Article Figures & Data
Tables
Characteristic Undergraduate College Pathway Total Non–Community College High School–Community College Community College–Transfer Postbaccalaureate–Community College P Valuea All graduates, No. (%) 32,138 (74.1) 4,846 (11.2) 1,241 (2.9) 5,157 (11.9) – 43,382 (100) Program type, No. (%) <.001 MD only 29,698 (73.6) 4,535 (11.2) 1,187 (2.9) 4,930 (12.2) 40,350 (100) MD dual degree 2,440 (80.5) 311 (10.3) 54 (1.8) 227 (7.5) 3,032 (100) Age, mean (SD), y 23.6 (2.2) 23.5 (2.2) 25.4 (3.4) 24.7 (3.2) <.001 23.7 (2.4) Sex, No. (%) <.001 Male 16,655 (74.2) 2,413 (10.8) 761 (3.4) 2,605 (11.6) 22,434 (100) Female 15,483 (73.9) 2,433 (11.6) 480 (2.3) 2,552 (12.2) 20,948 (100) Race/ethnicity, No. (%) <.001 White 21,379 (75.1) 3,043 (10.7) 745 (2.6) 3,318 (11.7) 28,485 (100) Asian 6,557 (74.1) 1,151 (13.0) 226 (2.6) 916 (10.4) 8,850 (100) Black or African American 1,879 (72.7) 238 (9.2) 85 (3.3) 383 (14.8) 2,585 (100) Latino 1,514 (64.6) 282 (12.0) 159 (6.8) 390 (16.6) 2,345 (100) Multiple 809 (74.4) 132 (11.8) 26 (2.3) 150 (13.4) 1,117 (100) Time in medical school, mean (SD), y 4.25 (0.70) 4.25 (0.68) 4.27 (0.69) 4.21 (0.59) <.001 4.25 (0.68) First-generation college student, No. (%) 2,893 (62.8) 714 (15.5) 294 (6.4) 706 (15.3) <.001 4,607 (100) High school US region, No. (%) <.001 West 5,174 (57.9) 1,924 (21.6) 479 (5.4) 1351 (15.1) 8,928 (100) Midwest 8,273 (75.0) 1,060 (9.6) 267 (2.4) 1,426 (12.9) 11,026 (100) Northeast 8,255 (88.4) 319 (3.4) 98 (1.1) 671 (7.2) 9,343 (100) South 10,436 (74.1) 1,543 (11.0) 397 (2.8) 1,709 (12.1) 14,085 (100) USMG = US doctor of medicine (MD)-granting medical school graduate.
Notes: Non–community college: medical graduates who never attended a community college; high school–community college: medical graduates who attended a community college while in high school and before graduating from high school; community college–transfer: medical graduates who attended a community college after graduating from high school and before transferring to a 4-year university; postbaccalaureate–community college: medical graduates who attended a community college after graduating from a 4-year university.
↵a ANOVA test for continuous variables and χ2 test of differences for proportions when both variables were categorical.
- Table 2
Comparison of USMGs 2010-2012 Who Trained in Family Medicine Residency vs Other Residency Specialties
Characteristic Family Medicine
(n = 3,787)Other Residency Specialtiesa
(n = 39,595)P Valueb College pathway, No. (%) <.001 Non–community college 2,489 (7.7) 29,649 (92.3) High school–community college 580 (12.0) 4,266 (88.0) Community college–transfer 157 (12.7) 1,084 (87.4) Postbaccalaureate–community college 562 (10.9) 4,596 (89.1) Program type, No. (%) <.001 MD only 3,551 (8.8) 36,799 (91.2) MD dual degree 236 (7.8) 2,796 (92.2) Age, mean (SD), y 23.7 (2.4) 24.4 (2.9) <.001 Female, No. (%) 2,245 (59.3) 18,703 (47.2) <.001 Race/ethnicity, No. (%) <.001 White 2,631 (9.2) 25,854 (90.8) Asian 446 (5.0) 8,404 (95.0) Black or African American 327 (12.6) 2,258 (87.4) Latino 268 (11.4) 2,077 (88.6) Multiple 115 (10.3) 1,002 (89.7) Time in medical school, mean (SD), y 4.31 (0.65) 4.24 (0.69) <.001 First-generation college student, No. (%) 606 (13.2) 4,001 (86.8) <.001 High school US region, No. (%) <.001 West 928 (10.4) 8,000 (89.6) Midwest 1,128 (10.2) 9,898 (89.8) Northeast 548 (5.9) 8,795 (94.1) South 1,183 (8.4) 12,902 (91.6) USMG = US doctor of medicine (MD)-granting medical school graduate.
Notes: Non–community college: medical graduates who never attended a community college; high school–community college: medical graduates who attended a community college while in high school and before graduating from high school; community college–transfer: medical graduates who attended a community college after graduating from high school and before transferring to a 4-year university; postbaccalaureate–community college: medical graduates who attended a community college after graduating from a 4-year university.
↵a Pediatrics, internal medicine, neurology, dermatology, radiology, surgery, and other specialties.
↵b ANOVA test for continuous variables and χ2 tests of differences for proportions when both variables were categorical.
- Table 3
Odds of Training in Family Medicine Residency Among USMGs 2010-2012 by Undergraduate College Pathway
College Pathway Odds Ratio (95% CI) P Valuea Marginal % (95% CI) Unadjusted analysis Non–community college Reference – 7.7 (7.5-8.0) High school–community college 1.62 (1.47-1.78) <.001 12.0 (11.1-12.9) Community college–transfer 1.72 (1.45-2.05) <.001 12.7 (10.8-14.5) Postbaccalaureate–community college 1.45 (1.32-1.60) <.001 10.9 (10.0-11.7) Adjusted analysisb Non–community college Reference – 8.1 (7.8-8.4) High school–community college 1.47 (1.33-1.63) <.001 11.4 (10.5-12.3) Community college–transfer 1.27 (1.06-1.52) .009 10.1 (8.5-11.6) Postbaccalaureate–community college 1.17 (1.06-1.29) .002 9.3 (8.6-10.1) USMG = US doctor of medicine (MD)-granting medical school graduate.
Notes: Non–community college: medical graduates who never attended a community college; high school–community college: medical graduates who attended a community college while in high school and before graduating from high school; community college–transfer: medical graduates who attended a community college after graduating from high school and before transferring to a 4-year university; postbaccalaureate–community college: medical graduates who attended a community college after graduating from a 4-year university.
↵a Wald test.
b Adjusted for age, sex, race/ethnicity, years in medical school, parental education, high school US region.
Additional Files
Supplemental Table
Supplemental Table
Files in this Data Supplement:
- Supplemental data: Table - PDF file
The Article in Brief
Community College Pathways to Medical School and Family Medicine Residency Training
Efrain Talamantes , and colleagues
Background With both a growing demand for primary care physicians and declining medical student interest in the field, this study examines a possible pathway to meeting the United States' primary care workforce needs.
What This Study Found The study of US medical school graduates from 2010 to 2012 finds that graduates who attended community college as pre-medical students are more likely to train in family medicine than those who attended other institutions. Specifically, among 43,382 medical school graduates, 3,787 (9 percent) trained in family medicine and, of those, 1,298 (34 percent) attended community college. According to logistic regression analysis models, community college attendees were more likely to train in family medicine compared to all other specialties. In addition, sensitivity analysis revealed that community college attendance was not significantly associated with training in internal medicine, pediatrics, and combined internal medicine/pediatrics. Within the family medicine residency workforce, 51 percent of Latinos, 35 percent of Asians, 33 percent of whites, and 32 percent of African Americans/blacks, as well as 42 percent of first generation college students, attended community college.
Implications
- Nurturing early interest in family medicine during high school and community college may be one strategy to increase the supply and diversity of the United States' primary care physician workforce, the authors explain. They call for longitudinal research that follows high school, community college, and four-year university students to better understand the experiences and programs that influence their career decisions.