Does the instructional quality of community-based clinical clerkships influence students' career preferences?

Abstract

The purpose of this study was to explore the association between student evaluation of their community-based clinical clerkship, their attitudes towards community health care and their career preferences. Self-administered pre- and post-questionnaire surveys were given to 693 fifth-year medical students participating in a two-week community-based clinical clerkship. Items measured were student preference for a career in primary care, student evaluation of the programme and student attitudes towards community health care. Six hundred and forty-five students (93.1%), 494 (76.6%) male and 151 (23.4%) female, completed the pre- and post-questionnaires. Student preference for a career in primary care (75.4 ± 20.2) increased after the clinical clerkship. By multivariate analysis, it was found that evaluation of the programme ('The programme was a worthwhile learning experience.' [multivariate regression coefficient: 0.143, p=0.014]) and their attitude ('I think practising community health care is worthwhile.' [0.367, p<0.001]) were strongly associated with the increase in preference for a career as a primary care physician after the clinical clerkship. Community-based education increases student preference for a future career as a primary care physician. Providing programmes of a high instructional quality further increases the chance of student physicians choosing a future career as a primary care physician.