Student Views of Internal Medicine Have Changed

More in 2007 than 1990 viewed IM as potentially meaningful; less interested in general IM career

WEDNESDAY, April 27 (HealthDay News) -- Although medical school students in 2007 were more likely than those in 1990 to view internal medicine (IM) as a potentially meaningful career, the more recent students had higher debt, more negative views of workload and stress in IM, and less interest in general IM as a career, according to a study published in the April 25 issue of the Archives of Internal Medicine.

Mark D. Schwartz, M.D., of the New York University School of Medicine in New York City, and colleagues conducted a secondary analysis of two similar national surveys of senior medical students from 1990 and 2007 that addressed specialties chosen, student characteristics, perceptions of IM compared with other specialties, clerkship experiences, and influential aspects of IM. The sample included 1,244 students at 16 schools in 1990 (response rate, 75 percent) and 1,177 students at 11 schools in 2007 (response rate, 82 percent).

The investigators found that, in 2007, there were more women (52 versus 37 percent) and higher educational debt ($101,000 versus $63,000) than in 1990. Similar proportions of students planned IM careers (23 versus 24 percent). However, the proportion of students with plans to practice general IM dropped from 9 percent in 1990 to 2 percent in 2007. While the appeal of primary care as an influence toward IM fell from 57 percent in 1990 to 33 percent in 2007, more 2007 students reported a high level of satisfaction with the IM clerkship (78 percent in 2007 versus 38 percent in 1990). In 2007, 58 percent of students felt that there were opportunities for meaningful work as compared to 42 percent of students in 1990. Both groups considered workload and stress greater in IM than in other fields.

"To rebuild the generalist physician work force, improving students' experience of IM in medical school is no longer sufficient. Bolder reform will be required to improve the educational pipeline, practice, and payment of generalist IM physicians," the authors write.

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