Influence of medical school curriculum on primary care specialty choice: analysis and synthesis of the literature. Acad Med 1995 May;70(5):388-97
Date
05/01/1995Pubmed ID
7748384DOI
10.1097/00001888-199505000-00015Scopus ID
2-s2.0-0029025519 (requires institutional sign-in at Scopus site) 68 CitationsAbstract
There is a growing consensus that the proportion of primary care physicians in the United States is inadequate to meet health care needs. Many graduating medical students continue to choose to subspecialize. The literature on curriculum and specialty choice is fraught with confounders and a lack of randomized trials, and recommendations for strategies to increase the production of generalists have not been based on clear evidence that the interventions will be effective, thus making it difficult for medical schools to react responsibly to these recommendations. To assist educators and policymakers in their efforts to produce more generalists, the author critically reviewed the literature on curriculum and primary care specialty choice from 1982 through April 1993. A literature search was conducted using the MEDLINE, Educational Resources Information Center, and PsychInfo databases. Of more than 150 studies found in the search, 31 were determined to be relevant and to meet inclusion criteria. The results confirm that the determinants of specialty choice are multifactorial and that there are many weaknesses in the published literature, making interpretation difficult. Important trends did emerge, however, providing direction for intervention and recommendations for further investigation. The evidence suggests that three types of curricular experiences may increase interest in primary care: third-year required family medicine clerkships (especially those that are six, rather than four, weeks long), continuity experiences in primary care settings, and, most promising of all, primary care tracks.
Author List
Meurer LNAuthor
Linda N. Meurer MD, MPH Professor in the Family Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Career ChoiceCurriculum
Education, Medical
Humans
Medicine
Primary Health Care
Specialization
