No abstract

The results suggest that the most effective way to increase the number of physicians with generalist practices is to increase the number of students interested in a family medicine career at matriculation.

The authors assess the importance of educational debt in graduates' primary care specialty choices, and the variety of mechanisms through which debt may influence career decisions. Logistic regression models were used to identify significant predictors of the primary care specialty choices made by the 1991 and 1992 graduates of U.S. medical schools. These predictors were debt itself; other financial indicators; certain medical school characteristics; certain practice location plans; certain demographic factors; aspects of academic performance; and students' predisposition to a primary care specialty. Data for this study were gathered from a variety of sources at the Association of American Medical Colleges and from the Health Education Assistance Loans program. Both direct and indirect effects of debt were identified under specific conditions. The study revealed complex relationships between debt and the other predictors identified. For example, debt operated in relation to the levels of the graduates' expected incomes; debt from subsidized loan sources was significant for women who chose general internal medicine; debt was important in choices of family practice; and debt by itself was significant for those planning to practice in the West and who chose general internal medicine. Also, seemingly opposing effects of debt occurred. For example, in the family practice model used in this study, the threshold effect of debt was positive, while the linear effect of debt above the threshold was negative. Such vriations help explain the conflicting findings of some past research. These and other findings prompt the authors to state that when investigating the effects of debt, it is not fruitful to ask what the effect of the debt is on all three primary care fields as a group. It is more appropriate to ask several questions, such as: under what conditions does debt influence specialty plans? Among which groups of students does debt have an impact on specialty plans? Are all of the primary care specialties similarly affected by the issues surrounding debt? Does the effect of debt change over time? The authors conclude by indicating possible policy implications of their findings.

No abstract

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.The "convergence hypothesis" of conventional modernization theory suggests that the nations of the world are becoming more similar. Critics have argued that nations are diverging and becoming dissimilar over time. This paper brings unique data, analytic procedures, and a world-system perspective to bear on this debate. We suggest that world-system theory provides a framework for explaining the simultaneous occurrence of both convergence and divergence. Specifically, the logic of world-system theory suggests that divergence occurs between the three zones of nations (core, semiperiphery, and periphery), whereas convergence occurs within them. With respect to economic development, our analyses indicate that predictions concerning divergence were partially supported and predictions concerning convergence held only for the core. Trends within the periphery and semiperiphery question the utility of world-system theory. INTRODUCTION AND HYPOTHESESDebate has long revolved around what has come to be known as the "convergence hypothesis" (Meyer, Boli-Bennett, and Chase-Dunn 1975). This hypothesis proposes that the societies of the world will become more similar over time with regard to various characteristics such as labor force structure, technology, level of development, occupational prestige rankings, and state bureaucratization and power (Lenski and Lenski 1987; Inkeles and Rossi 1956; Moore 1963). Central to this homogenizing process is the diffusion of industrial technology and "modern" values throughout the world. For instance, Kerr, Dunlop, Harbison, and Myers (1964, pp. 14-29) have described the "logic of industrialization," which pulls all nations toward a common point: industrial society. Others suggest that late developers can adopt rational policies and advanced technology and * Direct all correspondence to Walter Gillis Peacock, Department of Sociology, University of Alabama in Huntsville, Huntsville, AL 35899.The authors would like to thank Walter Sullins and Rick Christenson -for their assistance, two anonymous ASR reviewers for their helpful comments, and the Department of Sociology, University of Georgia, for supporting early stages of this research. achieve rapid development that will enable them to catch up with the already developed nations (Feldman and Moor 1969). In this scenario, the developing nations will skip the preliminary stages of development through which the leading nations gradually passed. Taking advantage of the latest in technological advances, developing nations are catapulted into the modern world.The critics of this hypothesis have argued that rather than converging, nations are diverging in many important respects. For instance, some have argued that ...

Most medical students make their final choices about specialty during or after their clerkship year. Knowledge of these students' attitudes toward internal medicine could form the basis for the development of strategies to enhance the attractiveness of internal medicine among these students while they are making their final decisions about specialty.

The findings point to one way of understanding better the influence of a medical school on its students' career choices. By using this model, each specialty may be able to develop studies to examine the complex interactions between students and specific medical schools.

No abstract