The effect of a medical school's admission and curriculum policies on increasing the number of physicians in primary care specialties.

Abstract

The Charles R. Drew University of Medicine and Science, which is affiliated with the University of California, Los Angeles, UCLA School of Medicine, has a mission to increase the number of physicians pursuing careers in primary care and/or providing care to the underserved. The authors sought to determine whether Drew's initial classes are pursuing career paths consistent with the institution's mission. In June 1992 the alumni from the Drew and UCLA classes of 1985 through 1987 were mailed questionnaires to ascertain their specialty choices and practice settings. Responses were analyzed using bivariate analyses and multiple logistic regression. The response rates were 89% (402 of 454) for the UCLA graduates and 76% (44 of 58) for the Drew graduates. Bivariate analyses showed that Hispanics, women, older individuals, and Drew graduates were more likely to choose primary care specialties (p < .001 for each variable). Multiple logistic regression also showed that these variables predicted primary care career choice: for being a Hispanic, odds ratio (OR) = 3.2, 95% CI (1.66, 6.35); for being a woman, OR = 1.9, 95% CI (1.28, 2.97); for being older, OR = .92, 95% CI (.86, .99); and for being a Drew graduate, OR = 2.4, 95% CI (1.09, 5.27). Older graduates practiced in underserved areas more than did younger ones (26% vs 13%, p = .03). To some degree, Drew has fulfilled its mission of graduating physicians who are primary care specialists and/or practice in underserved areas; however, the results raise questions regarding possible early influences on career choice.