1. Preliminary report Phoonyathorn Phatthanathitikarn, MD Prawit Kittidumrongsuk, MD Chulalongkorn hospital

2. Introduction  There has been much focus on factors influencing residents’ final subspecialty choice in aboard  sufficient future workforce  a cultural shift in values and priorities.  Once in a Thailand residency  little data on factors influencing residents’ final subspecialty choice.

3. Method  A cross-sectional survey was developed and content validated  The questionnaire was distributed  The study group included 2 nd, 3 rd and 4 th year orthopedic resident is four institutions

4. Questionnaire

8. Demographic Characteristics of Respondents n% SexMale 59 90. 77 Female 6 9.2 3 MaritalSingle 55 84. 62 Married 10 15. 38 AddressBKK and suburb 22 33. 85 Other parts in Thailand 43 66. 15 ScholarshipGovernment scholarship 41 63. 08 Free training 24 36. 92 Resident Year2 nd 21 32. 31 3 rd 23 35. 38 4 th 21 32. 31  N = 112, Response 65 residents (58%)

9. Subspecialty selected by respondents SpecialtyN% No train/ unsure37 56.90 % Arthroplasty7 10.80 % Spine7 10.80 % Undecide57.70% Sport46.20% Hand23.10% Trauma11.50% Other11.50% No response11.50% Ped00.00% Tumor00.00%

10. Year of training

11.  Mean ค่าเฉลี่ย 4.21-5.00 = สำคัญมากที่สุด Most important  Mean ค่าเฉลี่ย 3.41-4.20 = สำคัญมาก Very important  Mean ค่าเฉลี่ย 2.61-3.40 = สำคัญปานกลาง Moderate important  Mean ค่าเฉลี่ย 1.81-2.60 = สำคัญน้อย Little important  Mean ค่าเฉลี่ย 1.00-1.80 = ไม่สำคัญ No important

12. Procedure & Technical

13. Income & Pride

14. Mentor

15. Result Operation & Patient characteristic and Expectation

16. Work & Training Place

17. Life schedule control

18. Research & Teaching opportunity

20. The training place  92.3% expect the same institution for subspecialty training

21. The type of workplace Work place type % Government hospital 50.8 Anywhere 33.3 Medical school 14.3 Private hospital 1.6

22. The income Income (bath/month) n% <100k 6 9.37 5 100-150k 28 43.7 5 150-200k 12 18.7 5 200-300k 8 12.5 >300k 10 15.6 25

24. Discussion  Arthroplasty and spine are the most popular subspecialties.  The lowest popular specialties are pediatric and tumor.  Procedure & Technic group is the first concern as other researches.  Mentor factor concern are morality, characteristic and reputation not income.  Result of operation is also very important

25. Discussion  In our research is different from others research about Work Place concern that relatively very important.  Life style control is not affected the decision for choosing subspecialtly  but very important for arthroplasty  about Hobby time topic is very important for No training /uncertain group  Income topic is just moderate important in all groups.

27. Conclusion  The majority of residents has no plan for subspecialize training.  Multiple factors influencing subspecialty training similar to other research are Procedure&Technical and Mentor factor.  Result of the operation is very important differ from other researches

28. Very important factor

29. Conclusion  Life style control is not so important

30. Relative to low important factor

31. Thank you