Influence of Third-Year Clerkships on Medical Student Specialty Preferences.
Purpose - The purpose of this study was to investigate influences on third-year medical students' specialty preferences.Method - A survey questionnaire was mailed to third-year medical students at two medical schools. The questionnaire asked students to rate the degree to which various aspects of the third-year curriculum and perceived specialty characteristics influenced their specialty preferences.Results - A total of 214 (70%) of eligible students responded, of whom 46% were female and 57% preferred primary care (PC) specialties. The most frequently cited influential clerkship was internal medicine. Most clerkships (72%) had a positive influence on students' preferences. PC clerkships had more positive influences than non-primary care (NPC) clerkships, especially among PC-oriented students. The most influential aspects of clerkships were faculty and residents, especially in PC clerkships. For both PC- and NPS-oriented students, the diagnostic and patient-related characteristics of their preferred specialties were highly influential. PC-oriented students were more likely to be attracted to prevention and biopsychosocial aspects of specialties, and NPC-oriented students to the opportunity to do procedures and intervene in illnesses. Student gender appeared to have little influence on response patterns, except as a proxy for specialty preference, which, for women, was more likely to be a primary care specialty.Conclusion - These findings suggest that the third-year clerkships, especially at non-university sites, play an important role in specialty choice, and that factors attracting students to PC differ significantly from those attracting students to NPC.
Ellsbury
Kathleen E.
KE
University of Washington, Department of Family Medicine and Department of Medical Education, Box 356390, WA 98195, Seattle, USA; E-mail: Email: ellsbury@u.washington.edu
Carline
Jan D.
JD
Irby
David M.
DM
Stritter
Frank T.
FT