How Does Medical School Change Student Interest in Family Medicine?

Context: Medical school experiences undoubtedly affect and change specialty choice by medical students.

Objective: To document and compare changes from matriculation to graduation in the choice of family medicine versus other specialties among US medical students in four recent graduating classes.

Study Design and Analysis: Comparison of specialty choice surveys completed by US medical students at graduation and at matriculation.

Dataset: 2018-2021 graduation questionnaires and corresponding matriculation questionnaires administered by the Association of American Medical Colleges (AAMC).

Population studied: Graduating medical students from all LCME-accredited US medical schools from 2018-2021.

Instrument: 2018-2021 AAMC Medical School Graduation Questionnaire and corresponding Matriculating Student Questionnaires. Response rates for these surveys ranged between 70 and 79.4%.

Outcome Measures: Proportion of students choosing family medicine at graduation who had chosen it at matriculation, compared to the proportions for other specialties and to the total of all specialties.

Results: For the four years studied (2018-2021), an average of 26.1% (range 25.6-27.0%) of all graduating students who indicated a specialty had selected the same specialty when they matriculated. The four-year average for family medicine, 28.6% (range 27.5-30.3%), was slightly higher than the overall average. Pediatrics, by comparison, averaged 41.7% (range 39.1 to 43.0%). The highest maintenance of specialty choice was for orthopedic surgery, which averaged 47.4% (range 44.8% to 50.2%) over the four surveyed years.

Conclusions: Understanding the factors that influence and affect specialty choice would be important and useful in addressing specialty shortages in the US. In this study, about a quarter of all students who indicated a specialty choice at graduation had listed the same specialty at matriculation. Family medicine was slightly higher than that, but orthopedic surgery had the highest percentage, considerably higher than average. It would also be interesting to have data for the inverse of this analysis: i.e., the proportion of those choosing family medicine (and other specialties) at matriculation who then indicated the same specialty at graduation.