Journal of General Internal Medicine

, Volume 18, Issue 3, pp 159–169 | Cite as

Variation in predictors of primary care career choice by year and stage of training

A national survey
  • Maureen T. Connelly
  • Amy M. Sullivan
  • Antoinette S. Peters
  • Nancy Clark-Chiarelli
  • Natasha Zotov
  • Nina Martin
  • Steven R. Simon
  • Judith D. Singer
  • Susan D. Block
Original Articles


CONTEXT: It is not known whether factors associated with primary care career choice affect trainees differently at different times or stages of medical education.

OBJECTIVE: To examine how role models, encouragement, and personal characteristics affect career choice at different stages (medical school vs residency) and periods (1994 vs 1997) of training.

DESIGN: A split-panel design with 2 cross-sectional telephone surveys and a panel survey in 1994 and 1997.

PARTICIPANTS: A national probability sample of fourth-year students (307 in 1994, 219 in 1997), 645 second-year residents in 1994, and 494 third-year residents in 1997. Of the fourth-year students interviewed in 1994, 241 (78.5%) were reinterviewed as third-year residents in 1997.

MAIN OUTCOME MEASURE: Primary care (general internal medicine, general pediatrics, or family medicine) career choice.

RESULTS: Having a primary care role model was a stronger predictor of primary care career choice for residents (odds ratio [OR], 18.0; 95% confidence interval [95% CI], 11.2 to 28.8 in 1994; OR, 43.7; 95% CI, 24.4 to 78.3 in 1997) than for students (OR, 6.5; 95% CI, 4.3 to 10.2; no variation by year). Likewise, peer encouragement was more predictive for residents (OR, 5.4; 95% CI, 3.3 to 8.9 in 1994; OR, 16.6; 95% CI; 9.7 to 28.4 in 1997) than for students (OR, 2.1; 95% CI, 1.3 to 3.2; no variation by year). Orientation to the emotional aspects of care was consistently associated with primary care career choice across stages and years of training.

CONCLUSIONS: The effect of peer encouragement and role models on career choice differed for students and residents and, in the case of residents, by year of training, suggesting that interventions to increase the primary care workforce should be tailored to stage of training.

Key words

medical education primary care career choice role models 


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Copyright information

© Society of General Internal Medicine 2003

Authors and Affiliations

  • Maureen T. Connelly
    • 4
  • Amy M. Sullivan
    • 3
  • Antoinette S. Peters
    • 4
  • Nancy Clark-Chiarelli
    • 4
  • Natasha Zotov
    • 4
  • Nina Martin
    • 1
  • Steven R. Simon
    • 4
  • Judith D. Singer
    • 2
  • Susan D. Block
    • 3
  1. 1.the Department of Psychology and Human DevelopmentVanderbilt UniversityNashville
  2. 2.the Harvard Graduate School of EducationCambridge
  3. 3.the Division of PsychiatryBrigham and Women’s Hospital and Adult Psychosocial Oncology, Dana-Farber Cancer InstituteBoston
  4. 4.Department of Ambulatory Care and PreventionHarvard Medical School and Harvard Pilgrim Health CareBoston

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