Predictors of Primary Care Practice Among Medical Students at the Michigan State University College of Human Medicine

Abstract

Introduction: This study examines the evolution of student and physician interest in primary care from medical school matriculation to practice, focusing on student factors that potentiate primary care (PC) practice.

Methods: We compiled a dataset of 2,047 Michigan State University College of Human Medicine graduates from 1991 to 2010. PC interest was assessed using the Association of American Medical Colleges (AAMC) matriculating student (MSQ) and graduation (GQ) questionnaires. PC practice was determined using AMA physician Masterfile data. C² analyses and logistic regression were used to examine factors that predict PC practice.

Results: PC interest at matriculation and at graduation were the factors most likely to predict PC practice. After controlling for URM status, gender, and rural origin, the odds of practicing PC among those with a sustained interest in PC (on both the MSQ and GQ) were 100 times higher than those with no interest in PC, on either survey (P < .01). Among those students who developed an interest in PC by graduation, the odds of practicing PC were 60 times higher than noninterested students (P < .01). Finally, among students who were interested in PC at matriculation, but not graduation, the odds of eventually practicing PC were 3.8 times higher than noninterested students (P < .01).

Conclusions: Our study suggests that cultivating PC interest at any point during medical school may predict PC practice. Early and sustained interest in primary care was the most substantial predictor of PC practice in our study, highlighting the need for primary care education even before medical school matriculation.

Keywords: Family Medicine; Logistic Models; Medical Schools; Michigan; Physicians; Primary Health Care; Residency; Surveys and Questionnaires; Workforce.