Classification model that predicts medical studentsʼ choices of primary care or non-primary care specialties

Abstract

To identify factors that influence students to choose primary care or non-primary care specialties, the authors surveyed the 509 graduating students at the Medical College of Georgia School of Medicine in 1988, 1989, and 1990. Using a Likert-type scale, the 404 responding students rated potential influences on their specialty choices from 1, very negative, to 7, very positive. The students choosing primary care specialties were positively influenced significantly more often by their desire to keep options open (85% versus 58%, p less than .001) and their desire for longitudinal patient care opportunities (95% versus 54%, p less than .001). Those choosing non-primary care specialties were more often influenced by their desire for monetary rewards (69% versus 35%, p less than .001) and by their perceptions of lifestyle following residency (74% versus 60%, p less than .01) and prestige of the specialty (57% versus 36%, p less than .001). The authors used multiple discriminant analysis to derive a discriminant function that would permit classification of students into primary care and non-primary care groups. The potential influences of desire for longitudinal care opportunities and desire for monetary rewards were statistically and clinically significant for all three years. Using the discriminant function, the authors correctly classified 81%, 79%, and 78% of the students' specialty choices for 1988, 1989, and 1990, respectively. The authors suggest that addressing the issue of monetary rewards will be necessary before the primary care fields again become attractive to students.

A review of longitudinal clinical programs in US medical schools

“…These findings connect to outcomes in the literature demonstrating that LICs effectively support the primary care workforce [11,19,40,41]. We also consider these findings in the context of earlier studies demonstrating that 95% of students seeking primary care careers ‘desire for longitudinal patient care opportunities’ [42, p. 324]. Whether non-LIC LCPs such as clinic or patient attachments recruit and retain for primary care workforce remains unclear [10,13,23].…”

The International Health Program: the fifteen-year experience with Yale University's Internal Medicine Residency Program.

“…7,8 However, while individual factors may be the most powerful influences, studies have indicated that certain experiences during training can complement these inherent characteristics regarding career choices. [9][10][11][12][13] In assessing the pre-existing characteristics of our study cohort, we found that participants not only had a great deal of non-academic international experience prior to residency, they chose Yale for training in part because of its international elective program. Moreover, residents stated that cross-cultural experience and a desire to serve a less privileged population were the most important, not the most frequent, reasons for participation.…”

A Longitudinal Study of Determinants of Career Satisfaction in Medical Students

“…Available from of career satisfaction in medical students http://www.med-ed-online.org 4 them to indicate the specialty in which they are most interested. Using this approach, researchers have found, for example, that students who chose primary care specialties were more likely to be interested in longitudinal patient care 34,35 and to consider opportunities to provide care involving psychosocial aspects of medicine as important. 36 The second type of relationship, interest in specialties, begins with identifying students as interested in a particular specialty, then surveying them for their ratings of particular practice influences or characteristics.…”