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Effect of the inpatient general medicine rotation on student pursuit of a generalist career

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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 ipatient 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.

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Author information

Authors and Affiliations

  1. Department of Medicine, University of Chicago, Chicago, IL, USA

    Vineet Arora MD, MA & David Meltzer MD, PhD

  2. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Tosha B. Wetterneck MD

  3. Brigham and Women’/Faulkner Hospitalist Program, Division of General Medicine, Brigham

    Jeffrey L. Schnipper MD, MPH

  4. Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Jeffrey L. Schnipper MD, MPH

  5. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Andrew D. Auerbach MD, MPH & Robert M. Wachter MD

  6. Iowa City Veterans Affairs Medical Center and University of Iowa Carver College of Medicine, Iowa City, IA, USA

    Peter Kaboli MD, MS

  7. Department of Medicine, University of Toronto, Toronto, ON, Canada

    Wendy Levinson MD

  8. Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Holly J. Humphrey MD

  9. Departments of Economics and Public Policy, University of Chicago, Chicago, IL, USA

    David Meltzer MD, PhD

Authors
  1. Vineet Arora MD, MA
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  2. Tosha B. Wetterneck MD
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  3. Jeffrey L. Schnipper MD, MPH
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  4. Andrew D. Auerbach MD, MPH
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  5. Peter Kaboli MD, MS
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  6. Robert M. Wachter MD
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  7. Wendy Levinson MD
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  8. Holly J. Humphrey MD
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  9. David Meltzer MD, PhD
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Corresponding author

Correspondence to Vineet Arora MD, MA.

Additional information

Prior presentations of these data include Midwetern Society of General Internal Medicine Conference in Chicago, IL. on September 30, 2005 and the National Society of General Internal Medicine Conference in New Orleans, LA, on May 11, 2005.

This study was supported by the Agency for Healthcare Research and Quality grant R01 10597-A Multicenter Trial of Academic Hospitalists. We are grateful to Ms. Jennifer Higa, Mr. Micah Prochaska, Ms. Veronica Tirado, and Drs. David Gonzales, Anupama Gupta, and Rajiv Swamy for their research assistance.

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Arora, V., Wetterneck, T.B., Schnipper, J.L. et al. Effect of the inpatient general medicine rotation on student pursuit of a generalist career. J GEN INTERN MED 21, 471–475 (2006). https://doi.org/10.1111/j.1525-1497.2006.00429.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00429.x

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