COMMITMENT TO THE UNDERSERVED - EVALUATING THE EFFECT OF AN EXTRACURRICULAR MEDICAL-STUDENT PROGRAM ON CAREER CHOICE

Background: This study was conducted to compare the practice locations and characteristics of physicians who participated as medical student s in an extracurricular program to foster interest in careers of servi ce to medically underserved populations with those of their classmates who did nor participate in the program. Methods: Using a mailed quest ionnaire, we conducted a cross-sectional study of graduates from the c lasses of 1983-1987 at one southwestern, public medical school. All Co mmitment to Underserved People (CUP) participants (n = 94) and a rando m sample of nonparticipating classmates (n = 188) were surveyed. CUP i s an extracurricular project with components in each of 4 years of med ical school that provides peer and faculty support, curriculum enrichm ent, and direct service to medically underserved populations. Outcome measures included the size of community of practice, practice type, an d practice patient characteristics.Results: Sixty seven (71%) of CUP p articipants and 126 (67%) of nonparticipants responded. CUP participan ts were more likely to be women, to specialize in family practice, to practice in the Indian Health Service (IHS) or overseas, to be located in a community of 25,000 or less, and to have participated in the sta te, service-payback loan program. In multiple regression, the specialt y of family practice was associated with practice in a small community , the IHS, and a community health center; CUP participation was correl ated with practice in small communities, the IHS, and a foreign countr y. Conclusions: Participation in the CUP program was associated with t he specialty choice of family practice and with practice in settings a ssociated with medically underserved populations. The CUP program has been successful in sustaining entering medical students' interests in underserved practice.