· A high service index (reflective of a demonstrated orientation toward community service prior to medical school matriculation) predicted strongly the choice of a generalist medical career. Less strong predictors of a generalist practice included the selection of a generous number of non-science-content courses as an undergraduate, lower socioeconomic family origin, and a record of leadership in one or more extracurricular activities during college. If an admission committee informs itself of "what finally happens" to those it admits, its decisions can contribute to achieving whatever policy its medical school adopts with respect to the mix of physicians it wishes to produce. Acad Med 1994 Oct;69(10):825-31, Medical school admission and generalist physicians: a study of the class of 1985. (148 graduates UNC included, review of AMCAS data) Madison DL Department of Social Medicine, University of North Carolina, Chapel Hill School of Medicine, 27599-7240.
· Declining Medical School Class Size may result in fewer generalists and rural physicians Documentation is Fahey PJ, Sachs L, Bauer LC: Declining class size and the decline in graduates choosing family medicine. Academic Medicine 1992; 10(10): 680-4. also documentation in Canadian studies of recommendation to decrease medical school class size and result Canadian Study Warns of Worsening Rural Shortage. Flexner reforms also had major decreases in medical school positions and resulting rural shortages also
· Premedical Recruitment Efforts In multivariable analyses, premedical recruitment efforts and public school ownership (all p < .01) were associated with greater interest of matriculants in both generalism and rural practice. Acad Med 1998 Nov;73(11):1207-10, Associations between primary care-oriented practices in medical school admission and the practice intentions of matriculants. Basco WT Jr, Buchbinder SB, Duggan AK, Wilson MH. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA [email protected] cross-sectional, secondary analyses of databases from the Association of American Medical Colleges (AAMC). One hundred and twenty medical schools (95%) completed the AAMC's Survey of Generalist Physician Initiatives in either 1993 or 1994; 94% of matriculants replied to the AAMC's 1994 Matriculating Student Questionnaire.
·
Impact of Admission and Medical School Environment
The authors present new and existing data to show that: 1)
preadmission (BA/MD or post-baccalaureate) programs can help to identify
generalist-oriented students; 2) characteristics determined at admission to
medical school are predictive of future generalist career choice; 3) current
inpatient-oriented training programs strongly push students away from a primary
care career; 4) women are more likely than men to choose generalist careers,
primarily because of those careers' interpersonal orientation; and 5) residency
training programs are able to select applicants likely to become generalists.
Linzer M, Slavin T, Mutha S, Takayama JI, Branda L, VanEyck S, McMurray JE,
Rabinowitz HK. Admission, recruitment, and retention: finding and keeping the
generalist-oriented student. SGIM Task Force on Career Choice in Primary Care
and Internal Medicine. J Gen Intern Med 1994 Apr;9(4 Suppl 1):S14-23,
·
Special Preadmission Procedures Recommended
Successful recruitment of
generalism-oriented applicants requires identification and tracking of rural,
minority, and other special groups of students at the high school and college
levels. Urbina C, Hickey M,
McHarney-Brown C, Duban S, Kaufman A. Innovative generalist programs: academic
health care centers respond to the shortage of generalist physicians.
J Gen Intern Med 1994 Apr;9(4 Suppl
1):S81-9, Department of Family and Community Medicine, University of New Mexico
School of Medicine, Albuquerque 87131.
·
Medical education research has
identified a number of medical student characteristics that are related to
graduates' entering generalist careers. These include initial specialty
preference, geographic background, gender, age, ethnicity, economic and
lifestyle factors, attitudes and personal values, service orientation, and
premedical academic performance. Rabinowitz HK. The role of the medical
school admission process in the production of generalist physicians. Acad
Med 1999 Jan;74(1 Suppl):S39-44,
·
NYMC developed strategies to attract applicants interested in
primary care and to select primary care applicants for matriculation. These
strategies included use of recruiting newsletters to describe the primary care
curriculum, on-campus open houses for undergraduates, visits to regional
undergraduate schools by generalist faculty, changes in the admission committee
to include more generalists, and changes in the interview format to stress
nonacademic qualities in applicants… NYMC achieved its objectives Juster F,
Levine JK. Recruiting and selecting generalist-oriented students at New York
Medical College. Acad Med 1999 Jan;74(1 Suppl):S45-8, New York Medical
College, Valhalla 10595, USA.
·
The most influential factors under the control of the medical
school are the criteria used for admitting students and the design of the
curriculum, with particular emphasis on faculty role models. Personal social
values was the individual characteristic that most strongly influenced
graduates' career choice. Martini CJ, Veloski JJ, Barzansky B, Xu G, Fields
SK. Medical school and student characteristics that influence choosing a
generalist career. JAMA 1994 Sep 7;272(9):661-8, Division of Undergraduate
Medical Education, American Medical Association, Chicago, Ill.
·
Changes in admission criteria
to favor applicants oriented to generalism
Colwill JM, Perkoff GT, Blake RL Jr, Paden C,
Beachler M. Modifying the culture of medical education: the first three years of
the RWJ Generalist Physician Initiative.
Acad Med 1997 Sep;72(9):745-53, Department of
Family and Community Medicine, University of Missouri-Columbia (UMC), USA.
Basco, W.T., Jr., Gilbert, G.E., & Blue, A.V.(2002).
Determining the Consequences for Rural Applicants When Additional Consideration
is Discontinued in a Medical School Admission Process. Academic Medicine, 77,
S20-S22.
http://www.aamc.org/students/mcat/research/bibliography/basco002.htm
RESULTS: There were 2,033 in-state applicants with complete data (not missing
MCAT scores) in the four cohorts. Rural applicants comprised between 8.5% and
9.7% of applicants, depending on the year. MCAT science scores for rural
applicants were significantly lower in three of the four, but Verbal Reasoning
scores were not significantly different between rural and non-rural applicants.
Mean GPAs were not significantly different either. In three of the four years,
rural applicants were half as likely to have attended undergraduate schools in
the more competitive Barron's categories, but these differences reached
statistical significance in only one year-1998. Without the adjustment for rural
applicant status, the median ranks of rural applicants were lower than those for
non-rural applicants in all four years. Across all four years the adjustment for
being a rural applicant had a marked positive effect for rural applicants while
having minimal effects on non-rural applicants. The adjustment for rural status
did not ensure an admission interview for every rural applicant, but it did mean
that a large majority of the rural applicants received admission interviews in
all four years. Without the adjustment, fewer than half of the rural applicants
would have received admission interviews in two of the years evaluated-1997 and
1999.
Stop summary here
Admissions Abstracts for the above and more
Role of Black and Hispanic Physicians Volume 334
Federal Policy Legislation Needs to Focus on Rural Underserved Areas