HOME | LOG IN | SIGN UP

Open Access Open Access  Restricted Access Subscription Access

Addressing the Need for Primary Care Physicians: Factors Associated with Medical Student Residency Choice

Joy H Lewis, Lise McCoy, R. Curtis Bay

Abstract


ABSTRACTContext

            With projected shortages of primary care physicians and specific specialists, the needs of society are clear; however, factors influencing medical student residency choice and career goals are not well defined or understood.

Objectives

            This study analyzed residency and specialty preferences for two cohorts of fourth year osteopathic medical students (OMSIV) to determine the percentage of students selecting a primary care specialty or a needed specialty. It further investigated determinants of residency choices and residency program matches in order to better structure undergraduate medical education programs.  

Design

            A survey-based observational cohort study. 

Setting

            A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU SOMA), from March 2011 through August 2013.

Participants

            Participants were 175 graduating OMSIV students from the school’s inaugural and second cohorts, the classes of 2011 and 2012.

Measurements

            Measures included a 52-item graduation exit questionnaire. Exit survey data were merged with academic and admissions records to investigate factors bearing on residency match outcomes.

Results          

            The combined exit survey response rate was 95%. A majority (78.3%) of survey respondents matched with a primary care (58.3%) or a needed specialty in medicine (20%). Students reported advisors and clinical experiences influenced choice of residency.  Students wishing to work in underserved areas were more likely to match with a primary care residency (p=0.02). Students with dependents were more likely to match with a needed specialty (p = 0.03).

Limitations

            This study included a sample of two graduating classes from one Osteopathic medical school with a specific mission. The results cannot be generalized to other populations of students.

Conclusions

            Pre-admission social factors and performance in school were not associated with residency choice. Student desire to work in a medically underserved area was associated with a match in primary care. 


Keywords


primary care; residency; medical education; medical specialty

Full Text:

References


REFERENCES

Association of American Medical Colleges Physician shortages to worsen without increases in residency training. AAMC. 2010;32-33.

Iglehart JK. Grassroots activism and the pursuit of an expanded physician supply. NEJM. 2008;358:1741-9. http://dx.doi.org/10.1097/ACM.0b013e3182045ec9.

Green LA, Jones SM, Fetter G, Pugno PA. Preparing the personal physician for practice: Changing family medicine residency training to enable new model practice. Acad Med. 2007;82:12:1220-1227.

Salsberg E, Grover A. Physician workforce shortages: Implications and issues for academic health centers and policy makers. Acad Med. 2006;81:9:782-787.

Agency for Healthcare Research and Quality . Primary care workforce facts and stats: Overview of the primary care workforce in the United States. AHRQ; 2011. Retrieved from: http://www.ahrq.gov/research/findings/factsheets/primary/pcworkforce/index.html 3.13.14

Salsberg E, Rockey PH, Rivers KL, Brotherton SE, Jackson GR. U.S. residency training before and after the 1997 Balanced Budget Act. JAMA. 2008;300:10:1174. doi: 10.1001/jama.300.10.1174.

US. Department of Health and Human Services, Health Resources Services Administration (HRSA). The Physician Workforce: Projections and Research into Current Issues Affecting Supply and Demand. HRSA; 2008.

Teitelbaum HS, Ehrlich N, Travis L. Factors affecting specialty choice among osteopathic medical students. Acad Med. 2009;84:6:718-723. http://dx.doi.org/10.1097/ACM.0b013e3181a43c60.

DeZee KJ, Maurer D, Colt R, et al. Effect of financial remuneration on specialty choice of fourth-year U.S. medical students. Acad Med. 2011;86:2:187-193. http://dx.doi.org/10.1097/ACM.0b013e3182045ec9.

Mullan FC, Petterson, S, Kolsky, G, Spangnola, M. The social mission of medical education: Ranking the schools. Annals Int Med. 2010;152:2:804-811. http://dx.doi.org/10.7326/0003-4819-153-7-201010050-00026.

Brotherton SE, Rockey PH, Etzel SI. Trends in primary care specialties. JAMA. 2005;294:9:2004-2005.

Jeffe DB, Whelan AJ, Andriole DA. Primary care specialty choices of United States medical graduates,1997-2006. Acad Med. 2010;85:6:947-958. http://dx.doi.org/10.1097/ACM.0b013e3181dbe77d.

Hortobagyi G. A shortage of oncologists? The American Society of Cinical Oncology workforce study. J Clin Oncol. 2008;26:10.

Johnson R. Sports Medicine in Primary Care. Philadelphia, PA: W. B. Saunders; 2000.

Grover A, Gorman K, Dall T, et al. Shortage of cardiothoracic surgeons is likely by 2020. Circulation. 2009;120:488-494. http://dx.doi.org/10.1161/CIRCULATIONAHA.108.776278.

Mitka M. Looming shortage of physicians raises concerns about access to care. JAMA. 2007;297:10:1045-1046. http://dx.doi.org/10.1001/jama.297.10.1045.

Lehman C. Congress addresses child psychiatrist shortage. American Psychiatric News. Vol 36: American Psychiatric Association; 2001:13-13.

Watmough S, Taylor D, Ryland I. Using questionnaires to determine whether medical graduates' career choice is determined by undergraduate or postgraduate experiences. Med Teach. 2007;29:8:830-832.

Senf J, Campos-Outcalt, Watkins, A, Bastacky, S, & Killian, C. A systematic analysis of how medical school characteristics relate to graduates' choices of primary care specialties. Acad Med. 1997;72:6:524-533.

American Association of Colleges of Osteopathic Medicine (AACOM). AACOM 2009-10 academic year survey of graduating seniors summary report. 2009.

Licciardone JH, Singh KP. Sociodemographic and geographic characteristics associated with patient visits to osteopathic physicians for primary care. BMC Health Services Research. 2011; 11:303. http://dx.doi.org/10.1186/1472-6963-11-303.

Lakhan SE, Laird C. Addressing the primary care physician shortage in an evolving medical workforce. Int. Archives Medicine. 2009;2:1:14-14. http://dx.doi.org/10.1186/1755-7682-2-14.

Burack J, Irby, D., Carline, J. Ambrozy, D, Ellsbury K, Stritter F. A study of medical student's specialty-choice pathways: Trying on possible selves. Acad Med. 1997;72:6:534-541.

Erney S, Biddle B, Siska K, Riesenberg LA. Change in medical students' attitudes about primary care during the third year of medical school. Acad Med. 1994;69:11:927-929.

Lipkin M, Zabar SR, Kalet AL, et al. Two decades of Title VII support of a primary care residency: Process and outcomes. Acad Med. 2008;83:11:1064-1070. http://dx.doi.org/10.1097/ACM.0b013e31818928ab.




DOI: http://dx.doi.org/10.18103/mra.v0i1.16

Refbacks

  • There are currently no refbacks.