Abstract
BackgroundIndiana University School of Medicine (IUSM) employs eight regional basic science campuses, where half of the students complete their first two years of medical school. The other half complete all four years at the main campus in Indianapolis. The authors tested the hypothesis that training at regional campuses influences IUSM students to pursue primary care careers near the regional campuses they attended.MethodsMedical school records for 2,487 graduates (classes of 1988–1997) were matched to the 2003 American Medical Association Physician Masterfile to identify the medical specialty and practice location of each graduate. Multivariate logistic regression was performed to assess the effect of regional campus attendance on students' choice of medical specialty and practice location, while simultaneously adjusting for several covariates thought to affect these career outcomes.ResultsCompared to Indianapolis students, those who attended a regional campus were somewhat more likely to be white, have parents with middle class occupations, and score slightly lower on the Medical College Admission Test. Any such differences were adjusted for in the regression models, which predicted that four of the regional campuses were significantly more likely than Indianapolis to produce family practitioners, and that five of the regional campuses were significantly more likely than the others to have former students practicing in the region. When analyzed collectively, attendance at any regional campus was a significant predictor of a primary care practice located outside the Indianapolis metropolitan area.ConclusionAttending a regional campus for preclinical training appears to increase the likelihood of practicing primary care medicine in local communities.
Highlights
Indiana University School of Medicine (IUSM) employs eight regional basic science campuses, where half of the students complete their first two years of medical school
According to the regression models, four of the regional campuses were significantly more likely than Indianapolis to produce family practitioners, and five of the regional campuses were significantly more likely than the others to have former students practicing in the region
Attendance at any regional campus was a significant predictor of a primary care practice located outside the Indianapolis metropolitan area
Summary
Indiana University School of Medicine (IUSM) employs eight regional basic science campuses, where half of the students complete their first two years of medical school. The proportion of U.S medical graduates matching into primary care residency programs–internal medicine, family medicine, and pediatrics–has fallen sharply since 1998 [1]. This trend, coupled with anticipated shortages in the physician workforce [2], have renewed worries among policy-makers of a looming health care crisis resulting from inadequate access to primary care medicine [3]. It is more important to know how to get the right mix of physicians to practice where they are most needed To accomplish this goal will require a better understanding of the complex interplay of variables that influence medical students' career choices
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