Predicting career decisions in primary care medicine: A theoretical analysis

Abstract

Entering the 1960s, more than half of the medical doctors in the United States were family physicians, pediatricians, or general internists. Today, about one-third of all U.S. physicians are primary care practitioners. Although opinions vary on the optimal ratio of primary care to specialty physicians, in the mid-1990s, the consensus among leaders in medicine was that more primary care physicians would be needed to ensure access to quality care. The target output of graduates was set for a minimum of 50% primary care physicians, and medical school admission committees responded. The present study examines research related to career decision making in primary care medicine. We address career decision making in primary care with the expectation that selection of a medical residency is based on multiple factors, and multivariate statistical techniques comprise the most appropriate statistical procedure for developing predictive models of medical student residency choice. Additional multivariate studies for simultaneous analysis of multiple dependent and multiple independent variables are needed to determine whether health policy planners and medical schools should continue to address the distribution of primary care physicians through medical school admissions. Further to enabling prediction, researchers must renew efforts to base investigations on theoretical models, summarizing and organizing previous research, and providing one another with means to focus future studies while building on previous work.

Social dominance theory and medical specialty choice

“…There has been a wealth of research on medical students' career choices, particularly in terms of selecting primary care specialties or family medicine (Bland et al 1995;Connelly et al 2003;Jordan et al 2003;Lawson and Hoban 2003;Senf et al 2003;Wright et al 2004). Studies have found that both internal influences (e.g.…”

Physician migration, education, and health care

“…Efforts to select and matriculate medical students who will practice in certain specialties or in medically underserved regions have met with mixed results. [4][5][6] Initiatives to increase access to undergraduate and graduate medical education will take years before the promised results of increased numbers of qualified physicians can be evaluated. Medical passports are likely to be limited to a small number of physicians practicing in a few countries.…”

Can Self-declared Personal Values be Used to Identify those with Family Medicine Career Aspirations?

“…Various surveys have been used to study this issue, with questionnaire distribution beginning as early as matriculation into medical school (Scott et al, 2004). A pair of literature reviews have suggested that demographic factors including being female and older in age correlate with a desire to pursue primary care (Bland et al, 1995;Lawson and Hoban, 2003). In addition, personality variables such as maintaining a social orientation and a desire for a varied scope of practice have been indicated as potentially useful (Bland et al, 1995;Lawson and Hoban, 2003).…”