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Internal Medicine Clerkship Directors’ Perceptions About Student Interest in Internal Medicine Careers

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Abstract

Background

Experienced medical student educators may have insight into the reasons for declining interest in internal medicine (IM) careers, particularly general IM.

Objective

To identify factors that, according to IM clerkship directors, influence students’ decisions for specialty training in IM.

Design

Cross-sectional national survey.

Participants

One hundred ten institutional members of Clerkship Directors in IM.

Measurements

Frequency counts and percentages were reported for descriptive features of clerkships, residency match results, and clerkship directors’ perceptions of factors influencing IM career choice at participating schools. Perceptions were rated on a five-point scale (1 = very much pushes students away from IM careers; 5 = very much attracts students toward IM careers).

Results

Survey response rate was 83/110 (76%); 80 answered IM career-choice questions. Clerkship directors identified three educational items attracting students to IM careers: quality of IM faculty (mean score 4.3, SD = 0.56) and IM rotation (4.1, SD = 0.67), and experiences with IM residents (3.9, SD = 0.94). Items felt most strongly to push students away from IM careers were current practice environment for internists (mean score 2.1, SD = 0.94), income (2.1, SD = 1.08), medical school debt (2.3, SD = 0.89), and work hours in IM (2.4, SD = 1.05). Factor analysis indicated three factors explaining students’ career choices: value/prestige of IM, clerkship experience, and exposure to internists.

Conclusions

IM clerkship directors believe that IM clerkship experiences attract students toward IM, whereas the income and lifestyle for practicing internists dissuade them. These results suggest that interventions to enhance the practice environment for IM could increase student interest in the field.

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Acknowledgements

We gratefully acknowledge the Clerkship Directors in Internal Medicine Research Committee and staff, and Patricia O’Sullivan, EdD, for statistical assistance.

Funding Support

The Shadyside Hospital Foundation of Pittsburgh, PA, and the American Board of Internal Medicine Foundation.

Conflict of interest statement

None disclosed.

Author information

Authors and Affiliations

  1. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Karen E. Hauer MD

  2. Warren Alpert Medical School of Brown University, Providence, RI, USA

    Mark J. Fagan MD

  3. Yale University, New Haven, CT, USA

    Walter Kernan MD

  4. George Washington University, Washington, USA

    Matthew Mintz MD

  5. USUHS, Bethesda, MD, USA

    Steven J. Durning MD

Authors
  1. Karen E. Hauer MD
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  2. Mark J. Fagan MD
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  3. Walter Kernan MD
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  4. Matthew Mintz MD
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  5. Steven J. Durning MD
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Corresponding author

Correspondence to Karen E. Hauer MD.

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Hauer, K.E., Fagan, M.J., Kernan, W. et al. Internal Medicine Clerkship Directors’ Perceptions About Student Interest in Internal Medicine Careers. J GEN INTERN MED 23, 1101–1104 (2008). https://doi.org/10.1007/s11606-008-0640-y

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  • DOI: https://doi.org/10.1007/s11606-008-0640-y

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