Addressing the Need for Primary Care Physicians: Factors Associated with Medical Student Residency Choice

Abstract

Context With projected shortages of primary care physicians and specific specialists, the needs of society are clear; however, factors influencing medical student residency choice and career goals are not well defined or understood.Objectives This study analyzed residency and specialty preferences for two cohorts of fourth year osteopathic medical students (OMSIV) to determine the percentage of students selecting a primary care specialty or a needed specialty. It further investigated determinants of residency choices and residency program matches in order to better structure undergraduate medical education programs. Design A survey-based observational cohort study. Setting A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU SOMA), from March 2011 through August 2013.Participants Participants were 175 graduating OMSIV students from the school’s inaugural and second cohorts, the classes of 2011 and 2012.Measurements Measures included a 52-item graduation exit questionnaire. Exit survey data were merged with academic and admissions records to investigate factors bearing on residency match outcomes.Results The combined exit survey response rate was 95%. A majority (78.3%) of survey respondents matched with a primary care (58.3%) or a needed specialty in medicine (20%). Students reported advisors and clinical experiences influenced choice of residency. Students wishing to work in underserved areas were more likely to match with a primary care residency (p=0.02). Students with dependents were more likely to match with a needed specialty (p = 0.03).Limitations This study included a sample of two graduating classes from one Osteopathic medical school with a specific mission. The results cannot be generalized to other populations of students.Conclusions Pre-admission social factors and performance in school were not associated with residency choice. Student desire to work in a medically underserved area was associated with a match in primary care.