Factors associated with choosing a primary care career

Area of Science:

• Medical Education
• Physician Workforce

Background:

• Understanding factors influencing medical students' career choices is crucial for increasing primary care physicians.
• Primary care includes family practice, general internal medicine, general pediatrics, and general obstetrics and gynecology.

Purpose of the Study:

• To identify factors influencing medical students' specialty choices.
• To understand why fewer physicians are entering primary care.

Main Methods:

• A questionnaire was sent to 474 University of California, San Diego (UCSD) School of Medicine alumni from 1974, 1978, 1982, 1986, and 1990.
• 351 alumni responded (74% response rate), with 327 in direct patient care (38% in primary care).

Main Results:

• Older, female, underrepresented minority, rural background, and early specialty choice were linked to primary care.
• Personal values influenced primary care choices, while school environment factors dominated non-primary care choices.
• Many primary care physicians felt the UCSD environment was unsupportive of primary care.

Conclusions:

• Factors beyond the medical school environment, such as personal values, significantly influence primary care specialty selection.
• Medical school environments may inadvertently discourage students from pursuing primary care careers.
• Increased student debt did not significantly impact specialty choice.
• Interventions to boost primary care physician numbers should consider personal and environmental factors.