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Multicenter Study
. 2006 May;21(5):471-5.
doi: 10.1111/j.1525-1497.2006.00429.x.

Effect of the inpatient general medicine rotation on student pursuit of a generalist career

Vineet Arora  1 , Tosha B Wetterneck, Jeffrey L Schnipper, Andrew D Auerbach, Peter Kaboli, Robert M Wachter, Wendy Levinson, Holly J Humphrey, David Meltzer
Affiliations
Multicenter Study

Effect of the inpatient general medicine rotation on student pursuit of a generalist career

Vineet Arora et al. J Gen Intern Med. 2006 May.

Abstract

Background: Entry into general internal medicine (GIM) has declined. The effect of the inpatient general medicine rotation on medical student career choices is uncertain.

Objective: To assess the effect of student satisfaction with the inpatient general medicine rotation on pursuit of a career in GIM.

Design: Multicenter cohort study.

Participants: Third-year medical students between July 2001 and June 2003.

Measurements: End-of-internal medicine clerkship survey assessed satisfaction with the rotation using a 5-point Likert scale. Pursuit of a career in GIM defined as: (1) response of "Very Likely" or "Certain" to the question "How likely are you to pursue a career in GIM?"; and (2) entry into an internal medicine residency using institutional match data.

Results: Four hundred and two of 751 (54%) students responded. Of the student respondents, 307 (75%) matched in the 2 years following their rotations. Twenty-eight percent (87) of those that matched chose an internal medicine residency. Of these, 8% (25/307) were pursuing a career in GIM. Adjusting for site and preclerkship interest, overall satisfaction with the rotation predicted pursuit of a career in GIM (odds ratio [OR] 3.91, P<.001). Although satisfaction with individual items did not predict pursuit of a generalist career, factor analysis revealed 3 components of satisfaction (attending, resident, and teaching). Adjusting for preclerkship interest, 2 factors (attending and teaching) were associated with student pursuit of a career in GIM (P<.01).

Conclusions: Increased satisfaction with the inpatient general medicine rotation promotes pursuit of a career in GIM.

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Figures

Figure 1
Figure 1
*High stated likelihood of pursuing a career in general internal medicine (GIM) is defined as a response of 4 (Very Likely) or 5 (Certain) to the question, “Upon Completion of this clerkship,how likely are you to pursue a career in GIM?” †Envisioning a predominantly inpatient career is defined as a response of 1 (mostly inpatient) or 2 (somewhat more inpatient) to the question, “If you do choose a career in GIM, what balance of inpatient and outpatient do you envision for yourself?”
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