50 hours or more
per week, not including on-call hours.
z
Among medical residents, non-Primary Care respondents expected to work more hours per
week than Primary Care respondents.
z
Medical residents working in major cities anticipated working significantly more hours per
week than those in small cities or rural areas. Just 21.2% of respondents with commitments
in small cities or rural areas anticipated working over 50 hours per week, compared with
50% of their urban counterparts. This difference is partly due to variations in specialty mix
in urban/rural areas; Primary Care respondents were more likely to indicate location in rural
areas or small towns than were non-Primary Care respondents.
z
The majority of dentists (86.3%) and chiropractors (61.1%) anticipated working 39 hours
or less per week upon completion of training.
z
Among medical resident respondents, females anticipated working roughly 16% fewer hours
per week than male respondents (40.9 hours vs. 48.8 hours).
32
4
Labor Market
Experiences
While many recent reports have attempted to shed light on the existence of, or severity of, worker
shortages in the health professions, these studies have focused almost exclusively on demand-side
measures such as number of current or projected openings or relative difficulty filling positions.
Reliable supply-side measures, such as difficulty finding a position, have not yet been developed, in
part because it can be challenging to identify and survey job seekers who are looking for specific
classes of work.
Recipients of the 2002 Trainee Exit Surveys
Cases used for analysis in Chapter 4
were asked a variety of questions that, taken
N
together, can shed light on demand for occuAdvanced Practice Nurses (APN)
101
pations from the job seeker’s viewpoint. Each
Chiropractors (CH)
165
respondent was asked about length of time
Dental Students/Residents (DDS)
61
spent looking for a position, geographic areas
213
in which the respondent searched for a posi- Resident Physicians (MD)
75
tion, number of offers received, ease or diffi- Primary Care (PC)
Non-Primary Care (NPC)
138
culty in finding a satisfactory position,
24
whether or not difficulty in finding a satisfac- Physician Assistants (PA)
Pharmacy
Students/Residents
(PhD)
59
tory position led to a change in search strateTotal Cases used in Chapter 4
623
gies, and the factors that were important to
the respondent in their search for, and selection of, a practice position. Over time, changes in these
measures may allow for more detailed analysis of trends in the market for specific occupations or
specialties.
This section includes data only on those respondents who were planning to go directly into a
patient care position upon completion of training and who had searched for a job; a total of 623
respondents. Respondents on temporary (H1, H2, H3, J1 or J2) visas were excluded from all
analyses in this chapter. Because these respondents were more likely to experience problems in their
33
job search due to their visa status than other respondents, their inclusion in this analysis could have
biased the results for many provider types or specialties with relatively higher numbers of temporary
visa holders.
Location of Search
Figure 4.1
Location of Search
100%
3.3%
15.3%
90%
80%
70%
5.3%
32.7%
26.7%
.5%
36.8%
8.3%
16.7%
11.2%
10.3%
5.2%
84.5%
75.0%
73.5%
6.7%
60%
18.7%
63.3%
21.1%
50%
43.3%
40%
41.6%
30%
20%
10%
0%
APN
CH
Within MN Only
DDS
Within/Outside MN
MD
Outside MN Only
PA
PhD
Outside US Only
z
Pharmacy, Advanced Practice Nursing and Physician Assistant respondents were the most
likely to have searched only within Minnesota, at roughly 75% of respondents or more. Of
those who searched only within Minnesota, most focused their searches on the Twin Cities
metropolitan area rather than searching statewide.
z
Conversely, roughly 40% of medical resident and chiropractic respondents did not search
for a position within Minnesota at all, a higher proportion than other provider types.
z
Very few respondents in any group did statewide searches, nor did many respondents search
in Southwest, Northwest or Northeast Minnesota.
34
Job Offers
Table 4.1
z
The average number of job offers was lowest
for Physician Assistants at 1.2, compared to Provider Avg. Job
5 or more
3.5 for medical residents and 2.9 for pharType
Offers No Offers Offers
macists and dentists.
APN
1.6
21.10%
5.10%
z
Physician Assistants were the most likely to
have received no job offers, at 33.3%, with
another third having received just one offer
in the course of their search.
z
Virtually all pharmacy and medical resident respondents who had searched for a position
had received at least one job offer.
CH
DDS
MD
PA
PhD
2.0
2.9
3.5
1.2
2.9
10.60%
6.70%
1.00%
33.30%
3.40%
5.30%
15.00%
19.40%
0.00%
12.10%
35
Length of Search
Figure 4.2
Length of Search
100%
90%
80%
2.1%
5.9%
8.3%
15.9%
13.2%
19.2%
17.6
36.4%
18.1%
29.5%
16.7%
44.6%
50.0%
70%
60%
18.8%
22.9%
63.2%
56.3%
50%
18.2%
19.2%
40%
36.4%
17.6%
30%
25.3%
20%
25.0%
19.7%
10%
0%
APN
CH
Less than 1 month
DDS
1-2 months
MD
3-6 months
PA
PhD
6 months or more
z
Chiropractors, medical residents and dentists, in general, searched for a practice position
longer than the other surveyed provider types. While most respondents found satisfactory
positions relatively quickly, nearly 20% of these respondents had spent six months or more
searching before finding and accepting a practice position.
z
Advanced Practice Nursing and pharmacy respondents did not generally search long before
finding a position; more than half in each group had spent less than a month searching
before accepting a position.
z
Of those who were planning to go into patient care and had begun looking for a job, the
percentage that had found a job varied widely. Only 64.9% of chiropractors and 52% of
Physician Assistants who had actively searched for a job had found one at the time they
completed the survey, compared with 80% of pharmacists and 92.1% of medical residents.
36
Difficulty of Job Search
Figure 4.3
Level of difficulty in job search
2.4%
100%
7.5%
4.2%
4.8%
7.2%
5.2%
90%
24.6%
80%
24.1%
25.8%
70%
46.0%
45.4%
73.0%
66.7%
70.7%
66.7%
60%
50%
49.2%
47.4%
40%
30%
29.2%
20%
10%
0%
APN
CH
DDS
No Difficulty
MD
Some Difficulty
PA
PhD
Severe Difficulty
z
Physician Assistant respondents were the most likely to report difficulty finding a satisfactory position. The majority of P.A. respondents (70.9%) indicated they had some/severe difficulty finding a position, compared to just 27% of medical residents and 29.3% of
Pharmacists.
z
There was no significant difference in job search difficulty between Primary Care and nonPrimary Care medical residents.
z
For medical resident respondents, a lack of positions in the desired geographic area was the
most common explanation for a difficult search (45.6% respondents who had experienced
difficulties), while for chiropractors, the primary reason for difficulties was low salary/compensation (27.8%).
z
Physician Assistants and Pharmacists were the most likely to have changed their plans due
to a difficult job search, with roughly a third of those who experienced difficulties in their
job search making changes in their search strategy. The most common response for both
provider types was to expand the search into new practice settings.
37
Factors in Job Search
Figure 4.4
Factors Considered "Very Important" in Job Search
50.0%
58.3%
62.3%
58.7%
60.6%
65.5%
83.9%
87.5%
71.4%
62.9%
65.8%
82.5%
73.0%
59.6%
54.2%
50.0%
40%
58.8%
50%
55.6%
60%
63.2%
76.8%
70%
81.3%
80%
83.2%
91.6%
90%
91.7%
100%
30%
20%
10%
0%
Salary
Practice Setting
APN
CH
Geography
DDS
MD
PA
Family/Spouse
PHD
z
Practice setting was the single most important factor that graduates considered in their job
search. Respondents were asked about the relative importance of a series of factors, and
roughly three-quarters or more of respondents in all provider types listed practice setting as
“very important.”
z
Geographic location of the practice, family/spouse considerations and partners/coworkers in
the practice were also very important to the majority of respondents.
z
Relatively few respondents took military, loan or other obligations into account when
searching for a job. Only roughly 10-15% of respondents in most provider types indicated
that these obligations were very important to them as they searched for a job.
z
For pharmacy respondents, opportunities for professional growth and opportunities for
direct patient care were also very important factors in their job search.
38
Perceptions of Job Market
Figure 4.5
Perception of Opportunities in MN
100%
4.0%
12.7%
3.8%
12.5%
5.5%
16.8%
90%
47.3%
41.2%
11.7%
8.8%
7.1%
41.7%
7.0%
22.8%
80%
53.5%
70%
34.0%
60%
61.4%
50%
40%
47.3%
47.8%
DDS
MD
45.8%
41.5%
30%
25.7%
20%
10%
0%
APN
CH
Many Jobs
Some Jobs
Few Jobs
PA
PHD
Very Few/No Jobs
z
Respondents who had searched for a job were asked about their perception of the availability of practice opportunities in Minnesota. Again, Physician Assistants were markedly more
pessimistic about the labor market than were respondents from other provider types. More
than half of the P.A.s who had searched for a job (54.2%) reported that there were “few,”
“very few,” or “no” opportunities available. In contrast, fewer than a quarter of respondents
in other provider types responded in this way.
z
Pharmacy respondents were the most optimistic about the state labor market, with nearly
two-thirds of respondents reporting that there are many jobs available in Minnesota.
z
Perceptions of the national labor market were generally more favorable than perceptions of
Minnesota opportunities.
39
40
5
Policy Implications
Although debates around the existence and impact of worker shortages in the health professions
have been ongoing both nationally and in Minnesota, an overall lack of data on the labor market
experiences of these workers has made it difficult to design policy interventions to address issues of
distribution, labor force composition, in-state retention and lack of access to care in underserved
areas. The results presented in this report are an important first step towards the development of a
better understanding of the practice decisions made by a key group of new practitioners and the
factors that play into those decisions.
In the coming years, MDH will use multiple years of data from these surveys to construct a longitudinal database, which will make changes in relative demand for the surveyed health professions
easier to track. However, many questions remain unanswered. As long as access to healthcare
remains an issue, debates about the number and mix of health professionals needed in the state will
continue, as will questions about the best methods of recruiting new people into fields that are
anticipating large numbers of retirees in the coming years, the accuracy of predictions about future
supply and demand, and the appropriate role of the State and other stakeholders in ensuring an
adequate size and mix of health professionals in the future.
Several of the findings in this report point to areas in which state-level policies might be able to
impact retention of health professionals within Minnesota or to influence the mix of Primary Care
and non-Primary Care professionals working around the state. For example, survey results show
that across all six provider types, one of the strongest predictors of in-state practice is having attended a Minnesota high school, college or professional school. Given this finding, one of the best
approaches for increasing retention within the state may be to increase the number of entering professional students or residents who have Minnesota ties through preferential admissions or financial
41
aid policies or through the use of incentives to institutions to increase the number of ‘home grown’
students or residents admitted. Working to increase awareness of and interest in healthcare careers
at the high school and pre-high school levels would also be an important component of such an
approach; several existing Minnesota organizations and collaboratives, such as the Healthcare
Education-Industry Partnership (HEIP), have begun to focus on this strategy in recent years.
Another area where it might be possible to influence practice decisions is by expanding loan repayment programs that are tied to HPSA service or to increased service to underserved populations.
The majority of respondents indicated that service requirements related to loan repayment, visa status or military obligations were not a major factor they considered when looking for a practice position. But for those that had committed to a HPSA practice, such obligations were more likely to
have been an important factor leading to that choice.
According to the Minnesota Department of Health’s Office of Rural Health and Primary Care
(ORHPC), applications for Minnesota’s various midlevel practitioner, physician and other loan
repayment programs routinely outweigh the relatively small number of slots currently available.
Evaluations of loan repayment programs have shown that a significant percentage of program completers continue practicing in an underserved area after completion of their service obligation.
Given the finding that Primary Care respondents tended to have slightly higher debt levels than did
non-Primary Care respondents while expecting a lower average income, this implies that expanding
loan repayment or other incentive programs could have an impact on practice decisions and lead to
a greater number of practitioners opting to practice in rural or urban HPSAs.
The responses from Physician Assistants also highlight an interesting dynamic. Nationally, P.A.s
have taken on greater visibility and responsibility as healthcare providers, practicing in a wide variety of settings and specialties, often in rural areas or small cities. Physician Assistants have also
made great inroads in Minnesota; roughly 1,000 P.A.s were employed in Minnesota in 2001,14 and
the profession is expected to grow by 44% to roughly 1,300 between 1998 and 2008, making it
one of the fastest-growing occupations in the state in terms of percentage growth.15 Additionally,
the use of P.A./NP/physician teams is widely recognized as a way to maintain or increase services at
lower costs, an important consideration at a time when many practices are feeling pressure to
reduce costs.
However, despite these factors, the responses of Physician Assistants to questions about job opportunities were markedly more pessimistic than those of other provider types. While it is possible
that the outlook of P.A. respondents is partially due to a mismatch between job search area and job
location or to unrealistic expectations in terms of salary or level of responsibility, the responses of
Minnesota P.A. grads could also indicate underutilization of P.A.s in certain practice settings or geographic areas in the state. It is unclear from these results whether the appropriate policy response
would be a change in reimbursement policies for P.A. services, a change in the current status of
P.A.s as registered rather than licensed health professionals, or the promotion of other incentives to
utilize P.A.s as a critical part of a healthcare delivery team. Given the potential of P.A.s, along with
Nurse Practitioners and other physician extenders, to provide a wide variety of services at lower
costs, however, further research into the dynamics of the market for these providers may be warranted.
42
A
Appendix A:
About the 2002
Minnesota Health
Professional Trainee
Exit Surveys
The 2002 Minnesota Health Professions Trainee Exit Surveys were developed in conjunction with
the Medical Education and Research Costs (MERC) workforce subcommittee, with additional
input provided by representatives of specific Minnesota health professions educational programs.
The surveys were administered through GME coordinators and other institutional contacts in the
spring of 2002 to 1,403 students and residents at 19 institutions who were intending to complete a
dental, pharmacy or medical residency, an entry-level Pharm D or DDS degree, or an advanced
practice nursing, chiropractic, or Physician Assistant program between May and December 2002.
A total of 990 valid responses were received, or 70.6% of the total population of exiting
students/residents. Tables A.1 and A.2 show the response rate by provider type, physician specialty
area and institution. The gender and race/ethnicity distributions of respondents in each provider
type were tested for any significant variation from known gender and race/ethnicity distributions of
all graduating students/ residents within the provider type. None of the grouped respondents
showed significant variation from the known gender and race/ethnicity distributions of all graduates
in the provider type.
Table A.1
Response Rates by Provider Type and Physician Specialty
Provider Type
Advanced Practice Nursing
Chiropractic
Dental
Medical Resident
Physician Assistant
Pharmacy
Physician Specialty Categories
Primary Care
Non-Primary Care
Grads
Returned
Rate
196
219
133
698
26
131
1403
172
203
99
387
26
103
990
87.8%
92.7%
74.4%
55.4%
100.0%
78.6%
70.6%
Grads
Returned
Rate
245
453
698
137
250
387
55.9%
55.2%
55.4%
43
44
Advanced Practice
Nursing Exit Survey
Part 1. Identification Information
MN Nursing License Number: _____________
First Name: ___________________ M.I. __________
Last Name: ____________________
Name of program you are completing: _______________________________________________
Part 2. Back Ground/Education
1. Gender
16.3% M
(n=172)
83.7% F
2. Age median=35
(n=172)
3. Citizenship status
(n=172)
89.5%
4.1%
4.7%
0.0%
0.0%
1.7%
Native Born U.S.
Naturalized U.S.
Permanent Resident
H-1, H-2, H-3 Temp. Worker
J-1, J-2 Exchange visitor
Other
4. Race/Ethnicity
(n=172)
0.6% American Indian/Alaskan Native
4.7% Asian/Pacific Islander
0.6% Black/African American
(non-Hispanic)
1.2% Hispanic
(Spanish/Hispanic/Chicano/Latino)
1.7% Multiracial
89.0% White (non-Hispanic)
2.3% Other ______________
6. Where did you receive your baccalaureate
nursing degree?
(n=170)
1.8%
1.8%
4.7%
5.9%
7.6%
0.6%
4.7%
0.6%
7.1%
0.6%
3.5%
8.8%
8.2%
38.2%
2.4%
3.5%
Augsburg College
Bemidji State University
Bethel College
College of St. Catherine
College of St. Scholastica
Concordia College
Metropolitan State University
Minnesota Intercollegiate Nursing
Consortium (St. Olaf/Gustavus)
MN State University - Mankato
MN State University - Moorhead
St. Benedict/St. John=s
University of Minnesota
Winona State University
Non-Minnesota U.S. school
(Please specify state: _____)
Non-U.S. nursing school
(Please specify country: _______)
Other ___________________
7. What year did you receive your baccalaureate
nursing degree?
(n=155)
median = 1995
5. Where did you graduate from high school?
(n=172)
39.0%
18.6%
34.9%
7.6%
Greater Minnesota
Twin Cities metropolitan area
Other U.S. state
Other country
45
8. What is your current level of educational debt (including undergraduate loans)?
30.8%
11.2%
13.6%
7.7%
10.1%
7.1%
8.3%
11.2%
None
Less than $10,000
$10,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999
$50,000-$59,999
Over $60,000
9. What type of program are you completing in 2001? Check all that apply.
8.7%
2.3%
34.9%
2.9%
2.3%
46.5%
2.3%
46
(n=172)
Clinical Nurse Specialist
Nurse Administrator
Nurse Anesthesia
Nurse Educator
Nurse Midwifery
Nurse Practitioner
Other _______________________________
10. Please indicate the clinical specialty for which you are preparing:
5.8%
4.1%
9.9%
34.5%
2.3%
3.5%
22.8%
9.4%
3.5%
5.3%
5.8%
2.3%
9.4%
5.8%
(n=169)
Acute Care Nursing
Adolescent Nursing
Adult Health Nursing
Anesthesia Nursing
Child and Family Nursing
Children with Special Health Care Needs
Family Nursing
Gerontological Nursing
Oncology Nursing
Pediatric Nursing
Psychiatric Mental Health
Public Health Nursing/Community Health Nursing
Women’s Health Care
Other ____________________________
(n=171)
Part 3. Future Plans
11. What do you expect to be doing after completion of your current educational program?
(n=171)
Primary Activity (mark only one)
90.1% Patient care/clinical practice
0.0% Additional nursing education
1.2% Nursing administration
5.3% Teaching
0.0% Research
0.0% Working in another field
1.2% Other
2.3% Undecided/don’t know yet
12. Where is the location of your primary activity after completion of your current educational
program?
(n=171)
80.1% Within Minnesota
11.7% Other U.S. state
1.8% Outside of U.S.
6.4% Don’t know yet
13. If you are leaving the state to continue your
education, do you plan to return to Minnesota
to practice when your education is complete?
(n=34)
* If you have not considered entering patient
care/clinical practice, stop here and return your
completed survey.
15. Have you accepted a practice position?
(n=101)
68.3% Yes
31.7% No (Go To Q. 25)
16. Which best describes the type of patient
care practice you will be entering?
(n=61)
65.6% Hospital - inpatient
9.8% Hospital-based ambulatory care
16.4% Community (non-hospital based)
health center, clinic or other outpatient
facility
6.6% Long-term care facility
0.0% Public health agency
1.6% Other: __________________
17. What is the ZIP code and county of the
principal practice address at which you will be
working (if ZIP is unknown, please provide
city/town and state)?
ZIP: ________ County: ______________
City: __________________ State: _____
0.0%
26.5%
14.7%
58.8%
Yes
No
Don’t know yet
Does not apply
14. If you are planning to enter or have considered entering patient care/clinical practice, have
you actively searched for a job as an APN?
(n=154)
(If non-U.S., specify country:___________)
18. Is your practice in a federally designated
Health Professional Shortage Area?
(n=60)
11.7% Yes
41.7% No
46.7% Unknown
66.2% Yes
21.4% No, not yet (Go To Q. 32)
12.3% No, I plan to stay with my current employer for at least six months
(Go To Q. 32)
47
19. How long do you expect to be at your principal practice location?
(n=61)
13.1% Less than 2 years
32.8% 2-4 years
54.1% 4 years or more
20. Which best describes the demographics of
the area in which you will be practicing?
(n=60)
31.7% Inner city
21.7% Other area within major city
31.7% Suburban
8.3% Small city (pop. below 25,000)
6.7% Rural
21. Expected Gross Income during first year of
practice:
(n=61)
Base Salary (Full-time equivalent salary)
1.6% Less than $40,000
0.0% $40,000-$44,999
0.0% $45,000-$49,999
1.6% $50,000-$54,999
4.9% $55,000-$59,999
13.1% $60,000-$64,999
11.5% $65,000-$69,999
9.8% $70,000-$74,999
0.0% $75,000-$79,999
57.4% Over $80,000
22. How satisfied are you with your expected
gross income?
(n=61)
49.2% Very Satisfied
44.3% Somewhat Satisfied
3.3% Not Very Satisfied
3.3% Very Dissatisfied
48
23. How many total hours will you be working
per week, not including on-call hours? (n=61)
0.0% Less than 20
3.3% 20 to 29
21.3% 30 to 39
72.1% 40 to 49
3.3% 50 to 59
0.0% 60 or more
24. What percentage of your time will be spent
on the following activities?
(n=58)
Patient care – amb.
Patient care – inp.
Patient care – ltc
Teaching
Research
Consultation
Case Management
Administration
Other _________
mean
41.4%
45.2%
8.5%
1.3%
0.3%
0.6%
2.1%
0.4 %
0.0%
median
40.0%
50.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Part 4. Job Search Experience
(Does not include temporary visa holders)
25. How long have you been actively searching/did you search for a position?
(n=101)
54.5% Less than one month
22.8% 1-2 months
8.9% 3-4 months
7.9% 5-6 months
5.0% More than 6 months
1.0% Haven’t looked yet (Go to Q. 32)
26. How many positions have you applied for?
6.0% -0
54.0% -1
18.0% -2
11.0% -3
6.0% -4
2.0% -5
(n=100)
2.0% -6 to 10
1.0% -over 10
0.0% -n/a
27. In which geographic areas have you focused your search (check all that apply)?
(n=101)
7.9% All of Minnesota
48.5% Twin Cities metropolitan area
5.0% Northeastern Minnesota
2.0% Northwestern Minnesota
8.9% Central Minnesota
12.9% Southeastern Minnesota
6.9% Southwestern/S.Central Minnesota
13.9% Midwest U.S. (ND, SD, WI, IA, IL)
3.0% Eastern U.S.
10.9% Western U.S.
3.0% Southern U.S.
0.0% Outside of U.S.
28. How many offers for employment/practice positions did you receive (excluding fellowships and
other training positions)?
(n=99)
21.2% -0
39.4% -1
18.2% -2
6.1% -3
5.1% -4
2.0% -5
1.0% -6 to 10
2.0% -over 10
5.1% -n/a
29. How much difficulty did you have/are you having finding a practice position you are satisfied
with? (n=93)
66.7% No difficulty
25.8% Some difficulty
7.5% Severe difficulty
29a.If you have had some difficulty or severe difficulty finding a satisfactory position, what
was the main reason? (mark only one)
(n=28)
28.6% Overall lack of jobs in your specialty
28.6% Lack of jobs in desired geographic location
3.6% Lack of jobs in desired practice setting (i.e. hospital, LTC, etc)
7.1% Inadequate salary/compensation
14.3% Family/spouse considerations
0.0% Limited jobs due to visa status
17.9% Other ___________________________
49
30. Did you change your plans because of limited practice opportunities?
12.0% Yes
(n=92)
88.0% No
30a. If yes, how? (check all that apply)
(n=11)
36.4% Broadened search to new geographic area
63.6% Broadened search to new practice settings
27.3% Changed salary expectations/requirements
9.1% Going on for additional training
9.1% Other ___________________________
31. How important were the following factors in your job search and in the selection of your
upcoming practice position?
Very Important
Salary/benefits (n=95)
76.8%
Practice setting (n=95)
91.6%
Coworkers in the practice (n=56)
62.1%
Family/spouse considerations (n=94)
60.6%
Demographics of area (n=94)
37.2%
Military, visa, or loan obligation (n=91) 9.9%
Geographic location (n=89)
59.6%
Other (n=8)
50.0%
Somewhat Important
22.1%
7.4%
35.8%
29.8%
56.4%
15.4%
34.8%
12.5%
Not Important
1.1%
1.1%
2.1%
9.6%
6.4%
74.7%
5.6%
37.5%
32. What is your perception of opportunities for practice in your specialty within Minnesota?
(n=101)
38.6% Many Jobs
32.7% Some Jobs
10.9% Few Jobs
10.9% Very Few Jobs
1.0% No Jobs
4.0% Unknown
2.0% n/a - didn’t search in Minnesota
33. What is your perception of opportunities for practice in your specialty nationally?
(n=101)
44.6% Many Jobs
29.7% Some Jobs
6.9% Few Jobs
0.0% Very Few Jobs
0.0% No Jobs
50
6.9% Unknown
11.9% n/a - didn’t search nationally
Chiropractic Student Exit
Survey
Part 1. Identification Information
MN Chiropractic License Number (if available):
First Name:
M.I.
Part 2. Background/Education
1. Gender
65.5% M
(n=203)
34.5% F
2. Age 26 (median)
(n=203)
3. Citizenship status
(n=203)
82.8% Native Born U.S.
4.4% Naturalized U.S.
1.0% Permanent Resident
2.5% H-1, H-2, H-3 Temp. Worker
0.0% J-1, J-2 Exchange Visitor
9.4% Other
4. Race/Ethnicity
(n=202)
0.5% American Indian/Alaskan Native
3.5% Asian/Pacific Islander
0.5% Black/African American (nonHispanic)
0.5% Hispanic/Latino
(Spanish/Hispanic/Chicano/Latino)
2.0% Multiracial
93.1% White (non-Hispanic)
0.0% Other ______________
Last Name:
6. Where did you graduate from college (undergraduate degree)?
(n=201)
18.4% Greater Minnesota
12.9% Twin Cities metropolitan area
(Not concurrent with chiropractic program)
32.8% Other U.S. state
9.0% Other country
23.9% Undergraduate degree concurrent with chiropractic degree
3.0% n/a
7. What is your current level of educational
debt (including both undergraduate and chiropractic school loans)?
(n=203)
1.0% None
1.0% Less than $20,000
0.5% $20,000-$39,999
3.0% $40,000-$59,999
12.3 % $60,000-$79,999
15.3% $80,000-$99,999
47.3% $100,000-$124,999
17.2% $125,000-$149,999
2.5% $150,000-$199,999
0.0% Over $200,000
5. Where did you graduate from high school?
(n=203)
24.6% Greater Minnesota
16.7% Twin Cities metropolitan area
45.3% Other U.S. state
13.3% Other country
51
Part 3. Future Plans
8. What do you expect to be doing after completion of your current training program?
(n=203)
Primary Activity (mark only one)
96.1% Private patient care/clinical practice
1.5% Academic patient care
0.0% Additional professional training
0.0% Teaching
0.0% Research
0.0% Working in another field
1.0% Other ____________________
1.5% Undecided/Don’t know yet
9. Where is the location of your primary activity after current training? (n=203)
12. Have you accepted a practice position?
(n=174)
64.9% Yes
13. Which best describes the type of patient
care practice you will be entering?
(n=108)
30.6% Solo practice
7.4% Group practice - salaried employee
39.8% Group practice - as associate
17.6% Group practice - as partner
0.9% Academic group practice
3.7% Other: _____________________
14. What level of ownership will you have in
your upcoming practice?
(n=106)
20.8% None, I will be an employee
30.2% None currently, but I may have
the option to become a partner in the
future
6.6% I will be a partner, but will not
have any capital invested in the practice
42.5% I will be an owner/partner (i.e. I
will have capital invested and own a
financial stake in the practice).
48.3% Within Minnesota
38.4% Other U.S. state
6.4% Outside of U.S.
6.9% Don’t know yet
10. If you are leaving the state to continue your
training, do you plan to return to MN to practice when your training is complete? (n=105)
2.9% Yes
53.3% No
16.2% Don’t know yet
27.6% Does not apply
35.1% No (Go to Q. 23)
15. What is the ZIP code and county of the
principal practice address at which you will be
working (if ZIP is unknown, please provide
city/town and state)?
Zip
11. If you are planning to enter or have considered entering patient care/clinical practice, have
you actively searched for a job?
(n=198)
71.7% Yes
9.6% No, not yet (Go To Q. 29)
18.7% No, I will be self-employed in
private practice
* If you have not considered entering clinical
practice, stop here and return your completed
survey.
52
County:____________
City: __________________ State: _____
(If non-U.S., specify country:___________)
16. Is your practice in a federally designated
Health Professional Shortage Area?
(n=108)
1.9% Yes 54.6% No
43.5% Unknown
17. How long do you expect to be at your principal practice location?
(n=107)
8.4% Less than 2 years
23.4% 2-4 years
68.2% 4 years or more
18. Which best describes the demographics of
the area in which you will be practicing?
(n=108)
13.9% Inner city
13.0% Other area within major city
42.6% Suburban
20.4% Small city (pop. below 25,000)
10.2% Rural
19. Expected pre-tax personal (not clinic revenue) income during first year of practice:
(n=107)
Base Salary
17.8% Less than $30,000
18.7% $30,000-$39,999
24.3% $40,000-$49,999
11.2% $50,000-$59,999
6.5% $60,000-$69,999
4.7% $70,000-$79,999
3.7% $80,000-$89,999
2.8% $90,000-$99,999
4.7% $100,000-$149,999
5.6% Over $150,000
21. How many total hours will you be working
per week, not including on-call hours?
(n=108)
1.9% Less than 20
12.0% 20 to 29
47.2% 30 to 39
26.9% 40 to 49
6.5% 50 to 59
5.6% 60 or more
22. What percentage of your time will be spent
on the following activities?
(n=104)
mean
Patient Care
77.8%
Teaching
7.7%
Research
2.1%
Administration
8.8%
Other ______________ 3.2%
median
80.0%
0.0%
0.0%
0.0%
0.0%
Part 4. Job Search Experience
(Does not include temporary visa holders)
23. How long have you been actively searching
or did you search for a position?
(n=165)
21.8% Less than one month
20.6% 1-2 months
18.8% 3-4 months
15.2% 5-6 months
15.8% More than 6 months
7.9% Haven’t looked yet (Go to Q. 29)
20. How satisfied are you with your expected
gross income?
(n=106)
26.4% Very Satisfied
47.2% Somewhat Satisfied
24.5% Not Very Satisfied
1.9% Very Dissatisfied
53
24. In which geographic areas have you focused your search (check all that apply)?
(n=151)
11.7% All of Minnesota
35.8% Twin Cities metropolitan area
4.9% Northeastern Minnesota
6.2% Northwestern Minnesota
4.9% Central Minnesota
3.1% Southeastern Minnesota
4.3% SW/South Central Minnesota
25.9% Midwest reg. (ND, SD, WI, IL, IA)
6.2% Eastern U.S.
17.9% Western U.S.
3.7% Southern U.S.
9.3% Outside of U.S.
25. How many offers for employment/practice positions did you receive (excluding fellowships and
other training positions)?
(n=151)
10.6% - 0
28.5% - 1
30.5% - 2
14.6% - 3
4.6% - 4
2.0% - 5
2.0% - 6 to 10
1.3% - Over 10
6.0% - n/a
26. How much difficulty did you have/are you having finding a practice position you are satisfied
with?
(n=152)
47.4% No difficulty
45.4% Some difficulty
7.2% Severe difficulty
26a. If you had some or severe difficulty finding a satisfactory position, what was the
main reason?
(n=72)
4.2% Overall lack of jobs in your specialty
18.1% Lack of jobs in desired geographic location
9.7% Lack of jobs in desired practice setting (i.e. academic practice, etc)
8.3% Lack of jobs at desired level of ownership
27.8% Inadequate salary/compensation
8.3% Family/spouse considerations
2.8% Limited jobs due to visa status
20.8% Other ___________________________
27. Did you change your plans because of limited practice opportunities?
8.8% Yes
54
91.2% No
(n=148)
27a. If yes, how?
(n=13)
53.8% Broadened search to new geographic area
30.8% Broadened search to new settings
46.2% Broadened search to include different levels of ownership
7.7% Changed salary expectations/requirements
0.0% Going on for additional training
7.7% Other ___________________________
28. How important were the following factors in your job search and in the selection of your
upcoming practice position?
Salary/benefits (n=148)
Ownership level (n=148)
Practice setting (n=150)
Family/spouse considerations (n=146)
Demographics of area (n=150)
Military, visa, loan obligation (n=143)
Geographic location (n=149)
Partners in the practice (n=147)
Partnership buy-in costs (n=144)
Waiting period for partnership (n=143)
Other _____(n=15)
Very Important
58.8%
50.7%
81.3%
62.3%
54.7%
14.7%
65.8%
37.4%
25.7%
18.2%
20.0%
Somewhat Important Not Important
35.8%
5.4%
34.5%
14.9%
18.0%
0.7%
23.3%
14.4%
38.0%
7.3%
21.0%
64.3%
30.9%
3.4%
36.7%
25.9%
35.4%
38.9%
39.2%
42.7%
26.7%
53.3%
29. What is your perception of opportunities for practice of chiropractic within Minnesota?
(n=173)
16.8% Many Jobs
31.8% Some Jobs
10.4% Few Jobs
2.3% Very Few Jobs
0.0% No Jobs
15.0% Unknown
23.7% n/a - didn’t search in Minnesota
30. What is your perception of opportunities for practice of chiropractic nationally?
(n=172)
37.8% Many Jobs
31.4% Some Jobs
4.7% Few Jobs
0.6% Very Few Jobs
0.0% No Jobs
13.4% Unknown
12.2% n/a - didn’t search nationally
55
56
Dental
Graduate/Resident Exit
Survey
Part 1. Identification Information
MN Dental License Number (if available): _____________
First Name: ___________________ M.I. __________ Last Name: ____________________
Name of program you are completing: ______________________________________________
Part 2. Background/Education
1. Gender
61.6% M
(n=99)
2. Age
38.4% F
Median=27.0 (n=99)
5. Where did you graduate from high school?
(n=99)
22.2% Greater Minnesota
23.2% Twin Cities metropolitan area
43.4% Other U.S. state
11.1% Other country
3. Citizenship status: (n=99)
80.8% Native Born U.S.
7.1% Naturalized U.S.
4.0% Permanent Resident
0.0% H-1, H-2, H-3 Temporary
Worker
2.0% J-1, J-2 Exchange visitor
6.1% Other
4. Race/Ethnicity
(n=99)
0.0% American Indian/Alaskan Native
10.1% Asian/Pacific Islander
0.0% Black/African American (nonHispanic)
3.0% Hispanic
(Spanish/Hispanic/Chicano/Latino)
1.0% Multiracial
85.9% White (non-Hispanic)
0.0% Other ______________
6. Where did you graduate from college (undergraduate degree)?
(n=97)
22.7% Greater Minnesota
25.8% Twin Cities metropolitan area
42.3% Other U.S. state
9.3% Other country
7. Where did you attend, or are you attending,
dental school?
(n=99)
80.8% University of MN
9.1 % Non-Minnesota U.S. dental
school
(Please specify state: _____)
10.1% Non-U.S. dental school
(Please specify country:________)
57
8. What year did you complete, or will you complete, dental school? (n=98)
Median=2002
9. What is your current level of educational debt (including both undergraduate and dental school
loans)?
(n=99)
14.1% None
4.0% Less than $20,000
5.1% $20,000-$39,999
7.1% $40,000-$59,999
10.1% $60,000-$79,999
9.1% $80,000-$99,999
24.2% $100,000-$124,999
20.2% $125,000-$149,999
6.1% $150,000-$199,999
0.0% Over $200,000
10. What type of dental training program are you now completing?
(n=99)
74.7% General dentistry program (DDS degree)
25.3% Advanced specialty or advanced general dentistry residency program
11. Residents only: Please indicate the specialty you are completing in 2001.
16.0% Advanced Education in General Dentistry
0.0% Dental Public Health
16.0% Endodontics
12.0% General Practice Residency
0.0% Geriatric Dentistry
0.0% Orofacial Pain
0.0% Oral and Maxillofacial Pathology
12.0% Oral and Maxillofacial Surgery
0.0% Oral Radiology
20.0% Orthodontics
0.0% Pediatric Dentistry
12.0% Periodontics
12.0% Prosthodontics
0.0% Other _______________________________
58
(n=25)
Part 3. Future Plans
12. What do you expect to be doing after completion of your current training program?
(n=99)
Primary Activity (mark only one)
73.7% Private patient care/clinical practice
1.0% Academic patient care/clinical
practice
18.2% Additional dental training or fellowship
3.0% Teaching
1.0% Research
0.0% Working in another field
3.0% Other
0.0% Undecided/Don’t know yet
13. Where is the location of your primary activity after your current training?
(n=99)
64.6% Within Minnesota
26.3% Other U.S. state
5.1% Outside of U.S.
4.0% Don’t know yet
14. If you are leaving the state to continue your
training, do you plan to return to Minnesota to
practice when your training is complete?
(n=34)
2.9% Yes
35.3% No
29.4% Don’t know yet
32.4% Does not apply
* If you have not considered entering clinical
practice, stop here and return your completed
survey.
16. Have you accepted a practice position?
(n=64)
71.9% Yes
28.1% No (Go to Q. 27)
17. Which best describes the type of patient
care practice you will be entering?
(n=43)
88.4% Private practice
(owner/partner/employee)
0.0% Dental school faculty member
0.0% Hospital faculty member
4.7% Governmental service (military,
NHSC, VA, state/local health dept.)
0.0% Staff model HMO
2.3% Community clinic
2.3% Ind. Contractor at multiple clinics
2.3% Other _____________________
18. What level of ownership will you have in
your upcoming practice?
(n=43)
39.5% None, I will be an employee
58.1% None currently, but I may have
the option to become a partner in the
future
0.0% I will be a partner, but will not
have any capital invested in the practice
2.3% I will be an owner/partner (i.e. I
will have capital invested and own a
financial stake in the practice)
15. If you are planning to enter or have considered entering patient care/clinical practice, have
you actively searched for a job?
(n=76)
86.8% Yes
13.2% No, not yet (Go to Q. 33)
0.0% No, I will be self-employed
59
19. What is the ZIP code and county of the principal practice address at which you will be working
(if ZIP is unknown, please provide city/town and state)?
(n=51)
ZIP: ________
County: _____________
City: __________________ State: _____
(If non-U.S., specify country:___________)
20. Is your practice in a federally designated Health Professional Shortage Area?
2.3% Yes
51.2% No
(n=43)
46.5% Unknown
21. How long do you expect to be at your principal practice location?
(n=43)
6.5% Less than 2 years
18.6% 2-4 years
74.4% 4 years or more
22. Which best describes the demographics of the area in which you will be practicing?
(n=43)
18.6% Inner city
16.3% Other area within major city
39.5% Suburban
18.6% Small city (pop. below 25,000)
7.0% Rural
23. Expected gross income during first year of practice:
60
(n=42)
(n=21)
Base Salary
19.0%< $70,000
31.0% $70,000-$79,999
23.8% $80,000-$89,999
9.5% $90,000-$99,999
0.0% $100,000-$109,999
0.0% $110,000-$119,999
2.4% $120,000-$129,999
2.4% $130,000-$139,999
2.4% $140,000-$149,999
4.8% $150,000-$174,999
0.0% $175,000-$200,000
4.8% Over $200,000
Incentive Income
14.3% Zero
9.5% < $5,000
23.8% $5,000-$9,999
23.8% $10,000-$14,999
14.3% $15,000-$19,999
0.0% $20,000-$24,999
9.5% $25,000-$29,999
4.8% $30,000-$34,999
0.0% $35,000-$39,999
0.0% $40,000-$44,999
0.0% $45,000-$50,000
0.0% Over $50,000
24. How satisfied are you with your expected
gross income?
(n=43)
37.2% Very Satisfied
44.2% Somewhat Satisfied
18.6% Not Very Satisfied
0.0% Very Dissatisfied
25. How many total hours will you be working
per week, not including on-call hours?
(n=44)
0.0% Less than 20
6.8% 20 to 29
79.5% 30 to 39
13.6% 40 to 49
0.0% 50 to 59
0.0% 60 or more
26. What percentage of your time will be spent
on the following activities?
(n=38)
mean
Patient care – amb.
87.4%
Patient care – inp. hosp. 2.1%
Teaching
2.0%
Research
0.3%
Administration
0.7%
Other ____________ 0.0%
median
100.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Part 4. Job Search Experience
(Does not include temporary visa holders)
28. In which geographic areas have you focused
your search (check all that apply)?
(n=66)
6.1% All of Minnesota
40.9% Twin Cities metropolitan area
4.5% Northeastern Minnesota
3.0% Northwestern Minnesota
9.1% Central Minnesota
6.1% Southeastern Minnesota
4.5% Southwestern/South Central
Minnesota
13.6% Midwest region (ND, SD, WI,
IA, IL)
6.1% Eastern U.S.
10.6% Western U.S.
3.0% Southern U.S.
3.0% Outside of U.S.
29. How many offers for employment/practice
positions did you receive (excluding fellowships
and other training positions)?
(n=60)
6.7% -0
16.7% -1
35.0% -2
23.3% -3
3.3% -4
3.3% -5
6.7% -6 to 10
5.0% -over 10
0.0% -n/a
30. How much difficulty did you have/are you
having finding a practice position you are satisfied with?
(n=63)
49.2% no difficulty
46.0% some difficulty
4.8% severe difficulty
27. How long have you been actively searching
or did you search for a position?
(n=61)
26.2% Less than one month
23.0% 1-2 months
21.3% 3-4 months
14.8% 5-6 months
14.8% More than 6 months
0.0% Haven’t looked yet (Go to Q. 33)
61
30a. If you have had some difficulty or severe difficulty finding a satisfactory position, what
was the main reason? (mark only one)
(n=31)
0.0% Overall lack of jobs in your specialty
19.4% Lack of jobs in desired geographic location
19.4% Lack of jobs in desired practice setting (i.e. group practice, VA, etc)
6.5% Lack of jobs at desired level of ownership
22.6% Inadequate salary/compensation
6.5% Family/spouse considerations
0.0% Limited jobs due to visa status
25.8% Other ___________________________
31. Did you change your plans because of limited practice opportunities?
9.5% Yes
31a. If yes, how? (check all that apply)
(n=63)
90.5% No
(n=6)
66.7% Broadened search to new geographic area
16.7% Broadened search to new practice settings
0.0% Broadened search to include different levels of ownership
0.0% Changed salary expectations/requirements
0.0% Going on for additional training
16.7% Other ___________________________
32. How important were the following factors in your job search and in the selection of your
upcoming practice position?
Very Important
Salary/benefits (n=63)
55.6%
Ownership level (n=63)
44.4%
Practice setting (n=63)
73.0%
Family/spouse considerations (n=63)
58.7%
Demog. of surrounding area (n=63)
47.6%
Military, visa, or loan obligation (n=62) 12.9%
Geographic location (n=62)
62.9%
Opportunities for prof. growth (n=63)
71.4%
Partners in the practice (n=62)
58.1%
Other (n=6) _______________
66.7%
62
Somewhat Important
42.9%
31.7%
27.0%
28.6%
46.0%
17.7%
32.3%
27.0%
35.5%
33.3%
Not Important
1.6%
23.8%
0.0%
12.7%
6.3%
69.4%
4.8%
1.6%
6.5%
0.0%
33. What is your perception of opportunities for practice (for residents, opportunities in your specialty) within Minnesota?
(n=64)
40.6% Many Jobs
40.6% Some Jobs
4.7% Few Jobs
0.0% Very Few Jobs
0.0% No Jobs
3.1% Unknown
10.9% n/a – didn’t search in Minnesota
34. What is your perception of opportunities for practice (for residents, opportunities in your specialty) nationally?
(n=65)
55.4% Many Jobs
26.2% Some Jobs
4.6% Few Jobs
0.0% Very Few Jobs
0.0% No Jobs
6.2% Unknown
7.7% n/a – didn’t search nationally
63
64
Resident Physician
Exit Survey
Part 1. Identification Information
MN Medical License Number: _____________
First Name: _______________________ M.I. ___ Last Name:__________________________
Name of program you are completing: ______________________________________________
Part 2. Background/Education
1. Gender
61.5% M
(n=387)
38.5% F
2. Age
(n=387)
Median=32
3. Citizenship status: (n=387)
69.8% Native Born U.S.
9.3% Naturalized U.S.
5.7% Permanent Resident
0.8% H-1, H-2, H-3 Temporary
Worker
14.0% J-1, J-2 Exchange Visitor
0.5% Other
4. Race/Ethnicity
(n=384)
0.3% American Indian/Alaskan Native
16.7% Asian/Pacific Islander
1.0% Black/African American (nonHispanic)
4.9% Hispanic/Latino
(Spanish/Hispanic/Chicano/Latino)
1.0% Multiracial
75.3% White (non-Hispanic)
0.8% Other ______________
5. Where did you graduate from high school?
(n=387)
13.2% Greater Minnesota
11.6% Twin Cities metropolitan area
50.4% Other U.S. state
24.8% Other country
6. Where did you graduate from college (undergraduate degree)?
(n=386)
12.2% Greater Minnesota
8.8% Twin Cities metropolitan area
55.7% Other U.S. state
23.3% Other country
7. Where did you attend medical school? (If
you began medical school at UMD, indicate
University of MN - Duluth)
(n=385)
18.2% University of MN - Twin Cities
4.7% University of MN - Duluth
4.2% Mayo Clinic
48.1% Non-Minnesota U.S. medical
school
(Please specify state: _____)
24.9% Non-U.S. medical school
(Please specify country: _________)
8. What year did you complete medical school?
Median=1997
(n=363)
9. What is your current level of educational
debt (including both undergraduate and medical school loans)?
(n=383)
29.0% None
6.0% Less than $20,000
5.2% $20,000-$39,999
9.1% $40,000-$59,999
9.7% $60,000-$79,999
13.6% $80,000-$99,999
10.4% $100,000-$124,999
7.3% $125,000-$149,999
6.3% $150,000-$199,999
3.4% Over $200,000
10. Specialty
you are completing
in 2001 (Select only one)
(n=387)
1.0%
5.4%
0.0%
0.0%
0.0%
2.3%
3.1%
13.7%
14.2%
2.1%
1.3%
0.8%
1.3%
0.5%
2.1%
1.0%
0.8%
1.6%
0.5%
1.8%
1.0%
0.8%
3.6%
0.0%
2.3%
0.8%
1.3%
5.2%
0.8%
2.8%
0.5%
6.2%
0.5%
2.6%
0.5%
1.3%
0.5%
0.3%
4.4%
1.6%
0.0%
1.3%
0.8%
0.3%
0.5%
2.3%
0.8%
2.8%
66
11. If subspecializing/doing
additional fellowship,
Specialty you are entering next year (Select only one)
(n=92)
0.0%
0.0%
1.1%
3.3%
3.3%
1.1%
0.0%
0.0%
2.2%
3.3%
2.2%
4.3%
7.6%
2.2%
8.7%
2.2%
3.3%
1.1%
0.0%
1.1%
0.0%
0.0%
5.4%
0.0%
0.0%
3.3%
2.2%
3.3%
0.0%
1.1%
3.3%
0.0%
7.6%
4.3%
1.1%
0.0%
0.0%
2.2%
5.4%
0.0%
0.0%
0.0%
0.0%
0.0%
1.1%
4.3%
0.0%
8.7%
Allergy and immunology
Anesthesiology (general)
Anesthesiology (critical care medicine)
Anesthesiology (pain management)
Other anesthesiology subspecialty (specify) ____
Dermatology
Emergency Medicine
Family Practice
Internal Medicine (general)
Cardiology
Critical Care Medicine
Endocrinology and Metabolism
Gastroenterology
Geriatrics
Hematology/Oncology
Infectious Disease
Nephrology
Pulmonary Disease/CCM
Rheumatology
Other Internal Medicine subspecialty (specify) __
Internal Medicine and Pediatrics (Combined)
Neurological Surgery
Neurology
Nuclear Medicine
Obstetrics and Gynecology (General)
OB/GYN subspecialty - specify _____________
Ophthalmology
Orthopedic Surgery
Otolaryngology
Pathology (General)
Pathology subspecialty - specify ____________
Pediatrics (General)
Pediatrics subspecialty - specify _____________
Physical Medicine and Rehabilitation
Preventive Medicine/Public Health/Occupational Med.
Psychiatry
Child and Adolescent Psychiatry
Other Psychiatry Subspecialty (specify) _________
Radiology
Surgery (General)
Pediatric Surgery
Plastic/Reconstructive Surgery
Thoracic/Cardiovascular Surgery
Transplant Surgery
Vascular Surgery
Other Surgical Subspecialty (specify) ________
Urology
Other (specify) ____________________________
Part 3. Future Plans
12. What do you expect to be doing after completion of your current training program?
(n=387)
Primary Activity (mark only one)
44.7% Patient care/clinical practice private
20.4% Patient care/clinical practice academic
24.8% Additional training/fellowship
2.6% Chief Resident
0.0% Teaching
1.8% Research
0.0% Working in another field
1.0% Other ____________________
4.7% Undecided/Don’t know yet
13. Where is the location of your primary activity after your current training?
(n=385)
48.6% Within Minnesota
39.5% Other U.S. state
6.2% Outside of U.S.
5.7% Don’t know yet
14. If you are leaving the state to continue your
training, do you plan to return to Minnesota to
practice when your training is complete?
(n=195)
5.1% Yes
30.8% No
21.0% Don’t know yet
43.1% Does not apply
15. If you are planning to enter or have considered entering patient care/clinical practice, have
you actively searched for a job?
(n=253)
95.3% Yes
4.3% No, not yet (Go to Q. 34)
0.4% No, I will be self-employed
* If you have not considered entering clinical
practice, stop here and return your completed
survey.
16. Have you accepted a practice position?
(n=242)
92.1% Yes
7.9% No (Go to Q. 28)
17. Which best describes the type of patient
care practice you will be entering?
(n=192)
30.2% hospital - inpatient
16.1% hospital-based ambulatory care
2.1% Community (non-hospital based)
health center, clinic or other outpatient
facility without hospital privileges
42.7% Community (non-hospital based)
health center, clinic or other outpatient
facility with hospital privileges
0.0% Long-term care facility
8.9% Other: _____________________
18. What level of ownership will you have in
your upcoming practice?
(n=192)
53.1% None, I will be an employee
30.7% None currently, but I may have
the option to become a partner/owner in
the future
7.8% I will be a partner, but will not
have any capital invested in the practice
8.3% I will be an owner/partner (i.e. I
will have capital invested and own a
financial stake in the practice)
19. Which best describes the type of employer
for whom you will be working?
(n=192)
14.1% Self-employed (solo practice or
owner/partner in independent grp. practice)
38.5% Group practice
31.3% Hospital or clinic
5.7% Managed care organization
7.3% Military or government organization
3.1% Other __________________
67
20. What is the ZIP code and county of the principal practice address at which you will be working (if
ZIP is unknown, please provide city/town and state)?
24. Expected gross income during first year of practice:
(n=190)
ZIP: ________ County: ______________
Base Salary/Income
4.2% < $70,000
2.6% $70,000-$79,999
3.2% $80,000-$89,999
2.1% $90,000-$99,999
8.4% $100,000-$109,999
12.1% $110,000-$119,999
15.8% $120,000-$129,999
6.3% $130,000-$139,999
6.3% $140,000-$149,999
11.1% $150,000-$174,999
10.5% $175,000-$200,000
8.9% $200,000-$224,999
8.4% Over $225,000
City: __________________ State: _____
(If non-U.S., specify country:___________)
21. Is your practice in a federally designated Health
Professional Shortage Area? (n=194)
5.7% Yes
76.8% No
17.5% Unknown
22. How long do you expect to be at your principal
practice location?
(n=194)
3.6% Less than 2 years
18.0% 2-4 years
78.4% 4 years or more
23. Which best describes the demographics of the
area in which you will be practicing?
(n=194)
17.0% Inner city
26.3% Other area within major city
39.7% Suburban
8.2% Small city (population below 25,000)
8.8% Rural
68
Additional
Incentive Income
53.5% Zero
6.1% < $5,000
10.1% $5,000-$9,999
7.1% $10,000-$14,999
7.1% $15,000-$19,999
7.1% $20,000-$24,999
8.1% $25,000-$29,999
1.0% $30,000-$34,999
0.0% $35,000-$39,999
0.0% $40,000-$44,999
0.0% $45,000-$50,000
0.0% > $50,000
25. How satisfied are you with your expected gross
income?
(n=193)
52.3% Very Satisfied
42.0% Somewhat Satisfied
4.7% Not Very Satisfied
1.0% Very Dissatisfied
26. How many total hours will you be working per
week, not including on-call hours?
(n=192)
0.5% Less than 20
4.7% 20 to 29
23.4% 30 to 39
31.8% 40 to 49
26.6% 50 to 59
13.0% 60 or more
27. What percentage of your time will be spent on the following activities?
Patient care - ambulatory
Patient care - inpatient
Patient care - long term care
Rounds
Teaching
Research
Administration
Other _________________
mean
58.6%
25.1%
1.0%
2.6%
3.5%
5.4%
1.6%
2.0%
(n=188)
median
70.0%
15.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Part 4. Job Search Experience
28. How long have you been actively searching or did you search for a position?
(n=213)
20.5% Less than one month
16.7% 1-2 months
27.6% 3-4 months
17.1% 5-6 months
18.1% More than 6 months
1.4% Haven’t looked yet (Go to Q. 34)
29. In which geographic areas have you focused your search (check all that apply)?
(n=212)
8.0% All of Minnesota
39.2% Twin Cities metropolitan area
6.1% Northeastern Minnesota
3.3% Northwestern Minnesota
6.1% Central Minnesota
11.8% Southeastern Minnesota
3.8% Southwestern/South Central Minnesota
28.3% Midwest region (ND, SD, WI, IA, IL)
20.3% Eastern U.S.
21.2% Western U.S.
12.3% Southern U.S.
0.9% Outside of U.S.
30. How many offers for employment/practice positions did you receive (excluding fellowships,
chief residency and other training positions)?
(n=211)
0.9% -0
16.1% -1
22.3% -2
26.1% -3
11.4% -4
5.2% -5
9.5% -6 to 10
4.7% -over 10
3.8% -n/a
69
31. How much difficulty did you have/are you having finding a practice position you are satisfied
with?
(n=211)
73.0% No difficulty
24.6 % Some difficulty
2.4% Severe difficulty
31a. If you have had some difficulty or severe difficulty finding a satisfactory position, what
was the main reason? (mark only one)
(n=57)
3.5% Overall lack of jobs in your specialty
45.6% Lack of jobs in desired geographic location
12.3% Lack of jobs in desired practice setting (i.e. hospital, LTC, etc)
1.8% Lack of jobs at desired level of ownership
5.3% Inadequate salary/compensation
10.5% Family/spouse considerations
0.0% Limited opportunities due to visa status
21.1% Other ___________________________
32. Did you change your plans because of limited practice opportunities?
10.2% Yes
(n=205)
89.8% No
32a. If yes, how? (check all that apply)
(n=21)
76.2% Broadened search to new geographic area
28.6% Broadened search to new practice settings
9.5% Broadened search to include different levels of ownership
14.3% Changed salary expectations/requirements
0.0% Going on for additional training
4.8% Other ___________________________
33. How important were the following factors in your job search and in the selection of your
upcoming practice position?
Very Important
Salary/benefits (n=208)
50.0%
Ownership level (n=204)
25.0%
Practice setting (n=208)
83.2%
Family/spouse considerations (n=205)
83.9%
Demog. of surrounding area (n=205)
52.7%
Military, visa, or loan obligation (n=200) 3.0%
Geographic location (n=206)
71.4%
Partners in the practice (n=204)
61.3%
Partnership buy-in costs (n=196)
10.2%
Opportunities for prof. growth (n=208) 56.3%
Waiting period for partnership (n=200) 10.5%
Other (n=19) ____________
84.2%
70
Somewhat Important
48.1%
40.7%
15.9%
9.8%
42.4%
11.0%
25.7%
34.8%
35.2%
41.3%
35.5%
0.0%
Not Important
1.9%
34.3%
1.0%
6.3%
4.9%
86.0%
2.9%
3.9%
54.6%
2.4%
54.0%
15.8%
34. What is your perception of opportunities for practice in your specialty within Minnesota?
(n=215)
40.9% Many Jobs
35.8% Some Jobs
6.0% Few Jobs
3.3% Very Few Jobs
0.0% No Jobs
4.7% Unknown
9.3% n/a - didn’t search in Minnesota
35. What is your perception of opportunities for practice in your specialty nationally?
(n=211)
63.5% Many Jobs
20.9% Some Jobs
0.9% Few Jobs
0.9% Very Few Jobs
0.0% No Jobs
3.3% Unknown
10.4% n/a - didn’t search nationally
71
72
Physician Assistant
Exit Survey
Part 1. Identification Information
First Name: _______________________ M.I. ___ Last Name:__________________________
Part 2. Background/Education
1. Gender
23.1% M
(n=26)
76.9% F
2. Age
(n=26)
median=27
3. Citizenship status:
30.8% Greater Minnesota
42.3% Twin Cities metropolitan area
26.9% Other U.S. state
0.0% Other country
(n=26)
88.5% Native Born U.S.
3.8% Naturalized U.S.
7.7% Permanent Resident
0.0% H-1, H-2, H-3 Temp. Worker
0.0% J-1, J-2 Exchange Visitor
0.0% Other
4. Race/Ethnicity
6. Where did you graduate from college (undergraduate degree)?
(n=26)
7. What is your current level of educational
debt (including both undergraduate and P.A.
school loans)?
(n=25)
0.0% None
28.0% $60,000-$79,999
0.0% < $20,000
32.0% $80,000-$99,999
8.0% $20,000-$39,999 20.0% Over $100,000
12.0% $40,000-$59,999
(n=26)
0.0% American Indian/Alaskan Native
3.8% Asian/Pacific Islander
0.0% Black/African American (nonHisp.)
3.8% Hispanic
(Spanish/Hispanic/Chicano/Latino)
3.8% Multiracial
84.6% White (non-Hispanic)
3.8% Other ______________
5. Where did you graduate from high school?
(n=26)
46.2% Greater Minnesota
30.8% Twin Cities metropolitan area
23.1% Other U.S. state
0.0% Other country
Part 3. Future Plans
8. What do you expect to be doing after completion of your current training program?
(n=26)
Primary Activity (mark only one)
100% Patient care/clinical practice as
P.A.
0.0% Patient care/clinical practice as
another health care provider
0.0% Additional training as a P.A.
0.0% Teaching
0.0% Research
0.0% Working in another field
0.0% Other ____________________
0.0% Undecided/Don’t know yet
73
9. Where is the location of your primary activity after your current training?
(n=26)
80.8% Within Minnesota
11.5% Other U.S. state
0.0% Outside of U.S.
7.7% Don’t know yet
10. If you are leaving the state to continue your
training, do you plan to return to Minnesota to
practice when your training is complete?
(n=5)
40.0% Yes
40.0% No
0.0% Don’t know yet
20.0% Does not apply
11. If you are planning to enter or have considered entering patient care/clinical practice, have
you actively searched for a job as a P.A.?
(n=26)
96.2% Yes
3.8% No, not yet (Go to Q. 30)
* If you have not considered entering clinical
practice as a P.A., stop here and return your
completed survey.
12. Have you accepted a practice position as a
physician assistant?
(n=25)
52.0%Yes
74
48.0% No (Go to Q. 24)
13. Which best describes the type of patient
care practice you will be entering?
(n=12)
41.7% hospital - inpatient
25.0% hospital-based ambulatory care
16.7% Community (non-hospital based)
health center, clinic or other outpatient
facility without hospital privileges
8.3% Community (non-hospital based)
health center, clinic or other outpatient
facility with hospital privileges
0.0% Long-term care facility
0.0% Other: _____________________
14. What is the principal specialty of your
supervising physician at your principal practice?
(n=12)
8.3% Emergency Medicine
25.0% General/Family Practice
8.3% Internal Medicine - General
0.0% Internal Medicine - Geriatric
Medicine
0.0% Internal Medicine - Oncology
0.0% Internal Medicine - Other
0.0% Pediatrics - General
0.0% Pediatric Subspecialty
8.3% Surgery - General
33.3% Surgery Subspecialty
0.0% Obstetrics/Gynecology
0.0% Occupational Medicine
0.0% Psychiatry
0.0% Multiple Specialties
16.7% Other (specify _____________)
15. What level of ownership will you have in
your upcoming practice?
(n=12)
91.7% None, I will be an employee
8.3% None currently, but I may have
the option to become a partner in the
future
0.0% I will be a partner, but will not
have any capital invested in the practice
0.0% I will be an owner/partner (i.e. I
will have capital invested and own a
financial stake in the practice)
16. What is the ZIP code and county of the
principal practice address at which you will be
working (if ZIP is unknown, please provide
city/town and state)?
ZIP: ________
County: ____________
City: __________________ State: _____
(If non-U.S., specify country:___________)
17. Is your practice in a federally designated
Health Professional Shortage Area?
(n=12)
0.0% Yes
58.3% No
41.7% Unknown
18. How long do you expect to be at your principal practice location?
(n=12)
16.7% Less than 2 years
8.3% 2-4 years
75.0% 4 years or more
19. Which best describes the demographics of
the area in which you will be practicing?
(n=12)
16.7% Inner city
33.3% Other area within major city
33.3% Suburban
16.7% Small city (population below
25,000)
0.0% Rural
20. Expected gross income during first year of
practice:
(n=12)
Base Salary
0.0% Less than $40,000
0.0% $40,000-$44,999
8.3% $45,000-$49,999
0.0% $50,000-$54,999
25.0% $55,000-$59,999
41.7% $60,000-$64,999
0.0% $65,000-$69,999
25.0% $70,000-$74,999
0.0% $75,000-$79,999
0.0% $80,000-$84,999
0.0% $85,000-$89,999
0.0% Over $90,000
21. How satisfied are you with your expected
gross income? (n=12)
58.3% Very Satisfied
25.0% Somewhat Satisfied
16.7% Not Very Satisfied
0.0% Very Dissatisfied
75
22. How many total hours will you be working
per week, not including on-call hours?
(n=12)
0.0% Less than 20
0.0% 20 to 29
16.7% 30 to 39
58.3% 40 to 49
25.0% 50 to 59
0.0% 60 or more
23. What percentage of your time will be spent
on the following activities?
(n=11)
mean
Patient care - ambulatory
61.8%
Patient care - inpatient
26.8%
Patient care - ltc
0.0%
Teaching
0.0%
Research
0.0%
Administration
0.0%
Other _________________ 10.5%
median
50.0%
25.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Part 4. Job Search Experience
24. How long have you been actively searching
or did you search for a P.A. position?
(n=24)
16.7% Less than one month
33.3% 1-2 months
41.7% 3-4 months
0.0% 5-6 months
8.3% More than 6 months
0.0% Haven’t looked yet (Go to Q. 30)
76
25. In which geographic areas have you focused
your search (check all that apply)?
(n=25)
8.0% All of Minnesota
68.0% Twin Cities metropolitan area
6.1% Northeastern Minnesota
12.0% Northwestern Minnesota
28.0% Central Minnesota
12.0% Southeastern Minnesota
8.0% SW/South Central Minnesota
16.0% Midwest region (ND, SD, WI,
IA, IL)
0.0% Eastern U.S.
12.0% Western U.S.
4.0% Southern U.S.
0.0% Outside of U.S.
26. How many offers for employment/practice
positions did you receive (excluding fellowships
and other training positions)?
(n=24)
33.3% -0
33.3% -1
20.8% -2
8.3% -3
4.2% -4
0.0% -5
0.0%- 6 to 10
0.0% - > 10
0.0% - n/a
27. How much difficulty did you have/are you
having finding a P.A. practice position you are
satisfied with?
(n=24)
29.2% No difficulty
66.7% Some difficulty
4.2% Severe difficulty
27a. If you have had some difficulty or severe difficulty finding a satisfactory P.A. position,
what was the main reason? (mark only one)
(n=17)
29.4% Overall lack of jobs for P.A.’s
35.3% Lack of opportunities for P.A.’s with little or no experience
17.6% Lack of P.A. jobs in desired geographic location
5.9% Lack of P.A. jobs in desired practice setting (i.e. hospital, clinic, LTC, etc)
0.0% Lack of jobs at desired level of ownership
0.0% Inadequate salary/compensation
0.0% Family/spouse considerations
0.0 % Limited P.A. jobs due to visa status
11.8% Other (specify): _______________________
28. Did you change your plans because of limited P.A. practice opportunities?
25.0% Yes
(n=24)
75.0% No
28a. If yes, how? (check all that apply)
(n=6)
50.0% Broadened search to new geographic area
66.7% Broadened search to new practice settings
0.0% Broadened search to include different levels of ownership
0.0% Changed salary expectations/requirements
0.0% Going on for additional training
0.0% Other ___________________________
29. How important were the following factors in your job search and in the selection of your
upcoming practice position?
Very Important
Salary/benefits (n=24)
54.2%
Ownership level (n=24)
4.2%
Practice setting (n=24)
91.7%
Family/spouse considerations (n=24)
58.3%
Demographics of area (n=24)
66.7%
Military, visa, or loan obligation (n=24) 0.0%
Geographic location (n=24)
87.5%
Coworkers in the practice (n=24)
66.7%
Somewhat Important
45.8%
16.7%
8.3%
29.2%
33.3%
25.0%
12.5%
29.2%
Not Important
0.0%
79.2%
0.0%
12.5%
0.0%
75.0%
0.0%
4.2%
77
30. What is your perception of P.A. practice opportunities within Minnesota?
0.0% Many Jobs
44.0% Some Jobs
40.0% Few Jobs
12.0% Very Few Jobs
0.0% No Jobs
0.0% Unknown
4.0% n/a - didn’t search in Minnesota
31. What is your perception of P.A. practice opportunities nationally?
36.0% Many Jobs
48.0% Some Jobs
0.0% Few Jobs
0.0% Very Few Jobs
0.0% No Jobs
78
(n=25)
8.0% Unknown
8.0% n/a - didn’t search nationally
(n=25)
Pharm D
Graduate/Resident
Exit Survey
Part 1. Identification Information
MN Pharmacy License Number (if available): _____________
First Name: ___________________ M.I. __________ Last Name: ____________________
Name of program you are completing: ______________________________________________
Part 2. Background/Education
1. Gender
27.2% M
(n=103)
2. Age
median=26
3. Citizenship status:
72.8% F
(n=103)
35.0% Greater Minnesota
28.2% Twin Cities metropolitan area
30.1% Other U.S. state
6.8% Other country
(n=103)
82.5% Native Born U.S.
12.6% Naturalized U.S.
2.9% Permanent Resident
0.0% H-1, H-2, H-3 Temporary
Worker
0.0% J-1, J-2 Exchange visitor
1.9% Other
4. Race/Ethnicity
5. Where did you graduate from high school?
(n=103)
(n=102)
0.0% American Indian/Alaskan Native
15.7% Asian/Pacific Islander
2.0% Black/African American (nonHispanic)
1.0% Hispanic
(Spanish/Hispanic/Chicano/Latino)
0.0% Multiracial
81.4% White (non-Hispanic)
0.0% Other ______________
6. Where did you graduate from college
(undergraduate degree)?
(n=84)
20.2% Greater Minnesota
51.2% Twin Cities metropolitan area
26.2 % Other U.S. state
2.4% Other country
7. Where did you attend, or are you attending,
pharmacy school?
(n=103)
95.1% University of MN
4.9% Non-Minnesota U.S. pharmacy
school
(Please specify state: _____)
0.0% Non-U.S. pharmacy school
(Please specify country: __________)
79
8. What year did you complete, or will you complete, pharmacy school?
(n=102)
Median=2002
9. What is your current level of educational debt (including both undergraduate and pharmacy
school loans)?
(n=103)
2.9% None
1.9% Less than $20,000
13.6% $20,000-$39,999
19.4% $40,000-$59,999
12.6% $60,000-$79,999
31.1% $80,000-$99,999
14.6% $100,000-$124,999
3.9% $125,000-$149,999
0.0% Over $150,000
10. What type of training program are you completing in 2001?
(n=103)
87.4% Entry-level Pharm. D. program
12.6% Post-Pharm. D. residency or fellowship program
11. Residents only: Please indicate the specialty you are completing in 2001.
General Pharmacy Practice Residency
0.0% Community
16.7% Institutional
0.0% Managed Care
41.7% Other (please specify)________________________________
Specialty Residency
0.0% Cardiology
16.7% Critical Care
0.0% Drug Information
0.0% Geriatric
0.0% Infectious Disease
0.0% Internal Medicine
0.0% Managed Care
0.0% Neurology
16.7% Nephrology
0.0% Nutritional Support
0.0% Oncology
8.3% Pediatric
0.0% Primary Care
0.0% Psychiatry
0.0% Other (please specify)________________________________
80
(n=12)
Part 3. Future Plans
NOTE: For the purposes of this survey,
“patient care/clinical practice” refers to pharmacy practice in hospital, hospital-based
ambulatory care, community clinic or other
outpatient facility, or community retail pharmacy settings.
12. What do you expect to be doing after completion of your current training program?
(n=103)
Primary Activity (mark only one)
70.9% Patient care/clinical practice
17.5% Additional pharmacy training or
fellowship
1.9% Graduate School
1.9% Administrative pharmacy position
(i.e. industry or managed care position)
0.0% Teaching
0.0% Research
3.0% Working in another field
2.9% Other
4.9% Undecided
13. Where is the location of your primary activity after your current training?
(n=103)
75.7% Within Minnesota
19.4% Other U.S. state
0.0% Outside of U.S.
4.9% Don’t know yet
14. If you are leaving the state to continue your
training, do you plan to return to MN to practice when your training is complete?
(n=24)
16.7% Yes
16.7% No
14a. If you are leaving the state to continue your training, would the availability of an appropriate residency program
in Minnesota have made you more likely to stay in the state?
(n=24)
25.0% Yes
25.0% No
50.0 % Don’t know yet
0.0% Does not apply
14b. If you answered “Yes” to question
14a, What type of program(s) would
you be interested in seeing added or
expanded in Minnesota? (Check all that
apply)
(n=6)
0.0% Community
0.0% Institutional
0.0% Managed Care
100.0% Other (specify)_____________
0.0% Does not apply
15. If you are planning to enter or have considered entering patient care/clinical practice, have
you actively searched for a job?
(n=70)
85.7% Yes
14.3% No, not yet (Go to Q. 34)
0.0% No, I will be self-employed
* If you have not considered entering clinical
practice, stop here and return your completed
survey.
16. Have you accepted a practice position?
(n=60)
80.0% Yes
20.0% No (Go to Q. 27)
29.2 % Don’t know yet
37.5% Does not apply
81
17. Which best describes the type of patient
care practice you will be entering?
(n=47)
31.9% hospital - inpatient
4.3% hospital-based ambulatory care
14.9% Community (non-hospital based)
health center, clinic or other outpatient
facility
46.8% Community or retail pharmacy
2.1% Other: _____________________
18. What level of ownership will you have in
your upcoming practice?
(n=46)
95.7% None, I will be an employee
4.3% None currently, but I may have
the option to become a partner/owner in
the future
0.0% I will be a partner, but will not
have any capital invested in the practice
0.0% I will be an owner/partner (i.e. I
will have capital invested and own a
financial stake in the practice).
19. What is the ZIP code and county of the
principal practice address at which you will be
working (if ZIP is unknown, please provide
city/town and state)?
ZIP: ________ County: ______________
City: __________________ State: _____
(If non-U.S., specify country:___________)
20. Is your practice in a federally designated
Health Professional Shortage Area?
(n=47)
8.5% Yes
38.3% No
53.2% Unknown
21. How long do you expect to be at your principal practice location?
(n=44)
11.4% Less than 2 years
29.5% 2-4 years
59.1% 4 years or more
82
22. Which best describes the demographics of
the area in which you will be practicing?
(n=47)
31.9% Inner city
12.8% Other area within major city
40.4% Suburban
8.5% Small city (population below
25,000)
6.4% Rural
23. Expected Gross Income during first year of
practice:
(n=43)
(n=22)
Base Salary
Incentive Income
4.7% Less than $70,000 34.6% Zero
25.6% $70,000-$79,999 7.7% <$5,000
60.5% $80,000-$89,999 50.0% $5,000-$9,999
9.3% $90,000-$99,999
3.8% $10,000-$14,999
26.9% $100,000-$109,9990.0% $15,000-$19,999
0.0% $110,000-$119,999 0.0% $20,000-24,999
0.0% $120,000-$129,999 0.0% $25,000-29,999
0.0% $130,000-$139,999 3.8% $30,000-34,999
0.0% $140,000-$149,999 0.0% $35,000-39,999
0.0% $150,000-$174,999 0.0% $40,000-44,999
0.0% $175,000-$200,000 0.0% $45,000-50,000
0.0% Over $200,000
0.0% Over $50,000
24. How satisfied are you with your expected
gross income?
(n=47)
68.1% Very Satisfied
29.8% Somewhat Satisfied
2.1% Not Very Satisfied
0.0% Very Dissatisfied
25. How many total hours will you be working
per week, not including on-call hours?
(n=48)
0.0% Less than 20
0.0% 20 to 29
12.8% 30 to 39
87.2% 40 to 49
0.0% 50 to 59
0.0% 60 or more
26. What percentage of your time will be spent
on the following activities? (n=42)
Dispensing Prescriptions
Consulting
Patient care – ambulatory
Patient care - inpatient
Teaching
Research
Drug use management
Admin./business mgmt
Other _______________
mean
40.8%
15.4%
5.0%
25.2%
3.1%
1.1%
1.1%
2.3%
0.4%
median
50.0%
7.5%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
Part 4. Job Search Experience
(does not include temporary visa holders)
27. How long have you been actively searching
or did you search for a position?
(n=59)
54.2% Less than one month
23.7% 1-2 months
15.3% 3-4 months
5.1% 5-6 months
1.7% More than 6 months
0.0% Haven’t looked yet (Go to Q. 34)
28. How many positions have you applied for?
(n=58)
6.9% -0
32.8% -1
12.1% -2
20.7% -3
8.6% -4
3.4% -5
5.2% -6 to 10
5.2% -over 10
5.2% -n/a
29. In which geographic areas have you focused
your search (check all that apply)?
(n=60)
3.3% All of Minnesota
61.7% Twin Cities metropolitan area
6.7% Northeastern Minnesota
5.0% Northwestern Minnesota
15.0% Central Minnesota
0.0% Southeastern Minnesota
3.3% Southwestern/South Central
Minnesota
6.7 % Midwest region (ND, SD, WI,
IA, IL)
6.7 % Eastern U.S.
8.3% Western U.S.
3.3% Southern U.S.
0.0% Outside of U.S.
30. How many offers for employment/practice
positions did you receive (excluding fellowships
and other training positions)?
(n=58)
3.4% -0
20.7% -1
27.6% -2
22.4% -3
10.3% -4
3.4% -5
5.2% -6 to 10
3.4% -over 10
3.4% -n/a
31. How much difficulty did you have/are you
having finding a practice position you are satisfied with?
(n=58)
70.7% No difficulty
24.1% Some difficulty
5.2% Severe difficulty
83
31a. If you had some or severe difficulty finding a satisfactory position, what was the main
reason? (mark only one)
(n=16)
12.5% Overall lack of jobs (residents - lack of jobs in your specialty)
12.5% Lack of jobs in desired geographic location
37.5% Lack of jobs in desired practice setting (i.e. hospital, HMO, etc)
0.0% Lack of jobs at desired level of ownership
0.0% Inadequate salary/compensation
0.0% Family/spouse considerations
0.0% Limited jobs due to visa status
37.5% Other ___________________________
32. Did you change your plans because of limited practice opportunities?
10.3% Yes
32a.
(n=58)
89.7% No
If yes, how? (check all that apply)
(n=6)
16.7% Broadened search to new geographic area
83.3% Broadened search to new settings
0.0% Broadened search to include different levels of ownership
16.7% Changed salary expectations/requirements
0.0% Going on for additional training
0.0% Other ___________________________
33. How important were the following factors in your job search and in the selection of your
upcoming practice position?
Very Important
Salary/benefits (n=57)
63.2%
Ownership level (n=56)
5.4%
Practice setting (n=57)
82.5%
Coworkers in the practice (n=56)
55.4%
Direct patient care opportunities (n=55) 78.2%
Opportunities for prof. growth (n=56)
83.9%
Family/spouse considerations (n=56)
50.0%
Demographics of area (n=57)
47.4%
Military, visa, or loan obligation (n=54) 5.6%
Geographic location (n=55)
65.5%
84
Somewhat Important
31.6%
10.7%
17.5%
42.9%
18.2%
14.3%
30.4%
40.4%
24.1%
29.1%
Not Important
5.3%
83.9%
0.0%
1.8%
3.6%
1.8%
19.6%
12.3%
70.4%
5.5%
34. What is your perception of opportunities for practice (for residents, opportunities in your specialty) within Minnesota?
(n=58)
60.3% Many Jobs
22.4% Some Jobs
6.9% Few Jobs
8.6% Very Few Jobs
0.0% No Jobs
0.0% Unknown
1.7% n/a – didn’t search in Minnesota
35. What is your perception of opportunities for practice (for residents, opportunities in your specialty) nationally?
(n=58)
63.8% Many Jobs
24.1% Some Jobs
3.4% Few Jobs
1.7% Very Few Jobs
0.0% No Jobs
1.7% Unknown
5.2% n/a – didn’t search nationally
85
86
#
Endnotes
1
Minnesota Department of Health, Health Economics Program, "Medical Education and Research
Costs (MERC): a Final Report to the Legislature," 1996.
2
WWAMI Research Center, University of Washington, "Physician Education and Rural Location:
A Critical Review," February 1999.
3
Minnesota Department of Health, Office of Rural Health and Primary Care, "Minnesota Dentist
Workforce Profile," 2002.
4
Kington, Raynard, Diana Tisnado, and David Carlisle, "Increasing racial and ethnic diversity
among physicians: an intervention to address health disparities?" In The Right Thing To Do, The
Smart Thing To Do: Enhancing Diversity in the Health Professions. Summary of the Symposium
on Diversity in the Health Professions in Honor of Herbert W. Nickens, MD, National Academy
Press, 2001.
5
Minnesota Department of Health, Office of Rural Health and Primary Care, "Minnesota
Pharmacist Workforce Profile," 2002.
6
Minnesota Department of Health, Office of Rural Health and Primary Care, “Workforce
Demographics for Minnesota Dentists,” 2003.
7
Minnesota Department of Health, Office of Rural Health and Primary Care, 2003.
87
8
Minnesota Department of Health, Office of Rural Health and Primary Care, 2003.
9
American Academy of Physician Assistants, 2002 Survey of New Enrollees in Physician Assistant
Programs.
10
An exchange visitor or "J" visa allows the holder to remain in the country so long as he or she is
participating in an educational exchange program. Holders of "J" visas must return to their home
country for at least two years upon completion of training unless they receive a waiver to practice in
an underserved area. An "H" temporary worker visa allows the holder to work in the U.S. for up
to six years.
11
Minnesota Department of Health, Office of Rural Health and Primary Care, estimate based on
data from Minnesota Board of Pharmacy, 2002.
12
American Academy of Physician Assistants, 2002 Physician Assistant Census.
13
American Academy of Physician Assistants, 2002 Physician Assistant Census.
14
Minnesota Department of Economic Security, Research and Statistics Office, Occupational
Employment and Wage Statistics, 2001.
15
Minnesota Department of Economic Security, Research and Statistics Office, "1998-2008
Occupational Employment Projections."
If you require this document in another format, such as large print, Braille or cassette
tape, call (651) 282-6314
To obtain additional copies:
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Minnesota Department of Health
PO Box 64075
St. Paul, Minnesota 55164-0975
Phone: 651-282-6314
TDD: 1-800-627-3529