Residents' preferences and preparation for caring for underserved populations

Area of Science:

• Medical Education
• Health Services Research
• Public Health Policy

Background:

• Persistent disparities in healthcare access for low-income individuals and residents of rural/inner-city areas.
• Physician maldistribution exacerbates the problem, with a need to understand physician location preferences.

Purpose of the Study:

• To determine resident physicians' preferences for practicing in underserved areas.
• To assess resident physicians' preparedness to serve low-income populations.

Main Methods:

• National survey of 2,626 resident physicians across eight specialties in 162 US academic health centers.
• Assessed desirability of public hospitals, rural, and inner-city areas as employment locations.
• Evaluated preparedness to provide services for indigent populations using logistic regression analysis.

Main Results:

• Only one-third of residents found public hospitals desirable; preferences varied significantly by specialty.
• Approximately 25% of residents ranked rural or poor inner-city areas as desirable practice locations.
• While prepared for common conditions, fewer residents felt prepared for specific issues like domestic violence, HIV/AIDS, or substance abuse counseling (67%).

Conclusions:

• A significant gap exists between resident physicians' preferences and the need for care in underserved areas.
• Exposure to underserved populations during residency is crucial for improving preparedness.
• Minorities, women, and noncitizen international medical graduates (IMGs) show higher likelihoods of preferring and feeling prepared for underserved populations.