Department of Family and Community Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Acad Med. 2012 Aug;87(8):1086-90. doi: 10.1097/ACM.0b013e31825cfa54.
To analyze the previously unknown relationships between the specialty plans of entering medical students and their eventual rural practice outcomes.
For 5,419 graduates from the 1978-2002 classes of Jefferson Medical College, their self-reported specialty plans at the time of matriculation were obtained from the Jefferson Longitudinal Study, as were their 2007 practice locations. Specialty plans were grouped into 12 categories, and the percentages of graduates initially planning each specialty group who were actually practicing in rural areas were determined.
Entering medical students' specialty plans were strongly related to eventual rural practice (P < .001). Those students planning family medicine were "highly likely" to practice in rural areas (29.4%, 238/810). They were 1.5 times as likely to practice rural as a "mid-likely" group (those planning general surgery, psychiatry, emergency medicine, general internal medicine, or one of the medical subspecialties: 19.6% [range 17.9%-21.0%], 229/1,167). Students planning family medicine were also 2.1 times as likely to practice rural as those students planning a "lower-likely" group (those planning general pediatrics, one of the surgical subspecialties, the hospital specialties of radiology, anesthesiology and pathology, and obstetrics-gynecology, or other specialties: 14.0% [range 13.0%-14.3%], 142/1,016).
These findings show that students' specialty plans at medical school matriculation are significantly related to rural outcomes, and they provide new information quantifying the absolute and relative likelihood of those planning various specialties to enter rural practice. This information is particularly important for medical schools that have or plan to develop comprehensive rural programs.
分析医学生入学时的专业计划与最终农村执业结果之间以前未知的关系。
从杰斐逊纵向研究中获取了 1978-2002 届杰斐逊医学院的 5419 名毕业生在入学时的自我报告专业计划，以及他们在 2007 年的执业地点。将专业计划分为 12 类，确定最初计划每个专业组的毕业生中实际在农村地区执业的百分比。
入学医学生的专业计划与最终农村执业密切相关（P<0.001）。那些计划从事家庭医学的学生“极有可能”在农村地区执业（29.4%，238/810）。他们从事农村执业的可能性是“中等可能”群体（计划从事普通外科、精神病学、急诊医学、普通内科或医学亚专业之一的可能性的 1.5 倍：19.6%[范围 17.9%-21.0%]，229/1167）。计划从事家庭医学的学生从事农村执业的可能性也比计划从事“低等可能”群体的学生高 2.1 倍（计划从事普通儿科、外科亚专业之一、放射科、麻醉科和病理科、妇产科等医院专科或其他专科的可能性：14.0%[范围 13.0%-14.3%]，142/1016）。
这些发现表明，学生在医学院入学时的专业计划与农村结果显著相关，并且它们提供了量化计划从事各种专业的学生进入农村执业的绝对和相对可能性的新信息。这些信息对于已经或计划制定全面农村计划的医学院校尤为重要。
