The influence of organizational and environmental change on specialty choice: A retrospective study.

摘要

The purpose of this study was to explore the relationship between the specialty choice of family medicine and the organizational and environmental change in a medical school. We analyzed graduation data from the years 1984-2004 at the University of Alabama School of Medicine (UASOM) which consists of three campuses. Albert Bandura's concept of reciprocal determinism was used to conceptualize the data analysis. The data were divided into two eras, before and after a major organizational and environmental change within one of the branch medical campuses. The hypothesis was that the family medicine specialty choice would decrease after this change in organization and environment.;By using logistic regression, organizational and environmental change was found to be statistically significant in the campus of interest, but in the opposite direction. Organizational and environmental change was not significant in explaining the choice of family medicine within UASOM as a whole. Lower medical school raw scores, Tuscaloosa branch medical campus, older age, rural background, and race (Caucasian versus African American and Asian) were significant predictors for family medicine as a specialty choice among students within UASOM.