title: Primary care residency choice and participation in an extracurricular longitudinal medical school program to promote practice with medically underserved populations.
abstract: OBJECTIVE
  In 2006, the University of Washington School of Medicine (UWSOM) launched the Underserved Pathway (UP), an extracurricular longitudinal experience supporting student interest in caring for underserved populations. This study examined the association between UP participation and residency choice.
  
  
  METHODS
  The study population was 663 UWSOM graduates who matched to a residency from 2008 to 2011; 69 were UP participants. Outcomes included matching to primary care residencies (family medicine, internal medicine, pediatrics, or medicine-pediatrics). The authors calculated graduate rates and odds of UP participants versus nonparticipants matching to primary care residencies overall and to residencies in individual primary care specialties. This analysis included all graduates and 513 graduates who had dual interest in primary care and underserved care at matriculation. Of 336 graduates matching to primary care, the authors calculated rates of entering the individual specialties with respect to UP participation.
  
  
  RESULTS
  UP participants matched at significantly higher rates than nonparticipants to primary care (72.5% versus 48.1%, adjusted odds ratio [OR] 2.2) and family medicine residencies (33.3% versus 15.0%, adjusted OR 2.9). Of graduates with dual matriculation interest in primary care and underserved care, 73.4% of participants versus 53.5% of nonparticipants matched to primary care (adjusted OR 1.9), and 31.2% of participants versus 18.0% of nonparticipants matched to family medicine (adjusted OR 2.1). Of primary care matched graduates, 46.0% of participants versus 31.1% of nonparticipants entered family medicine.
  
  
  CONCLUSIONS
  Supporting student interest in underserved careers is associated with higher rates of graduates entering primary care residencies, specifically family medicine.
authors.affiliation: Dr. Kost is assistant professor, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington. Mr. Benedict is a fourth-year student, University of Washington School of Medicine, Seattle, Washington. Ms. Andrilla is biostatistician and research scientist, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Osborn is assistant professor, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Dobie is professor, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Amanda
authors.initials: A
authors.lastname: Kost
authors.forename: Joseph
authors.initials: J
authors.lastname: Benedict
authors.forename: C Holly A
authors.initials: CH
authors.lastname: Andrilla
authors.forename: Justin
authors.initials: J
authors.lastname: Osborn
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Dobie
mesh_terms: D000328:Adult; D002321:Career Choice; D005194:Family Practice / Q000193:education; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D008507:Medically Underserved Area; D010372:Pediatrics / Q000193:education; D011320:Primary Health Care; D012189:Retrospective Studies; D012577:Schools, Medical; D014861:Washington