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Beverly EA, Wietecha DA, Nottingham K, Rush LJ, Law TD. Premedical Students' Attitudes Toward Primary Care Medicine. J Osteopath Med 2017; 116:302-9. [PMID: 27111783 DOI: 10.7556/jaoa.2016.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Expanded insurance coverage will likely increase the demand for primary care physicians in the United States. Despite this demand, the number of medical students planning to specialize in primary care is decreasing. OBJECTIVE To explore premedical students' attitudes toward the primary care specialty. METHODS Students enrolled in premedicine at a large Midwestern university were invited to complete the Primary Care Attitudes Survey (Cronbach α=.76). This 25-item survey measures attitudes about primary care on a 5-point Likert scale, ranging from 1, "strongly disagree" to 5, "strongly agree." Basic sociodemographic characteristics were assessed using descriptive statistics, and frequencies of individual survey responses were calculated using SPSS statistical software version 21.0. RESULTS A total of 100 premedical students (mean [SD] age, 19.8 [1.5] years; 59 female, 82 white non-Hispanic, and 33 freshman) completed the survey. Of 100 students, 33 planned to pursue primary care; 66 thought that primary care physicians would always have a job; 25 thought that primary care may become obsolete as medicine becomes more specialized; 48 thought that physician assistants and nurse practitioners would take over many primary care duties in the future; 91 thought that primary care physicians make important contributions to medicine; and 84 agreed that primary care focuses on the whole patient. CONCLUSIONS Premedical students held positive views about the importance of primary care; however, many expressed uncertainty about the stability of primary care careers in the future. Further, a substantial number of students believed common misconceptions about the scope and practice of primary care, such as primary care doctors are gatekeepers and mostly diagnose colds and ear infections.
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Washko MM, Snyder JE, Zangaro G. Where Do Physicians Train? Investigating Public And Private Institutional Pipelines. Health Aff (Millwood) 2015; 34:852-6. [DOI: 10.1377/hlthaff.2014.1356] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Michelle M. Washko
- Michelle M. Washko ( ) is deputy director of the National Center for Health Workforce Analysis at the Health Resources and Services Administration (HRSA), in Rockville, Maryland
| | - John E. Snyder
- John E. Snyder is the senior medical officer in the Office of Planning, Analysis, and Evaluation at HRSA
| | - George Zangaro
- George Zangaro is director of the National Center for Health Workforce Analysis at HRSA
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Erikson CE, Danish S, Jones KC, Sandberg SF, Carle AC. The role of medical school culture in primary care career choice. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:1919-1926. [PMID: 24128615 DOI: 10.1097/acm.0000000000000038] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To examine individual-level and medical-school-level factors, including the school's primary care culture, that are associated with medical students' likelihood of practicing primary care. METHOD In spring 2010, the Association of American Medical Colleges Center for Workforce Studies invited all fourth-year medical students at a stratified random sample of 20 U.S. MD-granting medical schools to participate in an online survey examining factors in specialty choice decisions. Schools were stratified according to the historical percentage of their graduates who became practicing primary care physicians. Multilevel logistic regression modeling was used to determine which individual- and school-level characteristics significantly predicted students' likelihood of practicing primary care. RESULTS Of the 2,604 students invited, 1,661 (64%) responded. Of the 1,554 students with complete data on variables of interest, 207 (13%) planned to enter a primary care residency and stated they were "very likely" to become a primary care physician on completion of training. Students who attended schools with high reported levels of "badmouthing" primary care were less likely to practice primary care (OR, 0.6; 95% CI, 0.4-0.9). Attending a school where students had greater than the median number of positive experiences in primary care clerkships increased the likelihood of practicing primary care (OR, 1.6; 95% CI, 1.1-2.3). Overall, 8% of the total variation in a student's likelihood of practicing primary care was attributable to school-level factors. CONCLUSIONS Although individual students' characteristics and preferences drive specialty choice decisions, the prevailing primary care culture at a school also plays a role.
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Affiliation(s)
- Clese E Erikson
- Ms. Erikson is senior director, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC. Ms. Danish is an MBA student, University of Chicago Booth School of Business, Chicago, Illinois. At the time of writing, she was a data analyst, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC. Ms. Jones is senior data analyst, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC. Dr. Sandberg is research writer, Center for Workforce Studies, Association of American Medical Colleges, Washington, DC. Dr. Carle is assistant professor of pediatrics, University of Cincinnati School of Medicine, and assistant professor of psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio
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Kruschinski C, Wiese B, Hummers-Pradier E. Attitudes towards general practice: a comparative cross-sectional survey of 1st and 5th year medical students. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2012; 29:Doc71. [PMID: 23255966 PMCID: PMC3525916 DOI: 10.3205/zma000841] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 07/08/2012] [Accepted: 07/30/2012] [Indexed: 11/30/2022]
Abstract
Objective: Positive attitudes towards General Practice can be understood as a prerequisite for becoming a General Practitioner (GP) and for collaboration with GPs later on. This study aimed to assess attitudes of medical students at the beginning and the end of medical school. Methods: A total of 160 1st year students at Hannover Medical School were surveyed. Their attitudes were compared to those of 287 5th year students. Descriptive, bi- and multivariate analyses were performed to investigate influences of year of study and gender. Results: Year of study and gender both were associated with the attitudes towards General Practice. The interest in General Practice and patient-orientation (communication, care of older patients with chronic diseases) was higher in 1st year students compared to more advanced students. Female students valued such requirements more than male students, the differences in attitudes between the years of study being more pronounced in male students. Conclusion: Despite some limitations caused by the cross-sectional design, the attitudes towards General Practice competencies changed to their disadvantage during medical school. This suggests a formative influence of the strategies used in medical education. Educational strategies, however, could be used to bring about a change of attitudes in the other direction.
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Abstract
OBJECTIVE To better understand and characterize the challenges facing internal medicine from the perspective of internal medicine residency program directors. METHODS In 2007, internal medicine program directors were surveyed by the Association of Program Directors in Internal Medicine (APDIM). An open-ended question asked: "What are your major concerns regarding internal medicine?" Responses to this question were independently coded by two investigators and compared for agreement. Content analysis identified several major themes related to their concerns. RESULTS Of the 236 program directors completing the survey, 186 (79%) answered the question and explained their concerns. Approximately one half of the informants were general internists. There was a fairly even distribution among assistant, associate, and professor ranking. All regions of the country were represented. Five themes emerged as the program directors' major concerns about internal medicine: waning interest in internal medicine, especially primary care; onerous regulatory oversight; economic pressures; the eighty-hour work week; and fragmentation within internal medicine. CONCLUSION By virtue of their role, internal medicine residency directors gain a unique understanding about the core elements that contribute to declining interest in careers in internal medicine, which is particularly relevant given the current primary care workforce crisis. Collaboration among stakeholders that can influence healthcare policy to address these concerns about internal medicine will be necessary to revive interest in the field.
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Kleinsorge CA, Roberts MC, Roy KM, Rapoff MA. The program evaluation of services in a primary care clinic: attaining a medical home. Clin Pediatr (Phila) 2010; 49:548-59. [PMID: 20139106 DOI: 10.1177/0009922809358615] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
A program evaluation of a pediatric primary care training clinic was conducted using the criteria of a "medical home" set forth by the American Academy of Pediatrics (AAP). A total of 107 parents completed questionnaires regarding demographics, satisfaction with care, and questions related to the definition of medical home. Medical providers completed questionnaires regarding demographics, job satisfaction, and community resources. Parents reported acceptable levels of satisfaction with the quality of care provided, and the essential parts of the medical home definition were met. There were several areas that were designated as having room for improvement, including shortening clinic wait times and instructing the medical providers to be more sensitive to cultural differences in beliefs about health and wellness. The concepts of medical home set forth by the AAP are attainable for pediatric primary care clinics, but routine evaluations may be needed to ensure that goals continue to be met.
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Jeffe DB, Whelan AJ, Andriole DA. Primary care specialty choices of United States medical graduates, 1997-2006. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:947-958. [PMID: 20505392 DOI: 10.1097/acm.0b013e3181dbe77d] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE To describe trends in specialty choice and to identify predictors of primary care specialty choices among graduates of U.S. MD-granting medical schools. METHOD A longitudinal study evaluated 1997-2006 medical school graduates who completed the Association of American Medical Colleges' Matriculating Student Questionnaire and Graduation Questionnaire. Multivariate logistic regression identified significant predictors of graduates' choice of primary care specialty (general internal medicine, general pediatrics, internal medicine subspecialties, pediatrics subspecialties, family medicine, and obstetrics-gynecology) or "no-board-certification specialty," compared with all other specialties (reference). RESULTS The sample included 102,673 graduates (64.9% of all 1997-2006 graduates). General internal medicine, family medicine, general pediatrics, and obstetrics-gynecology choice decreased, whereas internal medicine subspecialties, pediatrics subspecialties, and no-board-certification specialty choice increased over time (each: P < .001). Female graduates and those who planned to practice in underserved communities, espoused more-altruistic beliefs about health care, and ascribed greater importance to social responsibility in their choice of medicine at matriculation were more likely to choose general internal medicine, general pediatrics, family medicine, or obstetrics-gynecology, whereas graduates who had a physician parent and who planned full-time academic medicine careers were less likely to do so (each: P < .01). Graduates with higher debt were less likely to choose internal medicine and pediatrics specialties (each: P < .001) and more likely to choose obstetrics-gynecology (P = .001). CONCLUSIONS Generalist-primary care specialty choices declined since 1997, whereas primary care subspecialty and no-board-certification specialty choices increased. Associations between primary care specialty choices and demographic, attitudinal, and career intention variables can inform the design of interventions to address expected primary care workforce shortages.
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Affiliation(s)
- Donna B Jeffe
- Washington University School of Medicine, St. Louis, MS, USA.
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Muller D, Meah Y, Griffith J, Palermo AG, Kaufman A, Smith KL, Lieberman S. The role of social and community service in medical education: the next 100 years. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2010; 85:302-309. [PMID: 20107360 DOI: 10.1097/acm.0b013e3181c88434] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Abraham Flexner's focus on science in medical school curricula was not intended to exclude or marginalize the importance of service in training American physicians. The erosion of service in academic medicine in the century after his report was the result of forces as wide ranging as research priorities, health care financing, and industry's influence. The authors review the historical context of these changes and make the case that reintroducing service into medical school curricula has never been more important. They describe the impact that neglecting service has had on society, patients, the medical profession, medical students, and medical education. After defining what is meant by social, public, or community service, they go on to detail signature programs at University of Texas Medical Branch, University of New Mexico Health Sciences Center, and Mount Sinai School of Medicine, focusing on the two major categories of health care delivery and education. These examples, in geographically and demographically disparate schools of medicine, demonstrate that it is possible to successfully reintegrate service into the missions of academic medical centers and medical schools.
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Affiliation(s)
- David Muller
- Mount Sinai School of Medicine, New York, New York 10029, USA.
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[What medical student characteristics are associated with improved knowledge and attitudes toward family medicine?]. Aten Primaria 2009; 41:431-6. [PMID: 19481304 DOI: 10.1016/j.aprim.2009.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 01/26/2009] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To find out what sociodemographic and academic variables are associated with better knowledge and attitudes towards family medicine, before and after carrying out an assignment in primary care. DESIGN "Before-after" study. SETTING Faculty of Medicine. PARTICIPANTS Students enrolled in a primary health care assignment. MAIN MEASUREMENTS Knowledge and attitudes on family medicine have been evalaluated as dependent variables, using an ad hoc designed questionnaire, consisting of 34 questions with 5 response options on a Likert type scale. The questionnaire, which also included questions on the sociodemographic and academic characteristics of the students was administered the day before classes started and at the end of the course. The scores on knlwledge and attitudes have been evaluated according to the different values of the sociodemographic and academic variable using multiple linear regression analysis. RESULTS A total of 44 students filled in both questionnaires (54.3% of those enrolled). Sex was the only variable that was associated with the questionnaire total score before starting the classess (P=0.004). However, when age was was included in the model as a dichotomic variable (19 years vs. 20 years or more) and the sex-age interaction, these were also significant (P=0.011 and P=0.031, respectively). At the end of the course, only sex showed a significant association (P=0.013). CONCLUSIONS Females and younger student are the ones who demonstrate more favourable attitudes towards family medicine and primary health care.
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Beaulieu MD, Dory V, Pestiaux D, Pouchain D, Gay B, Rocher G, Boucher L. General practice as seen through the eyes of general practice trainees: a qualitative study. Scand J Prim Health Care 2006; 24:174-80. [PMID: 16923627 DOI: 10.1080/02813430600795498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To explore the perceptions of general practice trainees regarding their discipline and to compare these spontaneously expressed views with recently proposed definitions of general practice. MATERIAL AND METHODS A qualitative focus-group study was conducted in one Belgian and two French medical schools. Twenty-eight trainees took part (16 from Belgium and 12 from France). The transcripts were analysed by the immersion crystallization method. RESULTS The participants in this study seemed prepared to take on the many responsibilities outlined in various definitions of general practice, but feared personal commitment to accessibility and continuous care. Being skilled clinicians and patients' advocates formed their "raison d'être" in the healthcare system. They were reluctant to act as gatekeepers within the system, a role that might jeopardize their advocacy function for their patients. They mentioned the lack of appeal of entrepreneurship aspect of practice. Participants reported that training settings typically offer traditional models of practice, which sometimes led them to feel estranged from a profession that they felt needs reorganization. CONCLUSIONS Participants' descriptions generally coincided with official definitions of general practitioners' tasks, except for practice management and gate-keeping aspects. They were willing to accept the burden of general practice as long as responsibility could be shared and as long as there was freedom for flexible progress along a modern career track.
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Affiliation(s)
- Marie-Dominique Beaulieu
- Département de Médecine Familiale, Université de Montréal, Centre de recherche du CHUM, Hôpital Notre-Dame, Montréal (QC).
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Friedman RH, Wahi-Gururaj S, Alpert J, Bauchner H, Culpepper L, Heeren T, Singer A. The views of U.S. medical school deans toward academic primary care. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2004; 79:1095-1102. [PMID: 15504779 DOI: 10.1097/00001888-200411000-00018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE To understand the views of U.S. medical school deans about their primary care faculties. METHOD In 2000, the authors mailed a questionnaire containing 43 multipart items to deans of 130 U.S. allopathic medical schools. The questionnaire assessed the deans' attitudes about and evaluation of primary care at their school and their school's efforts to strengthen it. Deans were asked to compare family medicine, general internal medicine, and general pediatrics with nonprimary care clinical departments at their schools. RESULTS Of the 83 (64%) deans who responded, 82% reported their school had departments or divisions of family medicine, general internal medicine, and general pediatrics. Deans rated general internal medicine and general pediatrics higher than nonprimary care faculty on clinical expertise and productivity (p < .001) and family medicine equivalent to nonprimary care faculty. Deans rated all three primary care faculties superior to nonprimary care faculty for teaching skills (p < .001) and programs (p < .05), but lower than nonprimary care disciplines for research productivity (p < .01) and revenues (p < .001). They rated family medicine and general pediatrics lower for research skills (p < .001), but 73% of deans stated research was equally important for primary care and nonprimary care departments. Deans considered overall financial resources to be equivalent for primary care and nonprimary care departments, but 77% of deans felt primary care departments or divisions needed financial support from the medical school to survive. Most deans attempted to strengthen primary care by changing the curriculum to promote primary care and by providing financial support. CONCLUSIONS Deans ranked primary care faculty high on clinical and teaching measures. Although they considered research to be an important activity for primary care faculty, they evaluated it low relative to nonprimary care departments.
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Affiliation(s)
- Robert H Friedman
- Boston Medical Center, Boston University School of Medicine, Medicine Information Systems Unit, 720 Harrison Avenue, Suite 1102, Boston, MA 02118, USA.
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Bergus GR, Randall CS, Winniford MD, Mueller CW, Johnson SR. Job satisfaction and workplace characteristics of primary and specialty care physicians at a bimodal medical school. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2001; 76:1148-1152. [PMID: 11704519 DOI: 10.1097/00001888-200111000-00020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE A few medical schools are highly successful in obtaining research funding and producing primary care physicians. The authors compared the job satisfaction of primary and specialty care faculty at one of these bimodal schools. METHODS In 1998, all full-time physician-faculty (n = 408) in 15 clinical departments at the University of Iowa College of Medicine (a bimodal medical school) were sent a questionnaire based on the Price-Mueller model of job satisfaction. Faculty rated their global job satisfaction and perceptions about 18 workplace characteristics, stressors, and supports. Responses of primary and specialty care physicians were compared in these domains. RESULTS A total of 71% of surveyed faculty (n = 341) returned usable questionnaires. Primary and specialty care faculty reported similar levels of job satisfaction (p =.20), and similar percentages (51% versus 54%, p =.63) reported overall satisfaction with their jobs at the medical school. However, primary care faculty perceived less opportunity to advance (p <.01), greater professional-role ambiguity (p =.02), less collegiality (p =.02), and less ability to make full use of their clinical skills (p =.01). Primary and specialty care faculty reported similar intentions of leaving the medical school within the coming year (p =.41). CONCLUSIONS Primary and specialty care physicians at one bimodal medical school reported similar levels of job satisfaction. However, the primary care physicians rated several important job-related domains lower than did their specialty care colleagues, most notably the opportunity to advance within the medical school.
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Affiliation(s)
- G R Bergus
- Department of Family Medicine, University of Iowa College of Medicine, Iowa City 52242, USA.
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Zinn WM, Sullivan AM, Zotov N, Peters AS, Connelly MT, Singer JD, Block SD. The effect of medical education on primary care orientation: results of two national surveys of students' and residents' perspectives. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2001; 76:355-365. [PMID: 11299151 DOI: 10.1097/00001888-200104000-00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE To examine changes among a nationally representative sample of students and residents in their orientations toward primary care as reflected in their attitudes toward the psychosocial and technical aspects of medicine and their perceptions of the academic environment for primary care. METHOD Confidential telephone interviews of stratified national probability samples of first- and fourth-year medical students and residents were conducted in 1994 and 1997. The 1997 survey included 219 students and 241 residents who had also been interviewed in 1994. Participants were asked about their attitudes toward addressing psychosocial issues in medicine and their perceptions of faculty and peer attitudes toward primary care. Responses were compared over time and across groups. RESULTS Between the first and fourth years of medical school, there was a decline over time in students' reported orientations to socioemotional aspects of patient care (61.6% versus 42.7%, p =.001) and their perceptions that working with psychosocial issues of patients made primary care more attractive (56.3% versus 43.5%, p =.01). This pattern continued for 1997 residents (PGY-3), who were even less likely to say that addressing psychosocial issues made primary care more attractive (26.9%). For fourth-year students in 1994 who became PGY-3 residents in 1997, there was an increased perception that non-primary-care house officers and specialty faculty had positive attitudes toward primary care (20.8% versus 33.0%, p =.005; 28.3% versus 45.7%, p <.0001; respectively). CONCLUSIONS Between 1994 and 1997 students and residents perceived a positive shift in the attitudes of peers and faculty toward primary care. During the course of their education and training, however, the students experienced an erosion of their orientations to primary care as they progressed through medical school into residency.
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Affiliation(s)
- W M Zinn
- Department of Medicine, Cambridge Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Abstract
OBJECTIVE To contrast prevailing behaviors and attitudes relative to prJgiary care education and practice in osteopathic and allopathic medical schools. DESIGN Descriptive study using confidential telephone interviews conducted in 1993-94. Analyses compared responses of osteopaths and allopaths, controlling for prJgiary care orientation. SETTING United States academic health centers. PARTICIPANTS National stratified probability samples of first-year and fourth-year medical students, postgraduate year 2 residents, and clinical faculty in osteopathic and allopathic medical schools, a sample of allopathic deans, and a census of deans of osteopathic schools (n = 457 osteopaths; n = 2,045 allopaths). MEASUREMENTS Survey items assessed personal characteristics, students' reasons for entering medicine, learners' prJgiary care educational experiences, community support for prJgiary care, and attitudes toward the clinical and academic competence of prJgiary care physicians. MAIN RESULTS PrJgiary care physicians composed a larger fraction of the faculty in osteopathic schools than in allopathic schools. Members of the osteopathic community were significantly more likely than their allopathic peers to describe themselves as socioemotionally oriented rather than technoscientifically oriented. Osteopathic learners were more likely than allopathic learners to have educational experiences in prJgiary care venues and with prJgiary care faculty, and to receive encouragement from faculty, including specialists, to enter prJgiary care. Attitudes toward the clinical and academic competence of prJgiary care physicians were consistently negative in both communities. Differences between communities were sustained after controlling for prJgiary care orientation. CONCLUSIONS In comparison with allopathic schools, the cultural practices and educational structures in osteopathic medical schools better support the production of prJgiary care physicians. However, there is a lack of alignment between attitudes and practices in the osteopathic community.
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Affiliation(s)
- A S Peters
- Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Helath Care, Boston, MA 02215, USA
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