Factors Associated With Medical Students' Career Choices Regarding Internal Medicine
JAMAPublished 9 September 2008
Karen E. Hauer
Citations468
SJR quartileQ1
SJR score5.35
SNIP10.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Medical students valued the teaching during IM clerkships but expressed serious reservations about IM as a career, and students who reported more favorable impressions of the patients cared for by internists, the IM practice environment, and internists' lifestyle were more likely to pursue a career in IM.
Abstract
Medical students valued the teaching during IM clerkships but expressed serious reservations about IM as a career. Students who reported more favorable impressions of the patients cared for by internists, the IM practice environment, and internists' lifestyle were more likely to pursue a career in IM.
Keywords
Social SciencesMedicine
JAMAInfluence of Controllable Lifestyle on Recent Trends in Specialty Choice by US Medical Students
715 Citations2003E. Ray Dorsey, David Jarjoura +1 more
Perception of controllable lifestyle accounts for most of the variability in recent changing patterns in the specialty choices of graduating US medical students.
New England Journal of MedicineThe Emerging Role of “Hospitalists” in the American Health Care System
705 Citations1996Robert M. Wachter, Lee Goldman
The explosive growth of managed care has led to an increased role for general internists and other primary care physicians in the American health care system, and this change is welcome in many respects, since generalists have perennially been undervalued by health care institutions, payers, and even patients.
Statistics in MedicineExtending the simple linear regression model to account for correlated responses: An introduction to generalized estimating equations and multi-level mixed modelling
624 Citations1998Paul R. Burton, Lyle C. Gurrin +1 more
The paper takes the reader through the relevant practicalities of model fitting, interpretation and criticism and demonstrates that, in a simple case such as this, analyses based upon these model-based approaches produce reassuringly similar inferences to standard analysesbased upon more conventional methods.
Advances in Health Sciences EducationA Visitor's Guide to Effect Sizes – Statistical Significance Versus Practical (Clinical) Importance of Research Findings
427 Citations2004Mohammadreza Hojat, Gang Xu
An introduction to the computation and interpretation of effect sizes from the perspective of the consumer of the research literature is given.
Academic MedicineDeterminants of primary care specialty choice
396 Citations1995C J Bland, Linda N. Meurer +1 more
It is found that students predominantly enter medical school with a preference for primary care careers, but that this preference diminishes over time (particularly over the clinical clerkship years), and that two curricular experiences are associated with increases in the numbers of students choosing primary care.
New England Journal of MedicinePrimary Care — Will It Survive?
388 Citations2006Thomas Bodenheimer
It is argued that primary care is facing a confluence of factors that could spell disaster and fewer and fewer U.S. medical students are choosing to enter the field.
Academic MedicineThe Impact of U.S. Medical Students?? Debt on Their Choice of Primary Care Careers: An Analysis of Data from the 2002 Medical School Graduation Questionnaire
206 Citations2005Roger A. Rosenblatt, C. Holly A. Andrilla
Although students with higher debt levels were less likely than were their counterparts to pursue a career in primary care, the effect was modest and factors such as gender and race appeared to have more explanatory power.
Annals of Internal MedicineWeighing the Evidence for Expanding Physician Supply
190 Citations2004Richard A. Cooper
The planning model that my colleagues and I have used to assess the adequacy of physician supply is based principally on long-term economic and demographic trends, which links the demand for health care services to growth of the economy and ties the necessary size of the physician workforce to the overall dimensions of the health care system.
Academic MedicineCareer Plans for Trainees in Internal Medicine Residency Programs
156 Citations2005Richard A. Garibaldi, Carol Popkave +1 more
There has been a dramatic decrease in the number of internal medicine residents planning to pursue careers in general medicine, and this trend will likely continue for the next few years, at least, and may have an impact on the manner in which the health needs of patients are met in the future.
Annals of Internal MedicineAchieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries
152 Citations2008Jack Ginsburg
Spending on health care in the United States has been rising at a faster pace than spending in the rest of the economy since the 1960s and is expected to reach $4.0 trillion and amount to 20% of the GDP by 2015.
Academic MedicineMore Training Needed in Chronic Care: A Survey of U.S. Physicians
149 Citations2004Jonathan Darer, Wenke Hwang +3 more
Physicians perceived their medical training for chronic illness care was inadequate and medical schools and residencies may need to modify curricula to better prepare physicians to treat the growing number of people with chronic conditions.
Archives of Internal MedicineWorklife and Satisfaction of General Internists
123 Citations2002Tosha B. Wetterneck
General internists' role of caring for patients with complex problems is associated with lower levels of satisfaction than for IMSSs and FPs, and adjusting caseload for patient complexity, expanding time for office visits, and additional training in the care of patients with psychosocially complex problems may improve the job satisfaction.
Evaluation & the Health ProfessionsThe Loss of Student Idealism in the 3rd-Year Clinical Clerkships
106 Citations2001Charles H. Griffith, John F. Wilson
It is concluded that in the 3rd year of medical school students become less idealistic toward elderly patients, those with chronic pain, and the profession.
The American Journal of MedicineMedical professionalism and the generation gap
105 Citations2005Lawrence Smith
Annals of Internal MedicineMedical Student Interest in Internal Medicine
104 Citations1991Mark D. Schwartz, Mark Linzer +3 more
Factor analysis showed that three factors, "intellectual challenge of internal medicine," "primary care interests" and "the medicine clerkship" attracted students toward internal medicine, whereas three others, "taking care of chronically ill patients," "level of satisfaction among internists and medical residents," and "workload and stress" pushed students away from internal medicine.
JAMAInfluence of Income, Hours Worked, and Loan Repayment on Medical Students' Decision to Pursue a Primary Care Career
103 Citations1994Michael P. Rosenthal
Assessment of specialty plans of current fourth-year medical students finds that including such changes as part of health system reform, especially within the context of a supportive medical school environment, could enable the United States to approach a goal of graduating 50% generalist physicians.
Annals of Internal MedicineWho Is Maintaining Certification in Internal Medicine—and Why? A National Survey 10 Years after Initial Certification
102 Citations2006Rebecca S. Lipner, Wayne H. Bylsma +4 more
A national survey of ABIM diplomates who earned certificates in internal medicine, a subspecialty, or an area of added qualifications in 1990, 1991, or 1992 found the most common reasons for participation were to improve professional image and to update knowledge.
Academic MedicineFrequency and effect of negative comments (“badmouthing”) on medical studentsʼ career choices
93 Citations1996D. Daniel Hunt, Chloé Scott +2 more
It is indicated that badmouthing, while pervasive across all disciplines and an unattractive aspect of the educational experience, cannot alone account for the low proportion of graduates choosing primary care careers.
Health EconomicsHow important are economic factors in choice of medical specialty?
91 Citations2002James Thornton, Fred G. Esposto
The findings indicate that economic factors are an important influence in the specialty choice process; in particular, medical residents are attracted to specialties that offer the prospect of longer and more certain annual vacations, higher earnings, shorter residency programs, and morecertain work schedules.
Academic MedicineInfluence of medical school curriculum on primary care specialty choice
76 Citations1995Linda N. Meurer
The author critically reviewed the literature on curriculum and primary care specialty choice from 1982 through April 1993, finding that the determinants of specialty choice are multifactorial and that there are many weaknesses in the published literature, making interpretation difficult.
Academic MedicineDo Clerkship Experiences Affect Medical Studentsʼ Attitudes toward Chronically Ill Patients?
70 Citations2001Beth E. Davis, David Nelson +4 more
Students begin medical school with positive attitudes toward caring for chronically ill patients, but this perception depreciates with clinical experience, which may affect specialty decisions.
Academic MedicinePerspective: The Unintended Consequences of Training Residents in Dysfunctional Outpatient Settings
70 Citations2008Carla C. Keirns, Charles L. Bosk
Current proposals continue the trend of increasing ambulatory exposure through providing more clinical hours in the outpatient setting as a pedagogic strategy to improve residents' practical skills in providing quality care in outpatient settings.
PubMedCareer preferences of medical students: influence of a new four-week attachment in general practice.
66 Citations1996Joe Morrison, T S Murray
The general practice attachment influenced students, especially males, towards a career in general practice, but this effect was transient and this cohort of doctors should be followed up in order to discover their ultimate career choices.
The American Journal of MedicineGeneral internists influence students to choose primary care careers: The power of role modeling
59 Citations1996Mark C. Henderson, Debra K. Hunt +1 more
Although career choice is clearly related to personal characteristics such as socioeconomic background and humanistic qualities, a high degree of exposure to general internists during the medicine clerkship is associated with choosing primary care.
Academic MedicineImpact of Reduced Duty Hours on Residents?? Educational Satisfaction at the University of California, San Francisco
58 Citations2006Arpana R. Vidyarthi, Patricia Katz +3 more
Educational satisfaction may be more a function of workload than hours worked; therefore, systematic changes to residents' work-life may be necessary to improve educational satisfaction.
PubMedIs medical student choice of a primary care residency influenced by debt?
52 Citations2006Marc J. Kahn, Ronald J. Markert +4 more
It is concluded that medical students make residency decisions on the basis of a complex set of factors and total debt was not a predictor of a PC residency after adjusting for medical school, year of graduation, and years of training in residency.
Academic MedicineThe More Things Change
48 Citations2002William B. Weeks, Amy E. Wallace
Although it remains the lowest of all professional groups examined, primary care medicine has made the largest percentage gain in net present value of all groups and the standing of physicians relative to other professional groups has not changed.
Academic MedicineA longitudinal, national study of the effect of implementing a required third-year family practice clerkship or a department of family medicine on the selection of family medicine by medical students
48 Citations1999Doug Campos‐Outcalt, Janet H. Senf
Implementing a required third-year family practice clerkship led to an immediate, significant increase in the proportion of students choosing family practice.
Academic MedicineThe Changing Paradigm of Contemporary U.S. Allopathic Medical School Graduates??? Career Paths: Analysis of the 1997???2004 National AAMC Graduation Questionnaire Database
44 Citations2007Donna B. Jeffe, Dorothy A. Andriole +2 more
As the medical student population becomes more demographically diverse, as graduates increasingly select non-primary-care specialties, and as dual-degree-program graduates and alternative career opportunities for physicians expand, the proportion of U.S. graduates planning full-time clinical practice careers likely will continue to decline.
Journal of General Internal MedicineEducational and career outcomes of an internal medicine preceptorship for first-year medical students
44 Citations1999D. Michael Elnicki, Kevin Halbritter +2 more
The PIM course is an intervention, early in students’ careers, which appears to benefit them academically and increase their interest in internal medicine as a career.
International Journal of Health Care Finance and EconomicsThe Growth of Managed Care and Changes in Physicians' Incomes, Autonomy, and Satisfaction, 1991–1997
43 Citations2002Jack Hadley, Jean M. Mitchell
Using survey data collected in 1991 and 1997 from a panel of almost 1,500 physicians, the relationship between changes in physicians' incomes, practice autonomy, and satisfaction, and the growth of HMOs and physicians' perceived financial incentives was analyzed.
Academic MedicineTraining U.S. Medical Students to Care for the Chronically Ill
41 Citations2004Hoangmai H. Pham, Lisa Simonson +4 more
Medical schools can improve training in chronic care by paying greater attention to specific methods for addressing important chronic care competencies, including screening for abuse, awareness of patients’ sociocultural perspectives, and protecting patients' confidentiality.
Academic MedicineThe Effect of Medical Education on Primary Care Orientation
39 Citations2001William M. Zinn, Amy Sullivan +5 more
There was a decline over time in students' reported orientations to socioemotional aspects of patient care as they progressed through medical school into residency and a positive shift in the attitudes of peers and faculty toward primary care.
Annals of Internal MedicineLeaving (Internal) Medicine
26 Citations2006Harold C. Sox
Young physicians are leaving general internal medicine much faster than they are leaving the subspecialties of internal medicine, an article by Lipner and colleagues in this issue contains a serendipitous but important finding.
Journal of General Internal MedicineThe impact of an ambulatory rotation on medical student interest in internal medicine
24 Citations1995Mark D. Schwartz, Mark Linzer +4 more
An ambulatory rotation is strongly associated with positive perceptions of, attraction to, and choice of a career in internal medicine, which could help attract more students to internal medicine.
Journal of General Internal MedicineInternal Medicine Clerkship Directors’ Perceptions About Student Interest in Internal Medicine Careers
20 Citations2008Karen E. Hauer, Mark J. Fagan +3 more
The results suggest that interventions to enhance the practice environment for IM could increase student interest in the field, and believe that IM clerkship experiences attract students toward IM, whereas the income and lifestyle for practicing internists dissuade them.
BMC Medical EducationThe impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotions
18 Citations2006Dongseok Choi, Jamie Dickey +2 more
With the implementation of the ACGME work hour limitations, the training experience became more negative for those residents who violated the work hour limits and had a small positive impact on those who did not violate them.
PubMedEffect of generalist preceptor specialty in a third-year clerkship on career choice.
16 Citations2002John D. Gazewood, John Owen +1 more
It is indicated that the type of generalist experience received during the third year did not affect students' choice of a generalist career, nor did it influence their career choice between the generalist specialties.
PubMedRequired first-year generalist clinical experience courses and their relationship to career choice: the critical effect of family medicine involvement.
14 Citations1996M B Mengel, Alan B. Davis
Family physicians are involved to some extent in the great majority of RFGCE courses, and such involvement is associated with an increase in the number of medical students selecting a family practice career upon graduation from medical school.