title: Variation in predictors of primary care career choice by year and stage of training.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A split-panel design with 2 cross-sectional telephone surveys and a panel survey in 1994 and 1997.
  
  
  METHODS
  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 re-interviewed as third-year residents in 1997.
  
  
  METHODS
  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.
authors.affiliation: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass 02215, USA. maureen_connelly@hphc.org
authors.forename: Maureen T
authors.initials: MT
authors.lastname: Connelly
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sullivan
authors.forename: Antoinette S
authors.initials: AS
authors.lastname: Peters
authors.forename: Nancy
authors.initials: N
authors.lastname: Clark-Chiarelli
authors.forename: Natasha
authors.initials: N
authors.lastname: Zotov
authors.forename: Nina
authors.initials: N
authors.lastname: Martin
authors.forename: Steven R
authors.initials: SR
authors.lastname: Simon
authors.forename: Judith D
authors.initials: JD
authors.lastname: Singer
authors.forename: Susan D
authors.initials: SD
authors.lastname: Block
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D005260:Female; D006801:Humans; D007396:Internship and Residency; D016015:Logistic Models; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013337:Students, Medical; D014481:United States