Table 2.
Predictors of Specialty Choice for Fourth-year Medical Students (Weighted Percentages)
| Distribution of Sample* | 1994, % Choosing† | 1997, % Choosing† | |||||||
|---|---|---|---|---|---|---|---|---|---|
| 1994 (N = 306) | 1997 (N = 219) | Primary Care (N = 83) | IMPS or Undecided (N = 60) | Specialty (N = 163) | Primary Care (N = 54) | IMPS or Undecided (N = 67) | Specialty (N = 98) | Fitted Odds Ratios for a Single-predictor Model (95% CI)ठ| |
| Role model | |||||||||
| Primary care | 36.4 | 38.0 | 48.4 | 18.8 | 32.8 | 46.1 | 29.8 | 24.2 | 6.54 (4.20 to 10.18)‖ |
| Specialist | 42.2 | 41.4 | 14.9 | 12.1 | 73.0 | 4.9 | 29.2 | 65.9 | P < .0001 |
| No role model | 21.3 | 20.6 | 30.3 | 3.3 | 66.4 | 21.6 | 35.9 | 42.4 | 2.83 (1.59 to 5.05)¶ |
| P < .0001 | |||||||||
| Peer encouragement | |||||||||
| Toward primary care | 24.0 | 30.9 | 40.3 | 19.2 | 40.5 | 40.0 | 27.5 | 32.5 | 2.06 (1.31 to 3.24)# |
| Toward specialties | 48.6 | 41.2 | 29.2 | 13.1 | 57.6 | 19.6 | 34.1 | 46.2 | P < .0001 |
| Toward neither | 27.4 | 28.0 | 23.5 | 6.1 | 70.4 | 12.7 | 29.6 | 57.7 | 3.08 (1.80 to 5.25)** |
| P < .0001 | |||||||||
| House staff encouragement | |||||||||
| Toward primary care | 23.9 | 34.1 | 41.6 | 10.2 | 48.2 | 40.6 | 31.5 | 27.9 | 2.09 (1.35 to 3.24)# |
| Toward specialties | 59.3 | 42.7 | 28.1 | 13.8 | 58.2 | 17.1 | 31.6 | 51.2 | P < .001 |
| Toward neither | 16.2 | 22.7 | 23.4 | 12.6 | 64.1 | 12.5 | 26.5 | 61.0 | 2.85 (1.63 to 4.95)** |
| P < .0001 | |||||||||
| Socioemotional orientation | |||||||||
| Socioemotional | 46.5 | 42.7 | 44.5 | 17.2 | 38.2 | 40.3 | 28.5 | 31.2 | 3.45 (2.32 to 5.13) |
| Non-socioemotional†† | 53.5 | 57.3 | 18.1 | 8.7 | 73.2 | 11.8 | 32.5 | 55.6 | P < .0001 |
| Gender | |||||||||
| Female | 36.4 | 39.5 | 40.7 | 15.4 | 44.0 | 32.5 | 29.2 | 38.4 | 1.94 (1.31 to 2.87) |
| Male | 63.6 | 60.5 | 24.5 | 11.1 | 64.4 | 18.4 | 31.9 | 49.7 | P < .001 |
Column percentages: distribution of predictor in total population (column percents add to 100).
Row percentages (row percents add to 100).
Fitted odds ratios represent the estimated cumulative odds of choosing a more primary care–oriented career (rather than less oriented toward primary care, such as primary care rather than IMPS, undecided between primary care and IMPS, and specialties) across specified levels of predictor variables (e.g., for female versus male students, or primary care versus specialist role model).
Results are not shown for the main effect of time (1994 versus 1997) or interactions of time with other predictors because the effect of time was not significant in any fourth-year student models.
Primary care versus specialist role model.
Primary care versus no role model.
Encouragement toward primary care rather than specialties.
Encouragement toward primary care rather than toward neither.
Includes technical-scientific (N = 240) and missing (N = 27). All models were tested with and without inclusion of missing values for socioemotional orientation, and produced similar results.
IMPS, internal medicine/pediatrics subspecialty; undecided, undecided between primary care and IMPS; 95% CI, 95% confidence interval.