Required first-year generalist clinical experience courses and their relationship to career choice: the critical effect of family medicine involvement.

BACKGROUND

This study examines the relationships among the presence of a required first-year generalist clinical experience (RFGCE) course, family medicine involvement in such courses, and the percentage of 1993 medical school graduates who chose family practice as a career upon graduation.

METHODS

A prospective cohort study measured predictor variables in 1989, the presence of a required third-year family medicine clerkship in 1991, and the outcome variable in 1993.

RESULTS

Data were collected from 122 US 4-year medical schools. Eighty-seven (71.3%) of 122 medical schools had RFGCE courses. In schools with courses and family medicine administrative units, family physicians were involved to some extent in most of these courses (88%). After controlling for type of medical school, the requirement of a third-year family medicine clerkship, and the involvement of a family medicine administrative unit, the presence of an RFGCE course was associated with a 3.5% increase in the number of students who selected a family practice career. This is a 28% increase on average over the mean percentage of medical students choosing a family practice career in 1993. However, in a second analysis, when all predictor variables were entered into the equation, family medicine involvement in such courses replaced the presence of such courses as a statistically significant predictor of medical students selecting family practice as a career.

CONCLUSIONS

Family physicians are involved to some extent in the great majority of RFGCE courses. Such involvement is associated with an increase in the number of medical students selecting a family practice career upon graduation from medical school.