Practice Characteristics of Graduates of East Tennessee State University Quillen College of Medicine: Factors Related to Career Choices in Primary Care.

摘要

The nation is facing a physician shortage, specifically in relation to primary care and in rural underserved areas. The most basic function of a medical school is to educate physicians to care for the national population. The purpose of this study was to examine the physician practicing characteristics of the graduates of East Tennessee State University Quillen College of Medicine including factors that influence graduates’ specialty choices and practice locations, especially those related to primary care.;Secondary data for this study were collected from the college’s student database system and the American Medical Association Physician Masterfile. The study population included all living graduates with Doctor of Medicine (MD) degrees who graduated from 1998 through 2009 (n=678). Statistical procedures included Pearson Chi-square, logistic regression, independent t tests, ANOVA, and multiple linear regression.;Data analyses revealed that the majority of graduates were between 24 and 29 years of age, male, white, non-Hispanic, and from metropolitan hometowns. Most had completed the generalist track and initially entered a primary care residency training program. The majority passed USMLE Step 1 and Step 2 on the first attempt. The USMLE Step 2-CK average was 212.50. The average cumulative GPA was 3.44. Graduates were nearly evenly divided between primary care and nonprimary care practice, with the majority practicing in metropolitan areas.;Graduates who initially entered primary care residency training were more likely to practice primary care medicine than those who entered nonprimary care programs; however, fewer graduates were practicing primary care than had entered primary care residency training. Graduates who attended internal medicine residency training were less likely to be practicing primary care medicine than those who attended family medicine, pediatrics, or OB/GYN programs. Women and Rural Primary Care Track graduates were significantly more likely to practice primary care than were men and generalist track graduates, respectively. Nonprimary care physicians had significantly higher USMLE Step 2-CK scores than did primary care physicians (PCPs). PCPs practiced in more rural locales than non-PCPs. Family physician graduates tended to practice in more rural locales than OB/GYNs or pediatricians. Hometown location predicted practice location over and above medical school track.