Evaluation of effects of the W.K.Kellogg Foundation's five-year (1991-1996) primary care curricular change initiative involving 27 medical schools found 199 courses were revised or developed, involving 141 interdisciplinary faculty. There were significant increases in the number of students choosing to specialize in primary care. Results support…

The University of Cincinnati's comprehensive emergency medicine residency curriculum provides significant practical training in ground and aeromedical transport, disaster work, telemetry communications, and administrative matters. Initial program feedback has been very positive. (MSE)

University of Washington medical school graduates' (n=519) practice specialties were compared with the one or more indicated earlier as possible choices. Nearly 70 percent remained stable, double the proportion when stability is based on a single choice at medical school entry, suggesting students consider several possibilities and choose one of…

The University of Pittsburgh School of Medicine's Division of General Internal Medicine is described, focusing on personnel and organization, educational programs, clinical and research activities, special programs, finances, and related issues and pressures. The program is proposed as a model for other institutions. (MSE)

A longitudinal study of 175 students entering the University of Maryland Medical School in 1982 found initial specialty preference a poor predictor of later specialty choice, and intolerance of ambiguity was not significantly associated with either initial medical specialty preferences or choices at graduation despite dramatic specialty changes…

A study of 11,136 1987 medical school seniors' specialty choices, before entering medical school and in preparation for residency, found similar preferences at both points, regardless of racial-ethnic background. (Author/MSE)

Five medical school characteristics previously identified as related to choice of family practice as a specialty were examined, with tuition level, for relationship to specialty choice among U.S. medical graduates between July 1986 and December 1987. Only two of the factors were found to be statistically relevant. (Author/MSE)

In three decades, the osteopathic profession has moved from primarily manipulative therapy to full-service health care, replacing primary care emphasis with specialization. The profession should return to its original mission of primary care, establish links with allopathic medicine, and support new national policy for primary health care.…

A study examined trends in the volume and type of inpatient clinical diagnoses, common medical services, and specialized services in academic medical centers (AMCs)--integrated and independent, other teaching hospitals, and nonteaching hospitals. Results indicate that despite rapid change in the health care environment, little change has occurred…

Medical school faculty members' broad understanding of their domains has atrophied as specialization has increased. Medical students need teachers who can integrate the specific areas of a subject with overarching themes. Expanding the values of the university to once again include the scholarship of integration and teaching would provide the best…

A rigorous approach to conducting nonstatistical meta-analyses of research literature is presented and illustrated in a study of literature on primary care medical specialty choice. The approach described includes model development, literature retrieval and coding, quality rating, annotation of high-quality references, and synthesizing the subset…

A study investigated relationships between specialty choice, success in obtaining residency choice, race (particularly underrepresented minorities), and gender among 14,450 medical residency matching program participants. Patterns of specialty switching after the first year of residency were also examined. Detailed tables of results and…

One reason medical students favor specialization over generalist medicine (primary care) is a perception of generalist medicine as nonrigorous. Chaos science, a new field, reveals an intellectual basis for generalist medicine. The history, strengths, and limits of reductionist thinking in medicine and aspects of chaos theory illuminate this…

Analysis of data from an annual graduating medical students' survey revealed that a required third-year family medicine clerkship of at least four weeks is associated with a higher percentage of students choosing training and specialty certification in family practice. Whether clerkship inspires or reinforces preexisting choices is not indicated.…

A survey of 723 medical school graduates investigated motivations for early specialty selections and later changes and factors involved in current specialty choice. Perceived match of personality and specialty, technology and methodology characteristic of specialty, and time for family were critical. Greater awareness of career lifestyles is…