Abstract
BackgroundThe desire of medical students to eventually work with underserved and vulnerable populations (hereafter ‘service interest’), has been shown to be shaped by individual factors including job satisfaction and financial considerations. School-level factors such as required longitudinal primary care experiences and the availability of extracurricular opportunities to work with underserved patients also affect service interest, but little is known about the impact of student volunteer activities.MethodsThis cross-sectional study gathered data from preclinical medical students via an online questionnaire. The data were linked to academic records, deidentified, and analysed using an ordinal logistic regression model with interest in caring ‘primarily for underserved or vulnerable populations’ as the outcome variable.ResultsOf 121 respondents (33% response rate), 24.8% expressed a definite interest, 55.3% expressed possible interest, and 19.9% expressed no service interest. Intent to work with the underserved was not related to age, sex, race/ethnicity, being from a rural hometown, academic qualifications prior to medical school, or anticipated debt at medical school graduation. Students with no service interest had a higher average academic performance in medical school and plans of subspecialising. When considering volunteerism prior to medical school, students in the highest and middle volunteerism tertiles had 5.68 (95% CI: 1.63, 19.81) and 4.34 (1.32, 14.32) times the odds, respectively, of having definite or possible service interest relative to those who were in the lowest volunteerism tertile, after adjusting for potential confounders. Volunteerism in a student-run clinic for the underserved during medical school was not correlated with service interest.ConclusionsMedical schools looking to enroll more students interested in working with underserved or vulnerable populations may choose to emphasise applicant premedical volunteerism record in their admissions decisions.
Highlights
The desire of medical students to eventually work with underserved and vulnerable populations, has been shown to be shaped by individual factors including job satisfaction and financial considerations
A questionnaire was designed after conducting an extensive literature review on the factors influencing the decision of medical students to pursue a career in primary care or serve vulnerable populations
Students with definite or possible service interest were similar to those with no interest in terms of age, sex, race/ethnicity, and whether or not they were from rural hometowns
Summary
The desire of medical students to eventually work with underserved and vulnerable populations (hereafter ‘service interest’), has been shown to be shaped by individual factors including job satisfaction and financial considerations. School-level factors such as required longitudinal primary care experiences and the availability of extracurricular opportunities to work with underserved patients affect service interest, but little is known about the impact of student volunteer activities. Research has shown that job satisfaction, financial considerations, and lifestyle of physicians in the chosen specialty are major contributors to specialty choice [4, 5]. Rogers BMC Medical Education (2020) 20:133 institutions that have required longitudinal primary care experiences, [6] a school culture that values primary care, [7] and special tracks aimed at recruiting and maintaining students interested in working with underserved populations [8] are more likely to graduate students who choose primary care
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