title: Factors associated with the choice of general medicine as a career among Japanese medical students.
abstract: BACKGROUND
  In Japan, there is a shortage of young physicians in various specialties; the present situation of general medicine or family medicine (GM/FM) in particular is risky. The factors influencing the career choice of Japanese medical students are poorly understood. This study aims to identify factors related to choosing GM/FM as a career.
  
  
  METHODS
  The study was designed as a cross-sectional survey. Students at one medical school in Japan filled out a questionnaire. Students were asked to state their intended medical specialty, and they rated the importance of specific individual and occupational aspects using a 4-point likert scale. Factor analysis was performed on the variables. Reliability of the factor scores was estimated using Cronbach's alpha coefficients; biserial correlations between the factors and career choices were calculated. Furthermore, multiple linear regression analysis was performed using career choice (GM/FM vs. others) as the criterion variable and the factors plus demographic characteristics as confounding variables.
  
  
  RESULTS
  Factor analysis produced six factors that explained future career plans. Medical students in this study had a positive and realistic idea about GM/FM, but only 18.8% of them chose GM/FM first as a career. The significant variables associated with choosing GM/FM first as a career were: 'Admission from hometown' (β=0.189, P=0.001), 'Student preparing for the entrance exam' (β=0.172; P=0.001), 'Intent for rural practice' (β=0.123, P=0.016), and 'Work-life balance' (β=0.126, P=0.013). While significant variables that were negatively associated with choosing GM/FM were 'Presence of medical relatives' (β=-0.107, P=0.037) and 'Scientific orientation' (β=-0.125, P=0.013).
  
  
  CONCLUSIONS
  Strategies have been suggested, such as recruiting medical students with significant variables that were associated with choosing GM/FM first as a career. By engaging students early in their choice of career, we may be able to increase enthusiasm for this specialty.
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.|Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan; rykawamo@m.ehime-u.ac.jp.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kawamoto
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.|Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ninomiya
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kasai
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Kusunoki
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohtsuka
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
mesh_terms: D000328:Adult; D002321:Career Choice; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005194:Family Practice / Q000193:education; D005260:Female; D058006:General Practice / Q000193:education*; D006801:Humans; D007564:Japan; D008297:Male; D013337:Students, Medical / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Japanese medical students; career choice; family medicine; general medicine