scholarly journals Association of Family Medicine Interest at Matriculation to Medical School and FMIG Participation With Eventual Practice as a Family Physician

2019 ◽  
Vol 51 (8) ◽  
pp. 682-686 ◽  
Author(s):  
Amanda Kost ◽  
Kimberly Kardonsky ◽  
Jeanne Cawse-Lucas ◽  
Tomoko Sairenji
Keyword(s):  
Family Medicine ◽  
Medical School ◽  
Family Physician ◽  
Family Physicians ◽  
The United States ◽  
Specialty Choice ◽  
Odds Ratios ◽  
Binary Logistic Regression Model ◽  
University Of Washington ◽  
Predicted Probability

Background and Objectives: An adequate family medicine workforce is needed to improve health and health care outcomes in the United States, yet few medical students in the US become family physicians. Indicators of family medicine interest upon medical school matriculation exist. Family medicine interest groups (FMIGs) may influence student choice. This study examines the association of FMIG participation with various matriculation interest indicators to predict which students go on to become family physicians. Methods: The American Medical Association Masterfile was used to identify the practice specialty of 601 graduates of the University of Washington School of Medicine who matriculated between 2003 and 2007. Graduates’ scores on the Family Medicine Interest Survey (FMIS) and whether a student listed family medicine as their top choice upon matriculation along with FMIG participation and demographic characteristics were used in a binary logistic regression model to predict eventual practice. The model output was used to calculate odds ratios and predicted probabilities of family medicine practice given initial family medicine interest and FMIG participation. Results: FMIG participation was associated with higher odds ratios and increased predicted probability of becoming a family physician regardless of initial interest although the magnitude of the difference varied. FMIG participants who listed family medicine as their top specialty had a 68% predicted probability of entering family medicine compared to 8% probability if they did not list family medicine first and did not participate in FMIG. FMIG participation was associated with odds ratios between 3.27-4.19 for entering family medicine regardless of FMIS score. Conclusions: Among University of Washington students with family medicine as their top specialty choice upon matriculation, FMIG participation was associated with higher odds of entering the specialty. The same was true, although to a lesser degree, for students who had a high score on the FMIS.

scholarly journals Institutional NIH Research Funding and a Culture of Support for Family Medicine—Their Relationship to Family Medicine Specialty Choice

2018 ◽  
Vol 50 (5) ◽  
pp. 369-371
Author(s):  
Arch G. Mainous ◽  
Maribeth Porter ◽  
Denny Fe Agana ◽  
Alexander W. Chessman
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
School Environment ◽  
The United States ◽  
Specialty Choice ◽  
Medicine Clerkship ◽  
Educational Support ◽  
Negative Comments ◽  
Nih Funding

Background and Objectives: The United States suffers from a low proportion of medical students pursuing family medicine (FM). Our objective was to examine institutional characteristics consistent with a focus on National Institutes of Health (NIH) research, institutional support for FM education, and the proportion of medical students choosing FM. Methods: The 2015 CERA Survey of Family Medicine Clerkship Directors was merged with institutional NIH funding data from 2014 and medical student specialty choice in 2015. Institutional educational support was operationalized as (1) clerkship director’s perception of medical school environment toward FM, and (2) amount of negative comments about FM made by faculty in other departments. The outcome was the percentage of students selecting FM. Bivariate statistics were computed. Results: As NIH funding increases, the proportion of students entering FM decreases (r=-.22). Institutions with higher NIH funding had lower clerkship director perceptions of medical school support toward FM (r=-.38). Among private institutions, the negative correlation between NIH funding and the proportion of students entering FM strengthens to r=-.48, P=.001. As perceptions of support for FM increase, the proportion of students entering FM increase (r=.47). Among private schools, perceptions of support toward family medicine was strongly positively correlated with the proportion of students entering FM (r=.72, P=.001). Conclusions: Higher institutional NIH funding is associated with less support for FM and lower proportions of students choosing FM. These issues appear to be even more influential in private medical schools. Understanding how to integrate the goals of NIH-level research and increasing primary care workforce so that both can be achieved is the next challenge.

scholarly journals Validation and Comparison of a Brief Instrument vs a Single-Item Screen to Predict Entry to Family Medicine at Matriculation to Medical School

2018 ◽  
Vol 50 (9) ◽  
pp. 672-678
Author(s):  
Amanda Kost ◽  
Rebecca E. Cantone ◽  
Ben Schneider ◽  
Tomoko Sairenji ◽  
Ryan Palmer
Keyword(s):  
Family Medicine ◽  
Medical School ◽  
Test Performance ◽  
Specialty Choice ◽  
Care Needs ◽  
Single Item ◽  
School Of Medicine ◽  
Primary Care Workforce ◽  
Predicted Probability ◽  
The University

Background and Objectives: A strong US primary care workforce is necessary to meet health care needs, yet fewer than 9% of allopathic medical students choose family medicine each year. No validated instrument exists to identify students likely to enter family medicine upon medical school matriculation. Methods: A subset of a larger survey at the University of Washington School of Medicine (UWSOM) was used to create the Family Medicine Interest Survey (FMIS), a 15-item instrument to predict eventual practice in family medicine for a 2003-2007 matriculating cohort. A single-item screen asking about top specialty choice was administered at UWSOM for the same cohort and for a 2006-2012 matriculating cohort of students at Oregon Health & Science University (OHSU). Test performance measures including D (discrimination) and Cronbach α were calculated. Logistic regression determined whether FMIS score or reporting family medicine as the top specialty choice predicted family medicine practice for 601 UWSOM graduates or family medicine residency match for 744 OHSU graduates. Results: The FMIS is reliable (Cronbach α=0.76). Both tests significantly predicted the probability of entering family medicine. Listing family medicine as the preferred specialty choice yielded a 47% predicted probability for UWSOM graduates entering family medicine. OHSU graduates listing family medicine first had an eightfold odds of matching to family medicine residencies. Combining the two instruments for UWSOM graduates showed a dose-response curve for predicted probability of entering family medicine with increasing levels of interest. Conclusion: Each screening tool can predict students more likely to enter family medicine upon matriculation.

scholarly journals Supporting Family Physician Maternity Care Providers

2018 ◽  
Vol 50 (9) ◽  
pp. 662-671 ◽  
Author(s):  
Jessica Taylor Goldstein ◽  
Scott G. Hartman ◽  
Matthew R. Meunier ◽  
Bethany Panchal ◽  
Christine Chang Pecci ◽  
...  
Keyword(s):  
Family Medicine ◽  
Family Physician ◽  
Maternity Care ◽  
Family Physicians ◽  
The United States ◽  
Care Providers ◽  
Care Access ◽  
Care Family ◽  
Interdisciplinary Relationships ◽  
Support Family

Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers.

How Experiences in a Medical School Affect Medical Students’ Attitudes Toward Family Medicine as a Career Choice: A Mixed-Method Study

2020 ◽  
Author(s):  
Kwanchanok Homsangpradit ◽  
Saipin Hathirat ◽  
Sutida Sumrithe
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Career Choice ◽  
Family Physician ◽  
Mixed Method ◽  
Family Physicians ◽  
Holistic Care ◽  
Mixed Method Study ◽  
Students Attitudes

Abstract Background: Family practice is the key element of a primary care system. A shortage of family physicians is an important issue in Thailand. However, Thai medical students still show low interest in pursuing a career in family medicine. The objective of this research is to study how a curriculum, an extra-curricular activity, and a hidden curriculum in a medical school affect medical students’ attitude toward family medicine as their career choice.Methods: This research is a mixed-method study with a sequential-explanatory design. The quantitative part is an online questionnaire to obtain a distribution of interest in a career of family physician. It was distributed among 181 senior medical students of Ramathibodi medical school; out of which 64 have participated. In the qualitative part, a total of 14 students who met the inclusion criteria were chosen from the questionnaire and from a snowball sampling to participate in an in-depth interview. Thereafter, a content analysis was done to identify themes.Results: Four out of 64 participants showed interest in a career of family physician, but only one participant was strongly interested. As the whole curriculum focuses mostly on specialty contents, only the family medicine department teaches holistic care and students find it difficult to understand. Some students perceive that a psychosocial assessment intrudes too much into a patient’s personal life and is not a physician task. The examination-based curriculum causes them to lack spare time to participate in any extra-curricular activity. The students received both positive and negative comments about family physicians from other specialists. However, this hidden curriculum does not have a direct impact on the student’s decision to choose their career path. Important factors that influence the decision are their personal interests, masteries, family factors, a work-life balance, and a humanized environment. Conclusions: Experiences in medical school have an impact on medical students’ attitudes toward family physician as a career choice. A disease-oriented care model is still dominating Thai medical education. Therefore, the curriculum needs to be reformed to promote the importance of holistic care. This will lead to an increase in the production of Thai family physicians.

pology) should help the student acquire a holistic approach to health and disease and to recognize the interrelationships of cultural, social, psychologi-cal, and environmental factors with the psysiological and biochemical pro-cesses of the body" (Willard Report, 1966, p. 27). Evaluation of the Mandate The important potential role of sociology in the curriculum of the family physician programs has been endorsed repeatedly before, during, and since the publication of the above-mentioned blue-ribbon commission reports (Silver, 1963, p. 74-77; GP, 1966, p. 225-246; Harrell, 1970, p. 61-64). That potential role has been greatly enhanced by the passage of the Health Educa-tion and Manpower Act in 1976, which mandated that by 1980, 50% of all medical students graduating from medical school should be entering residen-cies in the three designated primary care specialties—internal medicine, pediatrics, and family practice. An additional aspect of this act was the allocation of some $40,000,000 for the expansion and improvement of existing family medicine residencies and for the creation of additional resi-dency programs. The question at hand—almost 12 years after these recommendations were submitted to medical educators-is whether a new breed of physicians is being produced by training in family medicine. Is there a new type of physi-cian who is "aware not only of his patient's physicial illness, but also of interrelations of family members and of family and community and socio-economic factors affecting the health of family members?" (Silver, 1965, p. 188-189). There are clearly two elements that must be distinguished in evaluating this mandate to train family physicians—one quantitative and the other qualitative. As far as quantitative changes in the attention paid to training family physicians, there can be no doubt that significant shifts have occurred in the past decade. In 1967, there were only three family medicine training programs in the United States, at the Universities of Miami (Florida), Roches-ter, and Oklahoma. By 1970 there were 49 programs, in 1975 there were 233, and in 1977 there were well over 300. In 1970 family practice became a

2014 ◽  
pp. 126-132
Keyword(s):  
Family Medicine ◽  
Family Practice ◽  
Potential Role ◽  
Family Members ◽  
Family Physicians ◽  
Holistic Approach ◽  
The United States ◽  
Factors Affecting ◽  
Blue Ribbon ◽  
Quantitative Changes

scholarly journals Family physicians’ knowledge, attitudes, and behaviors regarding the weight effects of added sugar

2018 ◽  
Vol 6 ◽  
pp. 205031211880124 ◽  
Author(s):  
Christian Mackey ◽  
Melissa A Plegue ◽  
Marian Deames ◽  
Matthew Kittle ◽  
Kendrin R Sonneville ◽  
...  
Keyword(s):  
Family Physician ◽  
Family Physicians ◽  
The United States ◽  
Overweight And Obesity ◽  
P Value ◽  
Dietary Counseling ◽  
Added Sugar ◽  
Attitudes And Behaviors ◽  
Dietary Sugar ◽  
And Behaviors

Background and objectives: Added sugar consumption is a major risk factor for negative health outcomes and family physicians play an important role in educating patients regarding nutrition behaviors, such as consumption of added dietary sugar. The aim of this study was to describe the knowledge, attitudes, and behaviors of family physicians regarding added dietary sugar. Methods: An online questionnaire was administered to family physician members of the Council of Academic Family Medicine organizations, which support teaching physicians that train family physicians throughout the United States. Survey items underwent rigorous pilot and cognitive testing prior to administration. Descriptive statistics and Pearson’s chi-square test were performed to evaluate physician’s dietary counseling for patients with overweight and obesity. Results: Among practicing family physician members (n = 1196), 72% reported providing dietary counseling to the majority (⩾50%) of their patients with overweight and obesity. Most (90%) believed that their counseling was ineffective for the majority of patients. Frequency of counseling was significantly associated with beliefs about counseling effectiveness (p-value < 0.001). Nearly all physicians (97%) advised against consuming sugary beverages, while advising patients to limit foods with added sugar was less common (82%). Discussion: Dietary counseling is often, but not always, provided to patients with overweight and obesity by family physicians in our sample, though most physicians believed their counseling is ineffective. National attention to added sugar as a risk for poor health should serve as a catalyst for renewed efforts from primary care educators and clinicians to engage in innovative practices to empower at-risk patients to improve their nutrition.

scholarly journals Hivatással és hálapénzzel kapcsolatos vélekedések a magyarországi családorvosok és családorvos rezidensek körében

2016 ◽  
Vol 157 (36) ◽  
pp. 1438-1444
Author(s):  
Péter Torzsa ◽  
Dalma Csatlós ◽  
Ajándék Eőry ◽  
Csenge Hargittay ◽  
Ferenc Horváth ◽  
...  
Keyword(s):  
Family Medicine ◽  
Quantitative Study ◽  
Family Physician ◽  
Health Sector ◽  
Family Physicians ◽  
Payment Method ◽  
Informal Payment ◽  
The Family ◽  
Two Generations ◽  
Human Resource Crisis

Introduction: The changing of the family medicine can be observed in the New Millennium. Migration, the aging of the healers and informal payment are crucial to the human resource crisis of the health sector. Aim: The aim of this study was to investigate the family physicians’ and residents’ opinions about the vocation and informal payment. Method: Exploratory, quantitative study was carried out among family physicians (n = 363) and family physician residents (n = 180). The central questions of the study were the vocation, the income and the informal payment. Results: The most decisive factors of the carrier choice were altruism, service and responsibility. Residents were significantly rejective (19.7% vs. 38.3%, p<0.001) about informal payment. They would accept smaller amounts of informal payment (14.3% vs. 8.9%, p<0.034), and would spend it on praxis development (1.4% vs.9.4% p<0.023). Conclusions: The attitudes of family physicians and residents are the same in case of the vocation, but on the issue of informal payment, the two generations have different opinions. Orv. Hetil., 2016, 157(36), 1438–1444.

scholarly journals The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians

2020 ◽  
Vol 52 (6) ◽  
pp. 408-413
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Audrey Brock
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
The United States ◽  
Early Career ◽  
Residency Programs ◽  
Complex Patients ◽  
Semistructured Interviews ◽  
Administrative Tasks ◽  
The Impact ◽  
The Relationship

Background and Objectives: According to a previous study, obstetric deliveries may be protective against burnout for family physicians. Analyses of interviews conducted during a larger qualitative study about the experiences of early-career family physicians who intended to include obstetric deliveries in their practice revealed that many interviewees discussed burnout. This study aimed to understand the relationship between practicing obstetrics and burnout based on an analysis of these emerging data on burnout. Methods: We conducted semistructured interviews with physicians who graduated from family medicine residency programs in the United States between 2013 and 2016. We applied an immersion-crystallization approach to analyze transcribed interviews. Results: Fifty-six early-career family physicians participated in interviews. Burnout was an emerging theme. Physicians described how practicing obstetrics can protect from burnout (eg, brings joy to practice, diversity in practice), how it can contribute to burnout (eg, time demands, increased stress), how it can do both simultaneously and the importance of professional agency (ie, the capacity to make own free choices), and other sources of burnout (eg, administrative tasks, complex patients). Conclusions: This study identifies a family medicine-obstetric paradox wherein obstetrics can simultaneously protect from and contribute to burnout for family physicians. Professional agency may partially explain this paradox.

scholarly journals Factors Affecting Specialty Choice Among Doctors Who Received Tuition Scholarships

2019 ◽  
Vol 51 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Bich-May Nguyen ◽  
Gregory Bounds
Keyword(s):  
Primary Care ◽  
Medical School ◽  
Primary Care Physicians ◽  
Online Survey ◽  
The United States ◽  
Specialty Choice ◽  
Factors Affecting ◽  
Educational Debt ◽  
Medical School Graduation ◽  
School Graduation

Background and Objectives: The United States is projected to have a shortage of up to 46,000 primary care physicians by 2025. In many cases, medical students appear to select other specialties for financial reasons, including educational debt. Physicians who were part of two BS/MD programs and received full tuition and fee scholarships for college and medical school were surveyed to examine factors that may have impacted their specialty choice. This population of US students was selected because they do not have educational debt, so their choices could be examined independent of this influence. Methods: One hundred forty physicians who graduated from the programs as of June 2013 were invited to complete a 32-question online survey. Descriptive statistics described the population. χ2 tests and nonparametric Wilcoxon rank-sum (Mann-Whitney) tests compared primary care and nonprimary care physicians as well as those initially interested in primary care who changed before medical school graduation versus those who went into primary care. Factor analysis and Student t-test examined trends among Likert scale questions. Results: For the physicians for whom contact information was available, 74 (53%) responded. Out of 74 respondents, 18 (24%) went into primary care. Perceptions of family medicine, comments from faculty, and lifestyle played a role in deterring students from primary care. Conclusions: Full tuition and fee scholarships alone were not associated with more students choosing primary care.

scholarly journals FMAQ-S: Development of a Short Form of the Family Medicine Attitudes Questionnaire

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Hana Kang ◽  
Jacob Prunuske ◽  
Andrea L. Wendling ◽  
Jennifer Edwards-Johnson ◽  
Julie P. Phillips
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Student Attitudes ◽  
Short Form ◽  
Item Analysis ◽  
The United States ◽  
Criterion Validity ◽  
Specialty Choice ◽  
Supporting Evidence ◽  
Item Discrimination

Introduction: Identifying and training students who choose family medicine careers is essential to meeting primary care workforce needs in the United States. Medical students’ positive attitudes toward family medicine are associated with students’ choice of family medicine as a specialty. This study sought to refine a previously tested questionnaire assessing US medical students’ attitudes toward family medicine by shortening the questionnaire to make it more useful in educational practice and research settings. Methods: We refined our existing 14-item questionnaire by item analysis and validation. We conducted item analysis using a graded response model approach after identifying the unidimensionality of the original scale. We selected items based on their item discrimination parameters and item information levels, and calculated the correlation between specialty choice and family medicine attitudes score to evaluate criterion validity. Results: Exploratory factor analyses indicated the questionnaire is unidimensional. Among the original 14 items, 10 items had high item discrimination parameters and low standard error of measurement. These 10 items contribute the most to distinguishing individuals’ differences in family medicine attitudes and were selected for inclusion in the short-form questionnaire (FMAQ-S). The point-biserial correlation between the short-form scale and students’ choice of family medicine was 0.378, which provides supporting evidence for criterion validity. Conclusion: The FMAQ-S is a concise and validated measure for assessing medical student attitudes toward family medicine. This abbreviated questionnaire can be used by medical educators to identify students for specific programming or interventions intended to support family medicine specialty choice.

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