Finding, Recruiting, and Sustaining the Future Primary Care Physician Workforce: A New Theoretical Model of Specialty Choice Process

Abstract

This theoretical model is a guide to targeting interventions toward cultivation of more primary care physicians and clarifies areas needing further research.

Primary Care Careers Among Recent Graduates of Research-Intensive Private and Public Medical Schools

“…Demographic factors that have been associated with selection of a primary care career include female gender, lower socioeconomic status, older age, Latino ethnicity, rural background, nontraditional backgrounds, and plans for a primary care career at matriculation. 8,9 However, with schools rather than individual students as the unit of analysis, our study did not find that the proportion of under-represented minority students was associated with primary care career choices.…”

“…Medical students and residents cite lower pay, lack of prestige, greater stress and bureaucracy, lack of technological emphasis and research opportunities, and perceptions of job dissatisfaction as deterrents to pursuing primary care careers. 1,8,10 Positive and negative perceptions of primary care are shaped by students' experiences during clinical rotations, interactions with faculty members, and the school's culture or "hidden curriculum." 8 Research-intensive private medical schools are often able to attract very talented applicants from a wide range of racial, ethnic and socioeconomic backgrounds.…”

“…1,8,10 Positive and negative perceptions of primary care are shaped by students' experiences during clinical rotations, interactions with faculty members, and the school's culture or "hidden curriculum." 8 Research-intensive private medical schools are often able to attract very talented applicants from a wide range of racial, ethnic and socioeconomic backgrounds. A lack of emphasis on careers in primary care at these schools may influence students initially interested in primary care to shift their focus to specialist careers.…”

Is Training in a Primary Care Internal Medicine Residency Associated with a Career in Primary Care Medicine?

“…Professional and governmental organizations, including the Health Resources and Services Administration (HRSA) and the Council on Graduate Medical Education (COGME), endorse and support primary care residency programs in order to help promote a workforce that consists of at least 40 % outpatient primary care physicians as compared to the 2010 level of 32 %. 7 While several studies have examined which aspects of medical school curricula might pique medical students' interest in primary care careers, [14][15][16] the effect of primary care curricula in residency training on resident career choice is less well documented. Recent studies of primary care programs reveal that participation in a primary care track significantly increased intent to practice primary care at graduation from residency, but importantly, these cohorts were not followed into practice to determine whether stated career choices persisted.…”

The Impact of Debt on Young Family Physicians: Unanswered Questions with Critical Implications

“…Indeed, a number of survey studies demonstrate that students who choose family medicine value income and "lifestyle" less than their peers. 5,[12][13][14] The design of these studies reflects our own experience. When we chose to become family physicians, we viewed this as a career that offered economic security, even if it would not support extravagant luxury.…”