How Medical Education Pathways Influence Primary Care Specialty Choice

Abstract

Background and Objectives: Primary care is associated with improved patient health and reductions in health disparities. Consequently, the demand for primary care physicians is increasing. To meet this demand, medical schools have employed strategies to graduate students interested in primary care careers, including medical education pathways—structured, longitudinal experiences that are explicitly separate from the main curricular scope of the undergraduate medical education experience. Our goal was to explore and identify common characteristics of medical education pathways that influence primary care specialty choice. Methods: Using research articles identified through a scoping review, we performed a qualitative content analysis of studies that evaluated the impact of medical education pathways on medical students’ choices of primary care careers. Results: Sixty-three papers described 43 medical education pathways; most studies used quantitative methods to describe outcomes. Program characteristics mapped onto five levels of an emerging socioecological model: state or national, community, institutional, relational, and individual. Conclusions: Successful medical education pathway programs complement a medical school curriculum that supports a common goal, and demonstrate multiple levels of structural and institutional factors that develop community connectedness, relatedness, and longitudinal community engagement in students. Further work is needed to better understand how each of these levels influence career choice and to reassess how to measure and report medical education outcomes that will more accurately predict the student choice of primary care careers.