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Third-Year Medical Student Attitudes Toward Internal Medicine

Third-Year Medical Student Attitudes Toward Internal Medicine Abstract Background: Student attitudes offer insight into career decisions and may suggest causes of the diminished interest in internal medicine. Students entering a salaried managed health care environment may have different attitudes about careers and potential income. Additionally, we evaluate the effect of an ambulatory experience on student attitudes and career selection. Methods: We surveyed 163 medical students from the Uniformed Services University of the Health Sciences, Bethesda, Md, at the successful completion of the third year to determine their attitudes regarding the work, life-style, prestige, patient type, and challenge of internal medicine, as well as primary care interest, and the importance of income in career selection. A subgroup of 107 volunteers was randomized to either the traditional internal medicine clerkship (n=69), or to 6 weeks of ambulatory medicine and 6 weeks of ward medicine (n=38). Results: The selection rate was low for internal medicine (10%) and was high for family practice and transitional internships (37%). Although most students highly valued their internal medicine training, relatively few selected internal medicine as a career. Students saw chronic illness and type of work, but not lifestyle, as disincentives toward choosing an internal medicine career. Half of the students believed that income potential would be a major factor in attracting students into internal medicine, and that reimbursement should be shifted from procedural fields to primary care. The ambulatory clerkship did not affect student attitudes nor type of internship selected. Conclusions: Medicine clerkships, whether traditional or ambulatory, are highly valued educational experiences yet may be insufficient by themselves to attract students to an internal medicine career. Income potential remains an important concern in the setting of salaried managed care, even for students who lack financial debt.(Arch Intern Med. 1994;154:2459-2464) References 1. 1993 National Residency Match Program. Evanston, III: National Residency Match Program; 1993. 2. Schwartz MD, Linzer M, Babbott D, Divine GW, Broadhead E. Medical student interest in internal medicine . Ann Intern Med. 1991;114:6-15.Crossref 3. Kassirer JP. Primary care and the affliction of internal medicine . N Engl J Med. 1993;328:648-651.Crossref 4. Levinsky NG. Recruiting for primary care . N Engl J Med. 1993;328:656-660.Crossref 5. Petersdorf RG. Financing of medical education . N Engl J Med. 1993;328:651-654.Crossref 6. Rivo ML. Internal medicine and the journey to medical generalism . Ann Intern Med. 1993;119:146-152.Crossref 7. Stimmel B. The crisis in primary care and the role of medical schools . JAMA . 1992;268:2060-2065.Crossref 8. Babbott D, Baldwin DC, Jolly HP, Williams DJ. The stability of early specialty preferences among US medical school graduates in 1983 . JAMA . 1988;259: 1970-1975.Crossref 9. Bashook PR, Weissman S. Senior medical students' attitudes toward patients: influence on career choice . J Med Educ. 1981;108:101-115. 10. Schwartz RW, Haley JV, Williams C, et al. The controllable lifestyle factor and students' attitudes about specialty selection . Acad Med. 1990;65:207-210.Crossref 11. Robinson JP, Athanasiou R, Head KB. Measures of Occupational Attitudes and Occupational Characteristics . Ann Arbor, Mich: Institute for Social Research at the University of Michigan; 1989:145-161. 12. DeForge BR, Richardson JP, Stewart DL. Attitudes of graduating seniors at one medical school toward family practice . Fam Med. 1993;25:111-113. 13. Babbott D, Levey GS, Weaver SO, Killian CD. Medical student attitudes about internal medicine: a study of US medical school seniors in 1988 . Ann Intern Med. 1991;114:16-22.Crossref 14. Colwill JM. Where have all the primary care applicants gone? N Engl J Med. 1992;326:387-393.Crossref 15. Kassebaum DG, Haynes RA. Relationship between third-year clerkships in family medicine and graduating students' choices of family practice careers . Acad Med. 1992;67:217-219.Crossref 16. Bauer RL, Venkatachalam H, Forrester R, Harris G, Diehl AK. Ambulatory care in the third year clerkship: effect on career choice: a randomized trial . Clin Res. 1991;39:614. Abstract. 17. Babbott D, Baldwin DC, Killian CD, Weaver SO. Trends in evolution of specialty choice . JAMA . 1989;261:2367-2373.Crossref 18. Rosoff SM, Leone MC. The public prestige of medical specialties: overviews and undercurrents . Soc Sci Med. 1991;32:321-326.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Third-Year Medical Student Attitudes Toward Internal Medicine

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420210097011
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Student attitudes offer insight into career decisions and may suggest causes of the diminished interest in internal medicine. Students entering a salaried managed health care environment may have different attitudes about careers and potential income. Additionally, we evaluate the effect of an ambulatory experience on student attitudes and career selection. Methods: We surveyed 163 medical students from the Uniformed Services University of the Health Sciences, Bethesda, Md, at the successful completion of the third year to determine their attitudes regarding the work, life-style, prestige, patient type, and challenge of internal medicine, as well as primary care interest, and the importance of income in career selection. A subgroup of 107 volunteers was randomized to either the traditional internal medicine clerkship (n=69), or to 6 weeks of ambulatory medicine and 6 weeks of ward medicine (n=38). Results: The selection rate was low for internal medicine (10%) and was high for family practice and transitional internships (37%). Although most students highly valued their internal medicine training, relatively few selected internal medicine as a career. Students saw chronic illness and type of work, but not lifestyle, as disincentives toward choosing an internal medicine career. Half of the students believed that income potential would be a major factor in attracting students into internal medicine, and that reimbursement should be shifted from procedural fields to primary care. The ambulatory clerkship did not affect student attitudes nor type of internship selected. Conclusions: Medicine clerkships, whether traditional or ambulatory, are highly valued educational experiences yet may be insufficient by themselves to attract students to an internal medicine career. Income potential remains an important concern in the setting of salaried managed care, even for students who lack financial debt.(Arch Intern Med. 1994;154:2459-2464) References 1. 1993 National Residency Match Program. Evanston, III: National Residency Match Program; 1993. 2. Schwartz MD, Linzer M, Babbott D, Divine GW, Broadhead E. Medical student interest in internal medicine . Ann Intern Med. 1991;114:6-15.Crossref 3. Kassirer JP. Primary care and the affliction of internal medicine . N Engl J Med. 1993;328:648-651.Crossref 4. Levinsky NG. Recruiting for primary care . N Engl J Med. 1993;328:656-660.Crossref 5. Petersdorf RG. Financing of medical education . N Engl J Med. 1993;328:651-654.Crossref 6. Rivo ML. Internal medicine and the journey to medical generalism . Ann Intern Med. 1993;119:146-152.Crossref 7. Stimmel B. The crisis in primary care and the role of medical schools . JAMA . 1992;268:2060-2065.Crossref 8. Babbott D, Baldwin DC, Jolly HP, Williams DJ. The stability of early specialty preferences among US medical school graduates in 1983 . JAMA . 1988;259: 1970-1975.Crossref 9. Bashook PR, Weissman S. Senior medical students' attitudes toward patients: influence on career choice . J Med Educ. 1981;108:101-115. 10. Schwartz RW, Haley JV, Williams C, et al. The controllable lifestyle factor and students' attitudes about specialty selection . Acad Med. 1990;65:207-210.Crossref 11. Robinson JP, Athanasiou R, Head KB. Measures of Occupational Attitudes and Occupational Characteristics . Ann Arbor, Mich: Institute for Social Research at the University of Michigan; 1989:145-161. 12. DeForge BR, Richardson JP, Stewart DL. Attitudes of graduating seniors at one medical school toward family practice . Fam Med. 1993;25:111-113. 13. Babbott D, Levey GS, Weaver SO, Killian CD. Medical student attitudes about internal medicine: a study of US medical school seniors in 1988 . Ann Intern Med. 1991;114:16-22.Crossref 14. Colwill JM. Where have all the primary care applicants gone? N Engl J Med. 1992;326:387-393.Crossref 15. Kassebaum DG, Haynes RA. Relationship between third-year clerkships in family medicine and graduating students' choices of family practice careers . Acad Med. 1992;67:217-219.Crossref 16. Bauer RL, Venkatachalam H, Forrester R, Harris G, Diehl AK. Ambulatory care in the third year clerkship: effect on career choice: a randomized trial . Clin Res. 1991;39:614. Abstract. 17. Babbott D, Baldwin DC, Killian CD, Weaver SO. Trends in evolution of specialty choice . JAMA . 1989;261:2367-2373.Crossref 18. Rosoff SM, Leone MC. The public prestige of medical specialties: overviews and undercurrents . Soc Sci Med. 1991;32:321-326.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 14, 1994

References