Factors associated with residents' career plans in primary care

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  • AE Ryusuke
    Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University
  • OKAYAMA Masanobu
    Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University
  • SEKINE Sayaka
    Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University
  • TAKESHIMA Taro
    Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University
  • KAJII Eiji
    Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University

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  • 後期研修医のプライマリ・ケア医への進路志向に関連する要因
  • コウキ ケンシュウイ ノ プライマリ ケアイ エ ノ シンロ シコウ ニ カンレン スル ヨウイン

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Abstract

Owing to shortages of primary-care physicians, increasing their numbers has been recognized as an urgent issue in Japan and other countries. However, it is unclear which factors in medical education influence the decision of residents to go into primary care. We investigated the factors associated with residents' choosing to practice primary care.<br>Of 281 randomly selected medical facilities designated as residency training hospitals, 137 facilities answered. Self-administered questionnaires were completed by 724 residents in the third or fourth postgraduate year. Responses were compared between residents who intended to choose a career in primary care (n=175, 24.2%) and residents who intended to choose a career in other specialties (n=549, 75.8%).<br>In addition, for residents who had intended during their undergraduate years to enter a non-primary-care specialty (n=442, 61.1%), responses were compared between those who now intended to go into primary care (n=33, 7.5%) and those who did not (n=409, 92.5%).<br>Residents who had planned during their undergraduate years to choose a career in primary care (adjusted odds ratio [95% confidence interval]: 9.85 [6.24-15.5]), residents who were working as primary-care physicians at the time of the survey (7.58 [4.92-11.7]), and residents who wanted to enter rural practices in the future (2.24 [1.36-3.68]) were significantly more likely to plan to choose a career as a primary-care physician in the future.<br>Residents who had worked at a rural practice during residency training were significantly more likely to change their career plans from other specialties to primary care (crude odds ratio [95% confidence interval]: 2.18 [1.05-4.49]). Exposure to a rural practice during residency training may affect residents' career plans.<br>Integrating rural primary-care practice into residency training may help increase the number of primary-care physicians in the future.

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