Abstract
OBJECTIVE: To determine whether students who take ambulatory rotations in internal medicine are more likely to choose internal medicine careers.
DESIGN: National survey.
SETTING AND PARTICIPANTS: The intended sample was 1,650 senior U.S. medical students from 16 medical schools, of whom 1,244 (76%) responded. Representative schools nationwide were selected using a stratified, random-sampling method.
MEASUREMENTS: The questionnaire asked about characteristics of the ambulatory rotation, perceptions of internal medicine, and factors influencing students toward or away from an internal medicine career.
RESULTS: Ambulatory rotations were taken by 543 students (43%). Of these rotations, 73% were required, 74% were during the fourth year, 77% were in general internal medicine, 73% provided continuity of care, and 19% were during the medicine clerkship. Overall, 24% of the students chose careers in general (9%) or subspecialty internal medicine (15%). Thirty percent of the students who did ambulatory rotations planned internal medicine careers, compared with 19% of the students who had no rotation [odds ratio (OR)=1.8,95% confidence interval (CI) 1.3 to 2.4, p=0.0001]. This association was of similar magnitudes for students completing required rotations (OR=1.6, 95% CI 1.2 to 2.2, p=0.002) and for students completing rotations before or in proximity to when they chose careers (OR=1.7, 95% CI 1.1 to 2.4, p=0.01). Ninety percent of the 543 students who had ambulatory rotations were satisfied with the experience. Thirty-eight percent of the highly satisfied students chose internal medicine careers, compared with 21% of the students who had low or moderate satisfaction (p=0.0001).
CONCLUSIONS: An ambulatory rotation is strongly associated with positive perceptions of, attraction to, and choice of a career in internal medicine. Research is needed to determine specific components of an effective rotation. Further development of ambulatory rotations could help attract more students to internal medicine.
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Supported by grants from the American College of Physicians and the American Board of Internal Medicine.
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Schwartz, M.D., Linzer, M., Babboff, D. et al. The impact of an ambulatory rotation on medical student interest in internal medicine. J Gen Intern Med 10, 542–549 (1995). https://doi.org/10.1007/BF02640362
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DOI: https://doi.org/10.1007/BF02640362