Attitudes toward and subsequent career choice of family practice: a weak relationship

This study examined longitudinal relationships between attitudes and career choice in family practice from admission to medical school through the end of internship.

The sample included medical students graduating in 1990 and 1991. Surveys completed at the beginning of each year of medical school, at graduation, and at the end of PGY1 included measures of attitudes toward family practice and stated career choice at the time of each survey. Regression examined the relationship between attitudes and choice; repeated ANOVA measures examined changes over time.

Positive attitude scores toward family practice increased over the first 2 years, then declined; women's scores were higher. The proportion of students stating a preference for family practice also increased initially but declined overall; women chose family practice more frequently. Relationships between attitudes and choice were weak over time and neither attitude scores nor change in scores predicted specialty choice.

Although attitudes toward family practice remained positive throughout the 5-year study, student interest in family practice declined during the clinical years. Women maintained stronger interests in family practice than men; the reasons for this are not clear. Attitudes were poor predictors of choice. Care is needed in interpreting cross-sectional studies reporting significant relationships. We need to develop more sensitive attitude measures to improve the predictive validity of attitude measurement scales.