Effect of the Inpatient General Medicine Rotation on Student Pursuit of a Generalist Career

Authors: Arora, Vineet¹; Wetterneck, Tosha B.²; Schnipper, Jeffrey L.³; Auerbach, Andrew D.⁴; Kaboli, Peter⁵; Wachter, Robert M.⁴; Levinson, Wendy⁶; Humphrey, Holly J.⁷; Meltzer, David

Source: Journal of General Internal Medicine, Volume 21, Number 5, May 2006 , pp. 471-475(5)

Publisher: Wiley-Blackwell

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.

Keywords: medical student; career interest; general internal medicine

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1525-1497.2006.00429.x

Affiliations: 1: Department of Medicine, University of Chicago, Chicago, IL, USA; 2: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; 3: Brigham and Women's/Faulkner Hospitalist Program, Division of General Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; 4: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; 5: Iowa City Veterans Affairs Medical Center and University of Iowa Carver College of Medicine, Iowa City, IA, USA; 6: Department of Medicine, University of Toronto, Toronto, ON, Canada; 7: Pritzker School of Medicine, University of Chicago, Chicago, IL, USA;

Publication date: 2006-05-01

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