Effect of the inpatient general medicine rotation on student pursuit of a generalist career.
BACKGROUND
Entry into general internal medicine (GIM) has declined. The effect of the inpatient general medicine rotation on medical student career choices is uncertain.


OBJECTIVE
To assess the effect of student satisfaction with the inpatient general medicine rotation on pursuit of a career in GIM.


METHODS
Multicenter cohort study.


METHODS
Third-year medical students between July 2001 and June 2003.


METHODS
End-of-internal medicine clerkship survey assessed satisfaction with the rotation using a 5-point Likert scale. Pursuit of a career in GIM defined as: (1) response of "Very Likely" or "Certain" to the question "How likely are you to pursue a career in GIM?"; and (2) entry into an internal medicine residency using institutional match data.


RESULTS
Four hundred and two of 751 (54%) students responded. Of the student respondents, 307 (75%) matched in the 2 years following their rotations. Twenty-eight percent (87) of those that matched chose an internal medicine residency. Of these, 8% (25/307) were pursuing a career in GIM. Adjusting for site and preclerkship interest, overall satisfaction with the rotation predicted pursuit of a career in GIM (odds ratio [OR] 3.91, P<.001). Although satisfaction with individual items did not predict pursuit of a generalist career, factor analysis revealed 3 components of satisfaction (attending, resident, and teaching). Adjusting for preclerkship interest, 2 factors (attending and teaching) were associated with student pursuit of a career in GIM (P<.01).


CONCLUSIONS
Increased satisfaction with the inpatient general medicine rotation promotes pursuit of a career in GIM.
Arora
Vineet
V
Department of Medicine, University of Chicago, Chicago, IL, USA. varora@medicine.bsd.uchicago.edu
Wetterneck
Tosha B
TB
Schnipper
Jeffrey L
JL
Auerbach
Andrew D
AD
Kaboli
Peter
P
Wachter
Robert M
RM
Levinson
Wendy
W
Humphrey
Holly J
HJ
Meltzer
David
D
D002321:Career Choice; D002982:Clinical Clerkship; D015331:Cohort Studies; D005163:Factor Analysis, Statistical; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007588:Job Satisfaction; D016015:Logistic Models; D015999:Multivariate Analysis; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires