The Relationship Between Entering Medical Students' Backgrounds and Career Plans and Their Rural Practice Outcomes Three Decades Later
The Relationship Between Entering Medical Students' Backgrounds and Career Plans and Their Rural Practice Outcomes Three Decades Later
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DOI：
10.1097/acm.0b013e3182488c06
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发表时间：
2012-04-01
影响因子：
7.4
通讯作者：
Santana, Abbie J.
中科院分区：
文献类型：
--
作者：
Rabinowitz, Howard K.;Diamond, James J.;Santana, Abbie J.
虽然许多研究调查了农村地区医生执业的预测因素，但很少有研究考虑到医生背景的重要性。方法对1 111名1978-1982届杰斐逊医学院(JMC)毕业生进行了杰斐逊医学教育纵向研究，获得了3个与农村实习相关的因素：成长农村、规划农村实践、规划家庭医学。他们2007年的实习地点被确定为农村地区与非农村地区。结果资料完整的762名(69%)JMC毕业生中，172名(23%)在农村实习。在所有三个预测者中，45%(45/99)的毕业生在农村地区执业，而有两个预测者的比例为33%(48/145)，有一个预测者的比例为21%(42/198)，没有预测者的比例为12%(37/320)。2007年在农村执业的医生中，只有22%的人没有预测因素。结论医学院校入学时已知的三个因素与30年后的农村执业有很强的相关性。没有预测因素的学生相对较少在农村地区执业，这一点尤其重要，因为随后的因素已知与农村实习有关--例如，农村课程、居住地或配偶。这些结果对医学院招生过程在培养乡村医生方面的作用有重大影响。
PurposeAlthough many studies have investigated predictors of physician practice in rural areas, few have accounted for the importance of physicians' backgrounds. This study analyzed the relationship between the backgrounds and future career plans of entering medical students and their rural practice outcomes.MethodFor 1,111 graduates from Jefferson Medical College (JMC, classes of 1978-1982), three factors self-reported at matriculation and previously related to rural practice were obtained from the Jefferson Longitudinal Study of Medical Education: growing up rural, planning rural practice, and planning family medicine. Their 2007 practice location was determined to be in a rural versus nonrural area. Analyses of graduates with various numbers of predictive factors (0 -3) and rural practice were performed.ResultsOf the 762 JMC graduates (69%) with complete data, 172 (23%) were practicing in rural areas. Of graduates with all three predictors, 45% (45/99) practiced in rural areas compared with 33% (48/145) of those with two predictors, 21% (42/198) with one predictor, and 12% (37/320) of those with none. Of physicians practicing in rural areas in 2007, only 22% had no predictors.ConclusionsThree factors known at the time of medical school matriculation have a powerful relationship with rural practice three decades later. Relatively few students without predictors practice in rural areas, which is particularly significant given subsequent factors known to be related to rural practice-for instance, rural curriculum, residency location, or spouse. These results have major implications for the role of the medical school admissions process in producing rural physicians.