Factors Associated With Medical Students' Career Choices Regarding Internal Medicine
Top Cited Papers
- 10 September 2008
- journal article
- research article
- Published by American Medical Association (AMA)
- Vol. 300 (10) , 1154-64
- https://doi.org/10.1001/jama.300.10.1154
Abstract
Context Shortfalls in the US physician workforce are anticipated as the population ages and medical students' interest in careers in internal medicine (IM) has declined (particularly general IM, the primary specialty serving older adults). The factors influencing current students' career choices regarding IM are unclear. Objectives To describe medical students' career decision making regarding IM and to identify modifiable factors related to this decision making. Design, Setting, and Participants Web-based cross-sectional survey of 1177 fourth-year medical students (82% response rate) at 11 US medical schools in spring 2007. Main Outcome Measures Demographics, debt, educational experiences, and number who chose or considered IM careers were measured. Factor analysis was performed to assess influences on career chosen. Logistic regression analysis was conducted to assess independent association of variables with IM career choice. Results Of 1177 respondents, 274 (23.2%) planned careers in IM, including 24 (2.0%) in general IM. Only 228 (19.4%) responded that their core IM clerkship made a career in general IM seem more attractive, whereas 574 (48.8%) responded that it made a career in subspecialty IM more attractive. Three factors influenced career choice regarding IM: educational experiences in IM, the nature of patient care in IM, and lifestyle. Students were more likely to pursue careers in IM if they were male (odds ratio [OR] 1.75; 95% confidence interval [CI], 1.20-2.56), were attending a private school (OR, 1.88; 95% CI, 1.26-2.83), were favorably impressed with their educational experience in IM (OR, 4.57; 95% CI, 3.01-6.93), reported favorable feelings about caring for IM patients (OR, 8.72; 95% CI, 6.03-12.62), or reported a favorable impression of internists' lifestyle (OR, 2.00; 95% CI, 1.39-2.87). Conclusions Medical students valued the teaching during IM clerkships but expressed serious reservations about IM as a career. Students who reported more favorable impressions of the patients cared for by internists, the IM practice environment, and internists' lifestyle were more likely to pursue a career in IM.Keywords
This publication has 22 references indexed in Scilit:
- Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other CountriesAnnals of Internal Medicine, 2008
- The impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotionsBMC Medical Education, 2006
- Who Is Maintaining Certification in Internal Medicine—and Why? A National Survey 10 Years after Initial CertificationAnnals of Internal Medicine, 2006
- The Impact of U.S. Medical Students?? Debt on Their Choice of Primary Care Careers: An Analysis of Data from the 2002 Medical School Graduation QuestionnaireAcademic Medicine, 2005
- Weighing the Evidence for Expanding Physician SupplyAnnals of Internal Medicine, 2004
- Influence of Controllable Lifestyle on Recent Trends in Specialty Choice by US Medical StudentsJAMA, 2003
- How important are economic factors in choice of medical specialty?Health Economics, 2002
- A longitudinal, national study of the effect of implementing a required third-year family practice clerkship or a department of family medicine on the selection of family medicine by medical studentsAcademic Medicine, 1999
- Educational and career outcomes of an internal medicine preceptorship for first-year medical studentsJournal of General Internal Medicine, 1999
- The Emerging Role of “Hospitalists” in the American Health Care SystemNew England Journal of Medicine, 1996