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Cited by 102Diversity and Career in MedicineGlobal Health Workforce IssuesPrimary Care and Health Outcomes

Influence of Income, Hours Worked, and Loan Repayment on Medical Students' Decision to Pursue a Primary Care Career

Rosenthal, Michael P.·1994·JAMA: The Journal of the American Medical Association
DOI 10.1001/jama.1994.03510360040033
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Abstract

OBJECTIVE: To assess the specialty plans of current fourth-year medical students and, for those not choosing primary care specialties, to investigate the potential effect that changes in key economic or lifestyle factors could have in attracting such students to primary care. DESIGN AND PARTICIPANTS: A survey study was sent to 901 fourth-year medical students in the 1993 graduating classes of six US medical schools. OUTCOME MEASURES: Comparisons were made between students choosing and not choosing primary care specialties. For the non-primary care students, we also evaluated whether alteration of income, hours worked, or loan repayment could attract them to primary care careers. RESULTS: Of the 688 responses (76% response rate), primary care specialties were chosen by 27% of the students and non-primary care specialties by 73%. One quarter (25%) of the non-primary care students indicated they would change to primary care for one of the following factors: income (10%), hours worked (11%), or loan repayment (4%). For students whose debt was $50,000 or greater, the loan repayment option became much more important than for students with lesser debt. In all, a total of 45% (n = 313) of the students indicated either they were planning to enter primary care (n = 188) or they would change to a primary care specialty (n = 125) with appropriate adjustments in income, hours worked, or loan repayment. CONCLUSION: Significant changes in economic and lifestyle factors could have a direct effect on the ability to attract students to primary care. Including such changes as part of health system reform, especially within the context of a supportive medical school environment, could enable the United States to approach a goal of graduating 50% generalist physicians.

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  • Health care providers hold stereotypes based on patient race, class, sex, and other characteristics that influence their interpretation of behaviors and symptoms and their clinical decisions.

    “There is significant evidence that (1) health care providers hold stereotypes—based on patient race, class, sex, and other characteristics4–17—that influence their interpretation of behaviors and symptoms, and their clinical decisions17–25”

    From Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology (2007) · cites this paper as [13]

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Authors
Rosenthal, M. P.
Affiliations
Thomas Jefferson University (US)
Corresponding author
Rosenthal, Michael P.
Venue
JAMA: The Journal of the American Medical Association
Publisher
American Medical Association (AMA)
Published
1994-03-23
Volume
271
Issue
12
Pages
914
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.1994.03510360040033
OpenAlex
W2138268193
Cited by
102
References
27
Citations by year
2025: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 5 · 2016: 3 · 2014: 4 · 2013: 4 · 2012: 2
FWCI
13.98
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
primary care career choice, medical students, specialty choice, student debt, loan repayment, physician remuneration, working hours, economic incentives, health care reform
MeSH terms
Workforce, Career Choice, Costs and Cost Analysis, Education, Medical, Family Practice, Humans, Income, Life Style, Students, Medical, Training Support, United States, Work Schedule Tolerance

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