Influence of income, hours worked, and loan repayment on medical students' decision to pursue a primary care career.
Influence of income, hours worked, and loan repayment on medical students' decision to pursue a primary care career.
复制标题
收入、工作时间和贷款偿还对医学生从事初级保健职业的决定的影响。
DOI：
10.1001/jama.1994.03510360040033
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
M. Ruffin
中科院分区：
文献类型：
--
作者：
M. P. Rosenthal;J. J. Diamond;H. Rabinowitz;Laurence C. Bauer;Robert L. Jones;Gary W. Kearl;Robert B. Kelly;Kent J. Sheets;Arnold Jaffe;A. Patrick;M. Ruffin
OBJECTIVE
To assess the specialty plans of current fourth-year medical students and, for those not choosing primary care specialties, to investigate the potential effect that changes in key economic or lifestyle factors could have in attracting such students to primary care.
DESIGN AND PARTICIPANTS
A survey study was sent to 901 fourth-year medical students in the 1993 graduating classes of six US medical schools.
OUTCOME MEASURES
Comparisons were made between students choosing and not choosing primary care specialties. For the non-primary care students, we also evaluated whether alteration of income, hours worked, or loan repayment could attract them to primary care careers.
RESULTS
Of the 688 responses (76% response rate), primary care specialties were chosen by 27% of the students and non-primary care specialties by 73%. One quarter (25%) of the non-primary care students indicated they would change to primary care for one of the following factors: income (10%), hours worked (11%), or loan repayment (4%). For students whose debt was $50,000 or greater, the loan repayment option became much more important than for students with lesser debt. In all, a total of 45% (n = 313) of the students indicated either they were planning to enter primary care (n = 188) or they would change to a primary care specialty (n = 125) with appropriate adjustments in income, hours worked, or loan repayment.
CONCLUSION
Significant changes in economic and lifestyle factors could have a direct effect on the ability to attract students to primary care. Including such changes as part of health system reform, especially within the context of a supportive medical school environment, could enable the United States to approach a goal of graduating 50% generalist physicians.
