Graduating Medical Student Perspectives on Factors Influencing Specialty Choice

Abstract

Background and Objectives: Fewer than 10% of US medical school graduates enter family medicine residencies each year. Little is known about the perceptions and attitudes of senior medical students as they make final decisions about specialty choice, especially those that support a decision to pursue family medicine. The American Academy of Family Physicians (AAFP) administered a national survey to US seniors in 2015 to explore these factors. Methods: US seniors who were AAFP members (N=11,998) were invited to complete a survey exploring attitudes toward family medicine and experiences that influenced interest and choice of family medicine (FM) or other specialties. This was offered after students submitted their National Residency Matching Program rank list but before match. For those matching in family medicine, additional questions explored mentorship experience. Factors significantly predicting intent to match in family medicine, mentor attributes significantly influencing student attitudes, and family medicine interest group (FMIG) participation were identified via regression. Results: The survey response rate was 15.1%. Student perceptions of the respect of FM (OR=0.82), the future of FM (OR=2.04), and FMIG involvement (OR=1.75) predicted choosing FM, as did AAFP student membership (OR=2.13-2.44) and AAFP National Conference of Family Medicine Residents and Students attendance (OR=9.77). For students entering FM, having supportive mentors outside of FM and being dedicated to FM positively influenced their attitudes toward FM and their FMIG participation. Conclusion: National programs, FMIGs, mentorship, and medical school support of family medicine play a role in student selection of family medicine.