Primary Care Residency Choice and Participation in an Extracurricular Longitudinal Medical School Program to Promote Practice With Medically Underserved Populations

Kost, Amanda; Benedict, Joseph; Andrilla, C. Holly A.; Osborn, Justin; Dobie, Sharon A.

doi:10.1097/acm.0000000000000075

Cited by 22 publications

(18 citation statements)

References 22 publications

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“…Medical student specialty choice is a dynamic decision influenced by decades of life experiences before medical school and many elements during medical school. 14,18 The results of this study are consistent with previous research indicating that student interest in family medicine upon entry to medical school is strongly predictive of eventual family medicine specialty choice. This study adds to previous literature by quantitatively evaluating the impact of medical student experiences during medical school, particularly family medicinefocused extracurricular activities, which are intended to support and build student interest in family medicine.…”

Section: Discussionsupporting

confidence: 89%

Graduating Medical Student Perspectives on Factors Influencing Specialty Choice

Kost

Bentley

Phillips

et al. 2019

Fam Med

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Background and Objectives: Fewer than 10% of US medical school graduates enter family medicine residencies each year. Little is known about the perceptions and attitudes of senior medical students as they make final decisions about specialty choice, especially those that support a decision to pursue family medicine. The American Academy of Family Physicians (AAFP) administered a national survey to US seniors in 2015 to explore these factors. Methods: US seniors who were AAFP members (N=11,998) were invited to complete a survey exploring attitudes toward family medicine and experiences that influenced interest and choice of family medicine (FM) or other specialties. This was offered after students submitted their National Residency Matching Program rank list but before match. For those matching in family medicine, additional questions explored mentorship experience. Factors significantly predicting intent to match in family medicine, mentor attributes significantly influencing student attitudes, and family medicine interest group (FMIG) participation were identified via regression. Results: The survey response rate was 15.1%. Student perceptions of the respect of FM (OR=0.82), the future of FM (OR=2.04), and FMIG involvement (OR=1.75) predicted choosing FM, as did AAFP student membership (OR=2.13-2.44) and AAFP National Conference of Family Medicine Residents and Students attendance (OR=9.77). For students entering FM, having supportive mentors outside of FM and being dedicated to FM positively influenced their attitudes toward FM and their FMIG participation. Conclusion: National programs, FMIGs, mentorship, and medical school support of family medicine play a role in student selection of family medicine.

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Section: Discussionsupporting

confidence: 89%

Graduating Medical Student Perspectives on Factors Influencing Specialty Choice

Kost

Bentley

Phillips

et al. 2019

Fam Med

Self Cite

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“…The importance and value of mentorship is something that is being increasingly appreciated in medicine. [29][30][31] Mentors and primary care faculty in different training sites will have multiple aspects to their jobs, and additional exposure to full-time primary care physicians may help to give residents a more complete understanding of what a fulltime career in primary care might entail for them. Conversely, depending on the goals of the program, continued exposure to part-time faculty could offer an alternative to full-time practice for residents who are considering other aspects of their careers such as research or administration.…”

Section: Discussionmentioning

confidence: 99%

Why Aren’t More Primary Care Residents Going into Primary Care? A Qualitative Study

et al. 2016

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BACKGROUND:Workforce projections indicate a potential shortage of up to 31,000 adult primary care providers by the year 2025. Approximately 80 % of internal medicine residents and nearly two-thirds of primary care internal medicine residents do not plan to have a career in primary care or general internal medicine. OBJECTIVE: We aimed to explore contextual and programmatic factors within primary care residency training environments that may influence career choices. DESIGN: This was a qualitative study based on semistructured, in-person interviews. PARTICIPANTS: Three primary care internal medicine residency programs were purposefully selected to represent a diversity of training environments. Second and third year residents were interviewed. APPROACH: We used a survey guide developed from pilot interviews and existing literature. Three members of the research team independently coded the transcripts and developed the code structure based on the constant comparative method. The research team identified emerging themes and refined codes. ATLAS.ti was used for the analysis. KEY RESULTS: We completed 24 interviews (12 secondyear residents, and 12 third-year residents). The age range was 27-39 years. Four recurrent themes characterized contextual and programmatic factors contributing to residents' decision-making: resident expectations of a career in primary care, navigation of the boundary between social needs and medical needs, mentorship and perceptions of primary care, and structural features of the training program. CONCLUSIONS: Addressing aspects of training that may discourage residents from careers in primary care such as lack of diversity in outpatient experiences and resident frustration with their inability to address social needs of patients, and strengthening aspects of training that may encourage interests in careers in primary care such as mentorship and protected time away from inpatient responsibilities during primary care rotations, may increase the proportion of residents enrolled in primary care training programs who pursue a career in primary care.

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“…[13][14][15][16][17][18][19][20][21][22][23][24][25] Compared to our review of the 2013 literature relevant to general medicine educators, 26 we found more multi-institutional studies of high quality. Similar to last year, resident continuity clinic and handoffs were areas of focus.…”

Section: Discussionmentioning

confidence: 98%

For the General Internist: A Summary of Key Innovations in Medical Education

et al. 2016

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We conducted a review of published medical education articles to identify high-quality research and innovation relevant to educators in general medicine. Our review team consisted of six general internists with expertise in medical education and a professional medical librarian. We manually searched 15 journals in pairs (a total of 3062 citations) for original research articles in medical education published in 2014. Each pair of reviewers independently rated the relevance, importance, and generalizability of articles on medical education in their assigned journals using a 27-point scale (maximum of 9 points for each characteristic). From this list, each team member independently reviewed the 22 articles that received a score of 20 or higher from both initial reviewers, and for each selected article rated the quality and global relevance for the generalist educator. We included the seven toprated articles for presentation in this review, and categorized the studies into four general themes: continuity clinic scheduling, remediation, interprofessional education, and quality improvement and patient safety. We summarized key findings and identified significant limitations of each study. Further studies assessing patient outcomes are needed to strengthen the literature in medical education. This summary of relevant medical education articles can inform future research, teaching, and practice.

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Primary Care Residency Choice and Participation in an Extracurricular Longitudinal Medical School Program to Promote Practice With Medically Underserved Populations

Abstract: Supporting student interest in underserved careers is associated with higher rates of graduates entering primary care residencies, specifically family medicine.

Cited by 22 publications

References 22 publications

Graduating Medical Student Perspectives on Factors Influencing Specialty Choice

Graduating Medical Student Perspectives on Factors Influencing Specialty Choice

Why Aren’t More Primary Care Residents Going into Primary Care? A Qualitative Study

For the General Internist: A Summary of Key Innovations in Medical Education

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