Background and Objectives: The Family Medicine for America’s Health Workforce and Education Team aims to increase the number of medical students choosing family medicine to address the projected primary care physician shortage. This aim can be achieved by developing a well-trained primary care workforce. Our student- and resident-led FMAHealth work group aimed to identify factors that influenced fourth-year medical students’ choice to become family physicians. The secondary objective compared such factors between the 10 medical schools with the highest percentage of students matching into family medicine and non-top 10 medical schools. Methods: Fourth-year medical students nationwide participated in 90-minute virtual focus groups. Reviewers coded deidentified transcriptions and identified key themes and subthemes that were found to influence student choice. Results: Fifty-five medical students participated in focus groups over a 2-year period. Three key themes were found to influence students: perspective, choice, and exposure. Subthemes included: (1) the importance of high-quality preceptors practicing full-scope family medicine, (2) the value of a rural experience, and (3) institutional support to pursue family medicine. Physician compensation and loan repayment concerns were not major factors influencing student choice. Conclusions: Many factors influence student choice of family medicine including preceptors, clinical exposures, and institutional support. These factors varied by institution and many were found to be different between top 10 and non-top 10 schools. Addressing these factors will help increase students’ choice of family medicine and reduce the primary care shortage.

Purpose To explore the relationship between initial clinician type (generalist versus subspecialist) seen by infertile women, type of treatment received, and time to pregnancy. Methods In a retrospective cohort design, we analyzed mixed-mode questionnaire data from 867 women with primary infertility enrolled through population- and fertility clinic-based sampling. We compared women presenting first to generalist providers with women presenting first to fertility subspecialists, with the main outcomes of receiving in vitro fertilization (IVF), time to pregnancy, and live birth. Results The first point of contact for most (84%) women with infertility was a generalist provider. Only 8% of women sought care first from a fertility subspecialist, and these women were more likely to be older and have been trying to conceive longer before seeking care. Women who presented first to a generalist provider were less likely to receive IVF (aOR 0.48, 95% CI 0.28, 0.82), were equally likely to achieve pregnancy, and had similar times to pregnancy (aHR 1.11, 95% CI 0.80, 1.53) compared to women who presented first to a subspecialist. Conclusions Generalist providers are frequently the first point of care for women with difficulty conceiving and are uniquely positioned to promote a balanced management of infertility.