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                        JeffNEWS, October 25, 1994
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Medical School's Mission Makes a Difference in Students' Choice of 
Primary-Care Careers

Study shows schools' policies, curricula affect output of generalists.
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A medical school's stated mission, as reflected in its methods of
selecting and educating students, can have a significant impact on how
many of its students choose to become primary care physicians.

Those were the findings of a two-and-one-half-year study conducted
jointly by the American Medical Association and Thomas Jefferson
University, and reported in the Journal of The American Medical
Association. The study surveyed all medical colleges in the United
States, and singled out for further investigation those schools that
consistently turned out high proportions of primary care practitioners.
Primary care specialties, as defined by the scope of the study, include
family practice, general internal medicine, general pediatrics and
osteopathic general practice. 

"The schools doing the best job of producing generalists were the small,
public schools," said Jon Veloski, MS, director of Jefferson's Center
for Research in Medical Education, and a co-author of the article. "The
good news is that we also found that other types of schools are able to
do the same job - you start by picking students with strong personal
social values, then giving them clinical experiences in primary care,
and exposing them to faculty role models who are generalists."

According to Mr. Veloski, the most significant factors the researchers
found that affected students' choice of generalist careers were the
schools' criteria for admitting students and the design of the
curriculum, with particular emphasis on faculty role models. The
individual characteristic that most strongly influenced graduates'
career choice, he said, was personal social values. 

Mr. Veloski explained that the study included site visits to nine
schools that consistently turned out high percentages of generalists
typically anywhere from 30 to 50 percent generalists from their classes,
while the national average is approximately 26 percent.

Numerous government and private organizations, including the Council on
Graduate Medical Education, have called for increasing the numbers of
generalists to meet present and future healthcare needs, with most
groups recommending a balance of 50 percent generalists and 50 percent
specialists by the year 2000.

"No one factor can dramatically affect the numbers of graduates who
become generalists. Schools must embrace a mission that includes primary
care, then follow through with a supportive environment and a curriculum
that features strong primary care content. These schools have shown us
that it can be done," Mr. Veloski said.

What percentage of JMC graduates choose primary care as their specialty?
Jefferson is already very close to the national goal of 50 percent. Of
our graduates, 45 percent now choose to specialize in primary care. 


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