Factors influencing students' choices of primary care or other specialties

Because of the marked decline in the numbers of U.S. medical school graduates entering the primary care fields of internal medicine, pediatrics, and family medicine, medical educators are increasingly interested in determining the factors that influence students' choices of specialty.

A few months before graduation, the 142 seniors in the class of 1992 at the University of California, San Francisco, School of Medicine, were surveyed about their choices of first-year residency programs. They were asked to rate various influential factors by using a five-point Likert scale. Chi-square analysis was used to compare the students' responses, by specialty choice (i.e., primary care versus other specialties) and by gender.

A total of 102 students responded: 50 who were entering primary care specialties, and 52 who were entering other specialties. Three factors were found to significantly influence the students' choices: future income, opportunities to work with new technology, and faculty advisors. Income and working with new technology were significantly rated factors leading toward the non-primary-care fields (p = .031; p = .000), although a total of only 20 students (15 in non-primary-care) rated income as an important factor. A faculty advisor was a positive influence on the students who were entering residency training in the primary care specialties (p = .000).

That the influence of a faculty advisor was the significant factor in affecting students' decisions to choose primary care suggests that schools can increase the percentages of their students entering the primary care fields by increasing their students' contact with mentors in these fields.