Factors Influencing Primary Care Residency Selection among Students at an Urban Private Medical School

Abstract

This study investigated factors influencing primary care–focused students’ selection of a family medicine residency at a private urban medical school. Reasons for why or why not students chose family medicine as opposed to other primary care–focused residencies is discussed. A questionnaire was sent to all fourth-year students (N=157) selected for residency with a primary care focus (medicine and pediatrics (medicine/pediatrics), emergency medicine (EM), obstetrics/gynecology (OB/GYN), internal medicine, pediatrics, and family medicine) from 2006 to 2008. Sixty-three surveys were completed. Respondents reported the most influential factor in primary care selection was patient-care model, followed by patient population and mentor/role model. The factor reported as having the strongest positive and negative influence on residency choice was clerkship experience. Half of respondents (53%) reported being told or directly overhearing negative comments about their career interest in primary care frequently (5+ times) during clinical clerkships. The most frequently cited reasons for not pursuing family medicine as a residency choice were broad focus, lack of prestige, and stereotype of family medicine as a nonacademic field. The Department of Family Medicine is focusing on strategies to combat these perceptions and expose students to positive primary care experiences early in their medical education. Action must be taken to monitor and address family medicine’s negative stereotype, as it has a clear presence in medical education and may have a negative influence on residency selection.