Factors Associated With Osteopathic Primary Care Residency Choice Decisions

Dogbey, Godwin; Collins, Karen; Russ, Ronald; Brannan, Grace D.; Mivsek, Matt; Sewell, Sarah

doi:10.7556/jaoa.2018.046

Cited by 8 publications

(7 citation statements)

References 40 publications

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“…This trend has been validated by another study which found that a majority of students entering medical school undecided in career choice elected to enter an NPC residency by their fourth year [24]. Moreover, a significant number of students see their third year of medical school as the time they decide on career specialty [25]. With no statistically significant difference between the costs incurred from preparing and sitting for board examinations of those who Strongly Agreed and Strongly Disagreed to the statement "I Plan to Enter a Primary Care Residency," our study further supports the theory that financial costs during undergraduate medical training are not a significant factor in career choice.…”

Section: Discussionmentioning

confidence: 85%

“…Because of this smaller sample size, the influence of fourth-year students’ perceptions is underrepresented in our statistical models. Representation of these students' perceptions is important because it has been found that a majority of students who enter medical school, undecided on career choice, elect to apply for NPC residencies by their fourth year [25].…”

Section: Discussionmentioning

confidence: 99%

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A “U-shaped" Curve: Appreciating How Primary Care Residency Intention Relates to the Cost of Board Preparation and Examination

Bucur

Bhatnagar

Díaz

2019

Cureus

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Introduction: The shortage of primary care physicians in the United States has warranted an investigation into how medical education debt and other factors influence medical students’ interests in primary care (PC) residencies. However, sparse research has studied how the cost of board preparation and examination relates to career choice. The objective of this study was to determine if there is an association between the cost of preparing and sitting for board examinations and the intention to enter a PC residency for osteopathic medical students.Methods: We postulated that students who incurred higher financial costs from preparing and sitting for board examinations would be more likely to be interested in non-primary care (NPC) residencies. Using a non-experimental survey design, this study asked respondents to evaluate the following: “I plan to enter a Primary Care Residency (Family Medicine OR General Internal Medicine OR Pediatrics)” using a Likert scale. Respondents were also asked to select which board examination(s) and pertinent resource(s) they had purchased. Total costs were calculated per student.Results: A total of 25,852 osteopathic medical students received the survey, of which 1,280 students responded to and completed it, yielding a 4.95% response rate. The distribution of respondents’ intentions to pursue a primary care residency and costs spent yielded a “U” shaped curve. Respondents who Strongly Agreed and Strongly Disagreed to the statement “I plan to enter a Primary Care Residency” spent $5,744 and $5,070 on board-preparation and examination, respectively. No statistically significant differences were found between the cost of preparing and sitting for board examinations and the intention to enter primary care residencies when individuals were grouped by year in school and gender.Conclusions: Because competitive NPC specialties have relatively higher salaries, we suspected that students who intended to pursue these specialties would have had higher financial costs from board examination and preparation compared to students who intended to pursue PC residencies such as family medicine. Our findings further illustrate these specific educational costs do not correlate with students’ stated intentions to enter primary care residencies. As efforts continue to determine a solution for the primary care physician shortage, it becomes clearer that the focus must also encompass non-financial influences that shape career choice.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

A “U-shaped" Curve: Appreciating How Primary Care Residency Intention Relates to the Cost of Board Preparation and Examination

Bucur

Bhatnagar

Díaz

2019

Cureus

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“…Quality scores ranged from 4 to 34 with a mean (SD) score of 18.6 (6.2) and a median score of 19 (Figure 2). Six articles found no benefit [17][18][19][20][21][22] or a negative impact 23 from the studied intervention; all others described interventions that appeared to have a positive influence on PC specialty choice.…”

Section: Resultsmentioning

confidence: 99%

Impact of Curricula and Electives on Primary Care Specialty Choice: A Narrative Synthesis

Nguyen

Liaw

Polverento³

et al. 2022

Fam Med

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Background and Objectives: Educational components and electives that may influence medical student choice of primary care careers have been studied individually, but not reviewed or synthesized. Examining educational components and electives in a comprehensive manner may inform evidence-based approaches to raise the number of primary care physicians in the United States and help optimize use of finite resources. We sought to determine evidence-based educational components and electives associated with increased medical student choice of primary care careers. Methods: We searched PubMed, Scopus, and CINAHL for undergraduate medical education articles in English describing an educational component or elective and outcome relevant to primary care specialty choice. We assessed titles, then abstracts, and finally full texts for inclusion in a narrative synthesis. Results: The searches returned 11,211 articles and we found 42 that met the inclusion criteria. The most described components were outpatient clinical rotations, preclinical courses, and preceptorships. The most common electives were international health, summer preceptorships, and rural medicine. While most articles described curricula that appeared to have a positive correlation with primary care specialty choice, six articles found limited benefit. In sum, results were mixed. Conclusions: The current literature is limited, and many contemporary electives have not been studied with respect to primary care choice. Increased attention and funding to studying the impact of electives and other educational components on primary care specialty choice is warranted.

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“…In some national US studies that compared clerkship characteristics, the impact of a required primary care clerkship on specialty choice was found to be greater during the core clerkship year (commonly the third year) compared to the fourth year. 6,47 Other studies found no difference between clerkships in the third or fourth year. 24,56 One single-institution study of a required rural family medicine clerkship found that family medicine choice declined when the rotation was moved from the fourth year to the third year.…”

Section: Clerkship Quality Length and Timingmentioning

confidence: 96%

The Relationship Between Medical School Clerkships and Primary Care Specialty Choice: A Narrative Review

Lee

Erlich

Wendling

et al. 2022

Fam Med

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Background and Objectives: There is a persistent shortage of primary care physicians in the United States. Medical schools can help meet societal primary care health needs by graduating more students who select family medicine and other primary care careers. The objective of this narrative review was to evaluate the relationship between clerkships and primary care specialty choice. Methods: We conducted a systematic literature search and narrative review of research articles examining the association between clerkships and primary care specialty choice. We evaluated the quality of included articles using a validated scale, assessed for methodology and outcomes, and synthesized using a narrative approach. Results: We identified 59 articles meeting our research criteria. A required primary care clerkship in the core clerkship year was associated with increased primary care specialty choice. This finding was strongest for family medicine clerkships and family medicine specialty choice. Clerkships that were longer, were of higher quality, exposed students to a wider scope of primary care practice, and occurred within an institutional climate supportive of primary care were also correlated with more students choosing a primary care specialty. While student self-reported interest in primary care often increased following a primary care clerkship, this interest was not always sustained or consistently associated with a primary care residency match or primary care career. Conclusions: Required family medicine and primary care clerkships were correlated with primary care specialty choice. More high-quality research is needed to better understand how to maximize the impact of clerkships on primary care specialty choice.

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Factors Associated With Osteopathic Primary Care Residency Choice Decisions

Cited by 8 publications

References 40 publications

A “U-shaped" Curve: Appreciating How Primary Care Residency Intention Relates to the Cost of Board Preparation and Examination

A “U-shaped" Curve: Appreciating How Primary Care Residency Intention Relates to the Cost of Board Preparation and Examination

Impact of Curricula and Electives on Primary Care Specialty Choice: A Narrative Synthesis

The Relationship Between Medical School Clerkships and Primary Care Specialty Choice: A Narrative Review

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