Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation
Abstract Background Currently, Internal Medicine (IM) physicians do not reflect the ethno-racial diversity of the US population. Moreover, there is a shortage of IM physicians in Medically Underserved Areas (MUAs) in the US. The purpose of this study was to determine factors that influence medical s...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04392-0 |
| _version_ | 1797806667901960192 |
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| author | Aaron Lapidus Sapan Shah Meheret Mekonnen Joseph Araj Mytien Nguyen Hyacinth Mason Branden Eggan Inginia Genao |
| author_facet | Aaron Lapidus Sapan Shah Meheret Mekonnen Joseph Araj Mytien Nguyen Hyacinth Mason Branden Eggan Inginia Genao |
| author_sort | Aaron Lapidus |
| collection | DOAJ |
| description | Abstract Background Currently, Internal Medicine (IM) physicians do not reflect the ethno-racial diversity of the US population. Moreover, there is a shortage of IM physicians in Medically Underserved Areas (MUAs) in the US. The purpose of this study was to determine factors that influence medical students’ intent to practice IM in MUAs. We hypothesized students with intentions to pursue a career in IM and work in MUAs were more likely than their peers to identify as underrepresented in medicine (URiM), report greater student debt loads, and report medical school experiences in cultural competencies. Methods We analyzed de-identified data of 67,050 graduating allopathic medical students who completed the Association of American Medical Colleges’ (AAMC) Medical School annual Graduation Questionnaire (GQ) between 2012–2017 by multivariate logistic regression models, examining intent to practice IM in MUAs based on respondent characteristics. Results Of 8,363 students indicating an intent to pursue IM, 1,969 (23.54%) students also expressed an intent to practice in MUAs. Students awarded scholarships, (aOR: 1.23, [1.03–1.46]), with debt greater than $300,000 (aOR: 1.54, [1.21–1.95], and self-identified non-Hispanic Black/African American (aOR: 3.79 [2.95–4.87]) or Hispanic (aOR: 2.53, [2.05–3.11]) students were more likely than non-Hispanic White students to indicate intent to practice in MUAs. This pattern also existed for students who participated in a community-based research project (aOR: 1.55, [1.19–2.01]), had experiences related to health disparities (aOR: 2.13, [1.44–3.15]), or had experiences related to global health (aOR: 1.75, [1.34–2.28]). Conclusions We identified experiences and characteristics that associate with intention to practice IM in MUAs, which can aid future curricular redesign by medical schools to expand and deepen comprehension of health disparities, access to community-based research, and global health experiences. Loan forgiveness programs and other initiatives to increase recruitment and retention of future physicians should also be developed. |
| first_indexed | 2024-03-13T06:10:46Z |
| format | Article |
| id | doaj.art-bb4faebfd7e8443ab0d18f3d1262ed0d |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-03-13T06:10:46Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-bb4faebfd7e8443ab0d18f3d1262ed0d2023-06-11T11:16:58ZengBMCBMC Medical Education1472-69202023-06-012311810.1186/s12909-023-04392-0Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participationAaron Lapidus0Sapan Shah1Meheret Mekonnen2Joseph Araj3Mytien Nguyen4Hyacinth Mason5Branden Eggan6Inginia Genao7Department of Medical Education and Community Outreach, Albany Medical CollegeDepartment of Medical Education and Community Outreach, Albany Medical CollegeDepartment of Medical Education and Community Outreach, Albany Medical CollegeDepartment of Medical Education and Community Outreach, Albany Medical CollegeMD-PhD Program, Yale School of MedicineTufts University School of MedicineDepartment of Nursing, Siena CollegeOffice of Diversity, Equity and Belonging, Penn State College of MedicineAbstract Background Currently, Internal Medicine (IM) physicians do not reflect the ethno-racial diversity of the US population. Moreover, there is a shortage of IM physicians in Medically Underserved Areas (MUAs) in the US. The purpose of this study was to determine factors that influence medical students’ intent to practice IM in MUAs. We hypothesized students with intentions to pursue a career in IM and work in MUAs were more likely than their peers to identify as underrepresented in medicine (URiM), report greater student debt loads, and report medical school experiences in cultural competencies. Methods We analyzed de-identified data of 67,050 graduating allopathic medical students who completed the Association of American Medical Colleges’ (AAMC) Medical School annual Graduation Questionnaire (GQ) between 2012–2017 by multivariate logistic regression models, examining intent to practice IM in MUAs based on respondent characteristics. Results Of 8,363 students indicating an intent to pursue IM, 1,969 (23.54%) students also expressed an intent to practice in MUAs. Students awarded scholarships, (aOR: 1.23, [1.03–1.46]), with debt greater than $300,000 (aOR: 1.54, [1.21–1.95], and self-identified non-Hispanic Black/African American (aOR: 3.79 [2.95–4.87]) or Hispanic (aOR: 2.53, [2.05–3.11]) students were more likely than non-Hispanic White students to indicate intent to practice in MUAs. This pattern also existed for students who participated in a community-based research project (aOR: 1.55, [1.19–2.01]), had experiences related to health disparities (aOR: 2.13, [1.44–3.15]), or had experiences related to global health (aOR: 1.75, [1.34–2.28]). Conclusions We identified experiences and characteristics that associate with intention to practice IM in MUAs, which can aid future curricular redesign by medical schools to expand and deepen comprehension of health disparities, access to community-based research, and global health experiences. Loan forgiveness programs and other initiatives to increase recruitment and retention of future physicians should also be developed.https://doi.org/10.1186/s12909-023-04392-0UnderservedCareerDebtIdentityExtracurriculars |
| spellingShingle | Aaron Lapidus Sapan Shah Meheret Mekonnen Joseph Araj Mytien Nguyen Hyacinth Mason Branden Eggan Inginia Genao Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation BMC Medical Education Underserved Career Debt Identity Extracurriculars |
| title | Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation |
| title_full | Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation |
| title_fullStr | Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation |
| title_full_unstemmed | Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation |
| title_short | Medical student intentions to practice internal medicine in underserved areas associated with debt, identity and extracurricular participation |
| title_sort | medical student intentions to practice internal medicine in underserved areas associated with debt identity and extracurricular participation |
| topic | Underserved Career Debt Identity Extracurriculars |
| url | https://doi.org/10.1186/s12909-023-04392-0 |
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