Factors Affecting Medical Students’ Selection

Factors Affecting Medical Students' Selection

INTRODUCTION

Selection and recruitment of qualified medical school graduates is a major concern of internal medicine residency directors and faculty at teaching institutions. The process of residency program selection is highly competitive, particularly with regard to top-ranked applicants. Highly qualified underrepresent-ed minority (URM) applicants represent an ever-smaller proportion of candidates for residency programs. This is true despite the fact that minority populations are the fastest-growing segment of the U.S. population. According to the U.S. Census Bureau’s projections, African Americans, Latinos, American Indians/Alaskan Natives and Asians, which made up nearly 30% of the U.S. population in 2000, will comprise 47.2% by the year 2050. Despite the overall demographic changes in the United States, a decrease in URM applicants of 7.1% was noted from 1996 to 1997, such that minority applicants represented only 11% of the entire applicant pool to medical school. Much of this decrease may be attributed to changes in political climate, including limits or elimination on affirmative action policy in key states. On the other hand, the number of women enrolling in medical school has steadily increased over the last 25 years, with women enrollees making up 44.6% of all medical school enrollments in 2000.

While it is clear that the most important aspect of recruitment involves increasing the number of qualified medical school applicants, it remains critical to internal medicine residency programs to be able to recruit excellent URM applicants and maintain an increased proportion of women. Although studies have examined the effect of race and ethnicity on specialty choice, to our knowledge, few studies have examined how or why medical students select a particular residency program, and no studies have focused specifically on internal medicine residency programs. Furthermore, no studies have examined the residency program choices of URM applicants specifically or how the factors that determine applicant selection of a particular residency program differ between minority and majority candidates. The purpose of this study was to determine what factors most influence medical student selection of particular internal medicine residency programs. In addition, we sought to determine whether these factors differ by ethnicity and gender.
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