How Medical Education Pathways Influence Primary Care Specialty Choice

Abstract

Background and Objectives: Primary care is associated with improved patient health and reductions in health disparities. Consequently, the demand for primary care physicians is increasing. To meet this demand, medical schools have employed strategies to graduate students interested in primary care careers, including medical education pathways—structured, longitudinal experiences that are explicitly separate from the main curricular scope of the undergraduate medical education experience. Our goal was to explore and identify common characteristics of medical education pathways that influence primary care specialty choice. Methods: Using research articles identified through a scoping review, we performed a qualitative content analysis of studies that evaluated the impact of medical education pathways on medical students’ choices of primary care careers. Results: Sixty-three papers described 43 medical education pathways; most studies used quantitative methods to describe outcomes. Program characteristics mapped onto five levels of an emerging socioecological model: state or national, community, institutional, relational, and individual. Conclusions: Successful medical education pathway programs complement a medical school curriculum that supports a common goal, and demonstrate multiple levels of structural and institutional factors that develop community connectedness, relatedness, and longitudinal community engagement in students. Further work is needed to better understand how each of these levels influence career choice and to reassess how to measure and report medical education outcomes that will more accurately predict the student choice of primary care careers.

An 8-Year Review of Match Outcomes From a Primary Care Pipeline Program

“…Abbreviations: PCP, Primary Care Program Historically, primary care pipeline programs have been shown to provide valuable support for students matching into primary care residencies. 19,20 Consistent with previous literature on the success of primary care pathways, 17 the KSOM PCP has shown promising results among the first eight student cohorts. At the time of graduation, a statistically significant higher proportion of PCP medical students have matched into PC residencies than the general KSOM class, as well as the national average of medical students (70% vs 36% vs 39%, respectively).…”

“…In a scoping review of 43 various medical education pathways that influenced PC specialty choice, 40 pathways were deemed successful by meeting one of the following criteria: career preference/intention, residency match, residency trained, or physicians in practice. 17 While each of these primary care educational pathways are unique, many share the same focus of highlighting early primary care clinical training, exposure, and mentorship. [11][12][13][14][15][16] Primary care pathway students have higher match rates into primary care residencies compared to the national match average of 39% of MD allopathic seniors.…”

What Do Medical Students Learn about Community Care from Discussions with General Physicians? A Thematic Analysis

“…Recognizing the contributions of community care to social challenges indicates that it is perceived as a service and a dynamic interface between medical practice and societal needs [21]. Previous literature has often compartmentalized community care into distinct categories without accounting for its intrinsic diversity [22]. Our findings indicate a shift towards acknowledging the heterogeneity of community care, suggesting a broader, more holistic understanding of healthcare that transcends clinical perspectives.…”

Psychometric evaluation of the Chinese version of Self-assessment scale for the community- based and emergency practice among medical students

“…Medical schools are constantly de ning the skills and knowledge required of students to ensure that graduates are adequately prepared for work. [19,20] Its focus is on developing clinical practice skills of medical students to provide for the development of the manpower needed for primary care. The provision of planned community healthcare services is an ideal way to improve the capacity and effectiveness of primary care physician services, as well as the basis for implementing universal health coverage.…”