Attractiveness of Family Medicine for Medical Students: Influence of Research and Debt

Objective: To examine the association between students' personal characteristics, backgrounds, and medical schools and their intention to enter a family medicine (FM) specialty.

Design: Descriptive study using data from the 2007 National Physician Survey.

Setting: Canada.

Participants: Clinical (n=1109) and preclinical (n=829) medical student respondents to the 2007 National Physician Survey.

Main Outcome Measures: The main variable was hoping to enter an FM specialty, and 40 independent variables were included in regression and classification-tree models.

Results: Fewer than 1 medical student in 3 (30.2% at the preclinical level and 31.4% at the clinical level) hoped to enter into an FM career. Those who did were more likely to be female, were slightly older, were more frequently married or living with partners, were typically born in Canada, and were more likely to have previous exposure to non-urban environments. The most important predictor for both populations was the debt related to medical studies, which acted in the opposite direction of whether or not students were interested in research. Students interested in research were attracted by specialties with high earning potential, while those not interested in research looked for short residency programs, such as FM, so they could begin to pay off debt sooner. Therefore, the interest in research appears to be inversely related to the choice of FM.

Conclusion: Less than one-third of medical students were looking for residencies in FM in Canada. This is far below the goals of 45% set at the national level and 50% set by some provinces like Quebec. Debt and interest in research have strong influences on the choice of residency by medical students.