Effect of Financial Remuneration on Specialty Choice of Fourth-Year U.S. Medical Students

DeZee, Kent J.; Maurer, Douglas; Colt, Ross; Shimeall, William T.; Mallory, Renee; Powers, John H.; Durning, Steven J.

doi:10.1097/acm.0b013e3182045ec9

Cited by 46 publications

(47 citation statements)

References 23 publications

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“…9,27,28 One explanation for this dichotomy is that our study only addressed certain elements of clinic. Factors we did not study, such as patient no-show rates, lack of clinic resources, resident personality characteristics, and overall feelings of stress and/or burnout as well as known influences such as potential monetary compensation, 21,22,29 greater comfort with the inpatient setting, and attraction to a specific specialty 10 may contribute to the stress and devaluing of ambulatory training.…”

Section: Discussionmentioning

confidence: 99%

“…22 The selection of variables to include in the model used the following strategy based on the bivariate analysis. 25,26 In domains in which only one item was significantly associated with career choice, that item was used.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 We conducted principle components analysis on a subset of the data, which resulted in dropping 3 items because of redundancy and adding an additional domain, making a 32-item survey with 6 domains (Table 3), which demonstrated content validity based on the available literature. 15,16,[19][20][21][22][23][24] The final domains and their Cronbach alpha scores are (1) clinical preceptors (0.866), (2) educational environment (0.763), (3) ancillary staff (0.600), (4) time management (0.878), (5) administrative: records/ space (0.708), and (6) personal experience (0.853). Although ancillary staff had a lower than typically acceptable Cronbach's alpha, we kept this domain because the grouping intuitively made sense (front desk, nursing and medical assistant staff) and because we did not use the domains to create scores.…”

Section: Survey Design and Domain Structurementioning

confidence: 99%

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Resident Satisfaction with Continuity Clinic and Career Choice in General Internal Medicine

et al. 2013

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BACKGROUND: The quality of the continuity clinic experience for internal medicine (IM) residents may influence their choice to enter general internal medicine (GIM), yet few data exist to support this hypothesis. OBJECTIVE: To assess the relationship between IM residents' satisfaction with continuity clinic and interest in GIM careers. DESIGN: Cross-sectional survey assessing satisfaction with elements of continuity clinic and residents' likelihood of career choice in GIM. PARTICIPANTS: IM residents at three urban medical centers. MAIN MEASURES: Bivariate and multivariate associations between satisfaction with 32 elements of outpatient clinic in 6 domains (clinical preceptors, educational environment, ancillary staff, time management, administrative, personal experience) and likelihood of considering a GIM career. KEY RESULTS: Of the 225 (90 %) residents who completed surveys, 48 % planned to enter GIM before beginning their continuity clinic, whereas only 38 % did as a result of continuity clinic. Comparing residents' likelihood to enter GIM as a result of clinic to likelihood to enter a career in GIM before clinic showed that 59 % of residents had no difference in likelihood, 28 % reported a lower likelihood as a result of clinic, and 11 % reported higher likelihood as a result of clinic. Most residents were very satisfied or satisfied with all clinic elements. Significantly more residents (p≤0.002) were likely vs. unlikely to enter GIM if they were very satisfied with faculty mentorship (76 % vs. 53 %), time for appointments (28 % vs. 11 %), number of patients seen (33 % vs. 15 %), personal reward from work (51 % vs. 23 %), relationship with patients (64 % vs. 42 %), and continuity with patients (57 % vs. 33 %). In the multivariate analysis, being likely to enter GIM before clinic (OR 29.0,) and being very satisfied with the continuity of relationships with patients (OR 4.08, were the strongest independent predictors of likelihood to enter GIM as a result of clinic. CONCLUSIONS:Resident satisfaction with most aspects of continuity clinic was high; yet, continuity clinic had an overall negative influence on residents' attitudes toward GIM careers. Targeting resources toward improving ambulatory patient continuity, workflow efficiency and increasing pre-residency interest in primary care may help build the primary care workforce.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Survey Design and Domain Structurementioning

confidence: 99%

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Resident Satisfaction with Continuity Clinic and Career Choice in General Internal Medicine

et al. 2013

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“…Students were then asked which of nine widely studied contributors to specialty decisions they felt were determinants in their specialty choices: intellectual interest; patient contact; procedural skills; a particular course, elective, or clerkship experience; a particular extracurricular activity; an acquaintance, role model, or mentor; salary; lifestyle; and career opportunities. 2,8,9,[15][16][17][18][19] Responses regarding professional identity development were given in narrative format; responses regarding the contributors to specialty decisions could be given in both yes/no and narrative format.…”

Section: Methodsmentioning

confidence: 99%

“…Personal experiences contributing to professional formation included serious illness (14); the importance of family members either as role models or as a concern with family-work balance (12); the value of mentors, role models, and shadowing (12); and knowledge gained from volunteer or paid employment in health care (16).…”

Section: White Borges Geigermentioning

confidence: 99%

Perceptions of Factors Contributing to Professional Identity Development and Specialty Choice: A Survey of Third- and Fourth-Year Medical Students

White

Geiger

2011

ANN BEHAV SCI MED EDUC

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This study begins to explore whether there is a link between medical students' professional identity development and their specialty choice. Through an online survey, third-and fourthyear students at a US medical school were asked to identify the curricular, extracurricular, and personal experiences they felt influenced their professional identity development, and which of nine known considerations influenced their specialty choice. In 141 responses (68% return rate), students most frequently identified experiences involving humans -as cadavers, patients, colleagues, mentors, and role models -as contributing to their professional identity development. Of the nine contributors to specialty decisions, students highlighted intellectual interest, patient contact, procedural skills, lifestyle, and career opportunities. Narrative responses to both questions consistently emphasized the value of emotionally positive clerkship experiences, patient encounters, role models, and mentors. The abundance and consistency of these responses suggest that positive interpersonal and clinical experiences may influence both professional identity development and specialty choice.

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Neuroanatomy education: The impact on perceptions, attitudes, and knowledge of an intensive course on general practice residents

Arantes

Barbosa

Ferreira

2017

Anatomical Sciences Ed

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General practitioners are responsible for the management of an increasing number of patients with neurological illness, and thus a solid education in neurosciences is a necessary component of their training. This study examines the effects of an intensive clinical neuroanatomy course on twenty general practice residents' perceptions, attitudes, and knowledge. A knowledge test was completed by the participants and by a control group at four different time points. The participants were asked to answer a questionnaire about their reasons for signing up for the course and their attitudes and perceptions toward the course experience. Experimental and control groups demonstrated identical mean baseline test scores. The experimental group significantly increased its test scores (plus 49.0% correct answers, a mean improvement of 120%) relative to controls after the educational intervention. There were no differences among scores from the evaluated time points after the educational intervention in the experimental group. In the control group, there were likewise no significant differences between the four evaluated time points. Most participants indicated that they signed up for the course to update/acquire knowledge and skills in the field of neurosciences, and also because they had difficulty in diagnosing and managing patients with neurological diseases. Participants' attitudes and perceptions toward the course experience were very positive. Most of the participants (n = 17; 85%) rated the course as "extremely useful," and 3 (15%) rated it as "very useful." This study provides evidence demonstrating the potential positive effect of neurosciences education to general practice residents. Anat Sci Educ 10: 465-474. © 2017 American Association of Anatomists.

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Effect of Financial Remuneration on Specialty Choice of Fourth-Year U.S. Medical Students

Abstract: U.S. medical students, particularly those considering primary care but selecting controllable lifestyle specialties, are more likely to consider applying for a primary care specialty if provided a financial incentive.

Cited by 46 publications

References 23 publications

Resident Satisfaction with Continuity Clinic and Career Choice in General Internal Medicine

Resident Satisfaction with Continuity Clinic and Career Choice in General Internal Medicine

Perceptions of Factors Contributing to Professional Identity Development and Specialty Choice: A Survey of Third- and Fourth-Year Medical Students

Neuroanatomy education: The impact on perceptions, attitudes, and knowledge of an intensive course on general practice residents

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