Madison D L
Department of Social Medicine, University of North Carolina, Chapel Hill School of Medicine, 27599-7240.
Acad Med. 1994 Oct;69(10):825-31. doi: 10.1097/00001888-199410000-00012.
To examine the medical school applications of physicians who are now established in their careers to see whether any of the applicants' data might have had predictive value for the admission process of a medical school wishing to increase its production of generalist physicians.
Three members of the Committee on Admissions of the University of North Carolina at Chapel Hill School of Medicine followed the same procedure they use when reviewing current medical school applicants in reading the applications of 148 graduates of the class of 1985. The readers recorded data from all parts of the American Medical College Application Service form--face sheet, personal statement, and the record of course work--and used alumni records and published physician locators to determine these class members' whereabouts and the specialties (and subspecialties) they were practicing 13 or 14 years after applying to medical school.
Thirty-four percent of the class had elected generalist medical careers (the practice of family medicine, general internal medicine, or general pediatrics). A high service index (reflective of a demonstrated orientation toward community service prior to medical school matriculation) predicted strongly the choice of a generalist medical career. Conversely, the absence of any clear evidence of a service orientation predicted still more strongly a non-generalist career. Less strong predictors of a generalist practice included the selection of a generous number of non-science-content courses as an undergraduate, lower socioeconomic family origin, and a record of leadership in one or more extracurricular activities during college.
If an admission committee informs itself of "what finally happens" to those it admits, its decisions can contribute to achieving whatever policy its medical school adopts with respect to the mix of physicians it wishes to produce.
研究现已步入职业生涯的医生当初申请医学院时的相关资料，以探究申请人的某些数据是否对希望增加全科医生培养数量的医学院招生过程具有预测价值。
北卡罗来纳大学教堂山分校医学院招生委员会的三名成员，在审阅1985届148名毕业生的申请材料时，采用了他们在评审当前医学院申请者时所使用的相同程序。审阅人员记录了美国医学院申请服务表格所有部分的数据——封面、个人陈述以及课程学习记录——并利用校友记录和公开的医生名录来确定这些班级成员在申请医学院13或14年后的去向以及他们所从事的专业（和亚专业）。
该班级中有34%的人选择了全科医学职业（家庭医学、普通内科或普通儿科）。高服务指数（反映出在医学院入学前已表现出的社区服务倾向）对选择全科医学职业具有很强的预测作用。相反，没有任何明确的服务倾向证据则更能有力地预测其选择非全科医学职业。对全科医学实践的预测作用相对较弱的因素包括本科阶段选择了大量非科学课程、较低的社会经济家庭出身以及大学期间在一项或多项课外活动中的领导记录。
如果招生委员会了解其录取者的“最终去向”，那么其决策就能有助于实现医学院在希望培养的医生类型组合方面所采取的任何政策。
