Characteristics of junior residents within an established emergency medicine rotation choosing aesthetic medicine as the initial specialty without completing a full specialty residency training program

Background In Japan, most physicians complete a two-year postgraduate clinical training program and pursue board certification in a specialty. However, a growing number of junior residents are bypassing traditional residency pathways to enter aesthetic medicine. This study investigated the characteristics of these junior residents. Methods This retrospective, longitudinal, observational study assessed postgraduate year 1 (PGY1) residents during emergency medicine (EM) rotations at a university hospital from 2019 to 2023. An attending EM physician used a three-item survey (Clinical Attitude, Knowledge and Skills, Positive Participation) to evaluate 222 PGY1 residents. Data were collected on demographics, academic history, club activities, and parental occupation. Logistic regression analysis was used to identify factors associated with choosing aesthetic medicine as an initial specialty without completing the full residency. Results Four junior residents chose aesthetic medicine as the initial specialty. These individuals demonstrated significantly lower scores on the three-item survey compared to those entering traditional residencies. A history of academic difficulty (repeating at least one year of medical school) was also significantly associated with choosing aesthetic medicine. Multivariate analysis identified low scores on the three-item survey, history of academic difficulty, and graduating from public universities as factors significantly associated with choosing aesthetic medicine. Conclusion This study suggests that junior residents choosing aesthetic medicine as the initial specialty without completing a full residency may exhibit lower clinical performance during the EM rotation and have a history of academic difficulty. This information may be important for medical education and workforce planning.