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Why Aren't More Primary Care Residents Going into Primary Care? A Qualitative Study.

Abstract：

BACKGROUND:Workforce projections indicate a potential shortage of up to 31,000 adult primary care providers by the year 2025. Approximately 80 % of internal medicine residents and nearly two-thirds of primary care internal medicine residents do not plan to have a career in primary care or general internal medicine. OBJECTIVE:We aimed to explore contextual and programmatic factors within primary care residency training environments that may influence career choices. DESIGN:This was a qualitative study based on semi-structured, in-person interviews. PARTICIPANTS:Three primary care internal medicine residency programs were purposefully selected to represent a diversity of training environments. Second and third year residents were interviewed. APPROACH:We used a survey guide developed from pilot interviews and existing literature. Three members of the research team independently coded the transcripts and developed the code structure based on the constant comparative method. The research team identified emerging themes and refined codes. ATLAS.ti was used for the analysis. KEY RESULTS:We completed 24 interviews (12 second-year residents, and 12 third-year residents). The age range was 27-39 years. Four recurrent themes characterized contextual and programmatic factors contributing to residents' decision-making: resident expectations of a career in primary care, navigation of the boundary between social needs and medical needs, mentorship and perceptions of primary care, and structural features of the training program. CONCLUSIONS:Addressing aspects of training that may discourage residents from careers in primary care such as lack of diversity in outpatient experiences and resident frustration with their inability to address social needs of patients, and strengthening aspects of training that may encourage interests in careers in primary care such as mentorship and protected time away from inpatient responsibilities during primary care rotations, may increase the proportion of residents enrolled in primary care training programs who pursue a career in primary care.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Long T,Chaiyachati K,Bosu O,Sircar S,Richards B,Garg M,McGarry K,Solomon S,Berman R,Curry L,Moriarty J,Huot S

doi

10.1007/s11606-016-3825-9

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1452-1459

issue

eissn

0884-8734

issn

1525-1497

pii

10.1007/s11606-016-3825-9

journal_volume

pub_type

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Why Aren't More Primary Care Residents Going into Primary Care? A Qualitative Study.