The role of career pathway before medical school in graduates' choice of primary care versus other specialty practices

PURPOSE. To analyze the difference, if any, in the choices of primary care versus other specialty practices among graduates of the Albany Medical College who took one of three career pathways before entering medical school and who had entered primary care residencies. METHOD. Questionnaires were mailed in April 1992 to all 458 graduates from the classes of 1980 through 1985 who had entered primary care residencies (i.e., residencies in family practice, general internal medicine, general pediatrics, or medicine–pediatrics). The graduates had followed one of three pathways to admission: (1) after completion of four years of college, (2) after completion of the six-year biomedical program in conjunction with the Rensselaer Polytechnic Institute (RPI), and (3) after having pursued a nonmedical career and being older than 25 years of age. Logistics regression was the primary vehicle for analysis, defining career choice as the dependent variable and using the independent variables of sex, year of graduation, and pathway as well as their interactions for a saturated-model analysis. RESULTS. A total of 318 graduates (69%) responded. Among the three pathways, there was no statistically significant difference in the choices of primary care versus other specialty practices. However, in the RPI and age-greater-than-25 groups, there was a greater tendency for men to choose other specialties. CONCLUSIONS. The three career pathways before medical school did not appear to have a role in the choice of primary care versus other specialty practices among graduates who had entered primary care residencies. However, gender did influence this choice.