Comfort With Uncertainty in Medical Students and Their Residency Choice: A Residency Research Network of Texas Study

Abstract

Background and Objectives: Little is known about how comfort with uncertainty (CwU) influences career choice in medical students. The authors of this study examined the correlation between CwU and primary care career choice. Methods: In academic years 2017-2018 and 2018-2019, the authors distributed surveys to third-year medical students from eight US medical schools, seven in Texas. The survey tool included two CwU scales and one comfort with ambiguity scale. Other questions covered career plans, family and personal background, and student debt. In the subjects’ fourth year of medical school, authors obtained match data from the medical schools and the authors further communicated with the students where indicated. The primary outcome was the composite score of the three scales correlated to career choice, with a focus on primary care and family medicine. Results: Among 642 participants, there was no difference in CwU scores between students who matched into primary care versus specialty fields (3.39 vs 3.37 average of three scales, P=.65, each individual scale NS) or family medicine (FM) vs all other fields (3.39 vs 3.37 average of three scales, P=.81). Other bivariate predictors of FM choice were more similar than different to previous studies, such as osteopathic more likely than allopathic, lower family income, planning to care for underserved populations, and had a primary care role model. Logistic regression found the two biggest predictors of FM were osteopathic training and the importance of educating patients about health promotion and disease prevention. Conclusions: We found no correlation between CwU and medical student career choice for primary care or FM. We discuss confounding factors that may impact results, as well as recommendations for medication education and public policy.